title: Long-term course and outcome of severe postpartum psychiatric disorders.
abstract: Thirty-nine women who had suffered from a severe first-episode postpartum psychiatric illness were re-examined after a period of 6-26 years (averaging 12.5 years). Diagnoses were established according to ICD-10 and Leonhard's classification, revealing a marked predominance of cycloid psychoses (54%) according to Leonhard. There was no evidence of the nosological independence of postpartum psychosis. Only 4 patients (10%) had never recovered fully since the onset of the illness. In contrast, 6 patients had undergone a monophasic course without any further psychopathology. In 20 cases (51%) the illness had run a multiphasic course. The average number of episodes per patient was 2.5 (range 2-6). The course was not determinable in 4 patients (10%). Nineteen women (49%) had 22 further deliveries after the first manifestation of the illness. The frequency of a relapse in connection with further pregnancy or delivery was 50%. Applying the Strauss-Carpenter Outcome Scale, we found a favourable outcome for the total sample with a mean value of 14.1 (SD = 2.6). The vast majority of patients (75%) showed no persistent alterations. Our findings provide further evidence of a favourable prognosis of severe postpartum psychiatric disorder despite the remarkably high rate of puerperal relapses.
authors.affiliation: Department of Psychiatry, University of Würzburg, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Pfuhlmann
authors.forename: E
authors.initials: E
authors.lastname: Franzek
authors.forename: H
authors.initials: H
authors.lastname: Beckmann
authors.forename: G
authors.initials: G
authors.lastname: Stöber
mesh_terms: D000328:Adult; D019052:Depression, Postpartum / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011379:Prognosis; D011618:Psychotic Disorders / Q000523:psychology*; D012008:Recurrence; D012720:Severity of Illness Index; D016896:Treatment Outcome