title: High lifelong relapse rate of psychiatric disorders among women with postpartum psychosis.
abstract: BACKGROUND
  The relapse rate for psychiatric disorders after postpartum psychosis is high. Apart from subsequent puerperal periods, previous studies have not examined when relapses in psychiatric disorders occur. In addition, little is known about the impact of certain individual factors on the risk of non-puerperal readmission among women with previous postpartum psychosis.
  
  
  OBJECTIVE
  The first aim was to examine the association between non-puerperal readmission due to psychiatric disorders and years of follow-up (in total, 30 years) in women with postpartum psychosis. The second aim was to examine the impact of age, type of psychosis, previous hospitalization for psychiatric disorders and level of education on the risk of non-puerperal readmission due to psychiatric disorders.
  
  
  METHODS
  All Swedish women aged 20-44 with postpartum psychosis (n =3140) were followed between 1975 and 2004 for non-puerperal readmission due to psychiatric disorders. A Cox frailty regression model was used to estimate hazard ratios for non-puerperal readmission.
  
  
  RESULTS
  The risk of non-puerperal readmission, although gradually decreasing with time, remained high many years after the postpartum psychosis. The risk of non-puerperal readmission was significantly higher among women with schizophrenia, lower levels of education and previous psychiatric hospitalization.
  
  
  CONCLUSIONS
  Postpartum psychosis is often part of a lifelong recurrent psychiatric disorder. Women with schizophrenia, lower levels of education and hospitalization due to a psychiatric disorder prior to postpartum psychosis have a higher risk of non-puerperal readmission.
  
  
  CONCLUSIONS
  The findings constitute important knowledge for all healthcare workers encountering women with a previous postpartum psychosis.
authors.affiliation: Center for Family and Community Medicine, Karolinska Institutet, Stockholm, Sweden. anna@nager.net
authors.forename: Anna
authors.initials: A
authors.lastname: Nager
authors.forename: Robert
authors.initials: R
authors.lastname: Szulkin
authors.forename: Sven-Erik
authors.initials: SE
authors.lastname: Johansson
authors.forename: Leena-Maria
authors.initials: LM
authors.lastname: Johansson
authors.forename: Kristina
authors.initials: K
authors.lastname: Sundquist
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D010359:Patient Readmission / Q000706:statistics & numerical data*; D049590:Postpartum Period / Q000523:psychology; D011618:Psychotic Disorders / Q000453:epidemiology / Q000523:psychology*; D011644:Puerperal Disorders / Q000453:epidemiology / Q000523:psychology*; D012008:Recurrence; D012306:Risk; D012559:Schizophrenia; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult