Puerperal schizophrenia?

Abstract

Although many psychiatrists believe that schizophrenia and manic depression are aetiologically distinct conditions, it is also held that both can be precipitated by parturition. That the same provoking event should affect them equally seems rather improbable. The association with the manic depressive diathesis is well founded on the work of Bratfos and Haug (1966) and Reich and Winokur (1970) who showed high puerperal breakdown rates in these patients, but there is no such evidence in schizophrenia. Is it possible that the apparent occurrence of puerperal schizophrenia is spurious, another consequence of the muddle over the diagnosis of schizophrenia? In theory this should be a simple epidemiolo- gical question to answer; all we need do is to define ‘puerperal psychosis’ and ‘schizophrenia’ and study a series of postpartum psychoses to see whether the form of the illness is schizophrenic.