Approaches to the ascertainment, recruitment and clinical assessment of women with puerperal psychosis

Summary

Puerperal psychosis is the most severe and rare form of postnatal psychiatric disorder. Researchers in Birmingham are currently involved in a wide range of studies into the disorder, which necessitates the recruitment of subjects who have suffered from this relatively uncommon illness, as well as conducting a comprehensive clinical assessment of the phenotype. This paper describes the approaches we have developed for sample ascertainment and the methodology for recruitment and clinical assessment used in research studies of puerperal psychosis. These include the establishment of a national panel of women who have suffered from the illness (Action on Puerperal Psychosis) and the use of the media as well as systematic routes of ascertainment. Clinical evaluation includes collection of key social, obstetric, and demographic data, together with life-time assessment of mania, depression and psychotic symptomatology by modified SCAN interview and review of case notes. We believe that the methods employed will be useful to other researchers investigating puerperal psychosis, as well as other psychiatric disorders.