Hostname: page-component-848d4c4894-nr4z6 Total loading time: 0 Render date: 2024-05-16T10:32:06.024Z Has data issue: false hasContentIssue false
  • English
  • Français

Is puerperal psychosis the same as bipolar manic-depressive disorder? A family study

Published online by Cambridge University Press:  09 July 2009

C. Dean ,
R. J. Williams  and
I. F. Brockington
C. Dean*
Affiliation:
Department of Psychiatry, University of Manchester
R. J. Williams
Affiliation:
Department of Psychiatry, University of Manchester
I. F. Brockington
Affiliation:
Department of Psychiatry, University of Manchester
*
1Address for correspondence: Dr C. Dean, Department of Psychiatry, Queen Elizabeth Hospital, Birmingham B15 2TH.
Get access Rights & Permissions [Opens in a new window]

Synopsis

The first degree relatives of three groups of women were interviewed; 51 women who had had an illness within two weeks of childbirth and no non-puerperal episodes (the puerperal group), 33 who had puerperal and non-puerperal episodes (the mixed group), and 19 women with bipolar manic-depressive disorder who had non-puerperal episodes only (the manic-depressive group).

Over 60% of the affected relatives in all three groups had affective illnesses; in the main these were not puerperal. There were significantly more first degree relatives who had had general practitioner or hospital treatment for psychiatric illness in the puerperal group and in the mixed group than in the manic-depressive group. The puerperal patients had a better prognosis in terms of their illness (number of relapses and time on medication), work functioning and social functioning than the manic-depressive group and the mixed group. The mixed group had an earlier age of onset than the manic-depressive group and the puerperal group. The hypothesis that puerperal psychosis is the same as bipolar manic-depressive disorder was not upheld. The mixed group and the puerperal group were similar with respect to the risk in first degree relatives but differed in terms of prognosis.

There were no significant differences between the groups with respect to puerperal episodes in first-degree relatives, although the rate of puerperal psychosis in the first-degree relatives of the puerperal patients was significantly greater than in the general population. The hypothesis that there is a specific genetically determined puerperal psychosis was not supported. Women who had had an illness with an onset within two weeks of childbirth (mixed and puerperal) subsequently had an illness following 36% of their childbirths. In women who had had puerperal and non-puerperal episodes (mixed) the risk was higher; over 50 % of deliveries in these women were followed by psychiatric illness.

Type
Original Articles
Information
Psychological Medicine , Volume 19 , Issue 3 , August 1989 , pp. 637 - 647
Copyright
Copyright © Cambridge University Press 1989

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Angst, J., Frey, R., Lohrmeyer, B. & Zerbin-Rudin, E. (1980). Bipolar manic depressive psychoses: results of a genetic investigation. Human Genetics 55, 237–254.CrossRefGoogle ScholarPubMed
Baron, M., Risch, N., Hamburger, R., Mandel, B., Kushner, S., Newman, M., Drumer, D. & Belmaker, R. H. (1987). Genetic linkage between X-chromosome markers and bipolar affective illness. Nature 326, 289–292.CrossRefGoogle ScholarPubMed
Brockington, I. F., Cernik, K. F., Schofield, E. M., Downing, A. R., Francis, A. F. & Keelan, C. (1981). Puerperal psychosis. Archives of General Psychiatry 38, 829–833.CrossRefGoogle ScholarPubMed
Brockington, I. F., Winokur, G. & Dean, C. (1982). Puerperal psychosis. In Motherhood and Mental Illness (ed. Brockington, I. F. and Kumar, R.), pp. 37–39. Academic Press: London.Google Scholar
Da Silva, L. & Johnstone, E. C. (1981). A follow-up study of severe puerperal psychiatric illness. British Journal of Psychiatry 139, 346–355.CrossRefGoogle ScholarPubMed
Davidson, J. & Robertson, E. (1985). A follow-up study of post partum illness 1946–1978. Acta Psychiatrtca Scandinavica 71, 451–457.CrossRefGoogle ScholarPubMed
Dean, C. & Kendell, R. E. (1981). The symptomatology of puerperal illnesses. British Journal of Psychiatry 139, 128–133.Google Scholar
Egeland, J. A., Gerhard, D. S., Pauls, D. L., Sussex, J. N., Kidd, K. K., Allen, C. R., Hostetter, A. M. & Housman, D. E. (1987). Bipolar affective disorder linked to DNA markers on chromosome 11. Nature 325, 783–787.CrossRefGoogle ScholarPubMed
Endicott, J. & Spitzer, R. L. (1978). A diagnostic interview: the schedule for affective disorder and schizophrenia. Archives of General Psychiatry 35, 837–844.CrossRefGoogle Scholar
Johnson, G. F. S. & Leeman, M. M. (1977). Analysis of familial factors in bipolar affective illness. Archives of General Psychiatry 34, 1074–1083.CrossRefGoogle ScholarPubMed
Kadramas, A., Winokur, G. & Crowe, R. (1979). Postpartum mania. British Journal of Psychiatry 135, 551–555.CrossRefGoogle Scholar
Kendell, R. E., Rennie, D., Clarke, J. A. & Dean, C. (1981). The social and obstetric correlates of psychiatric admission in the puerperium. Psychological Medicine 11, 341–350.CrossRefGoogle ScholarPubMed
Leonhard, K. (1986). Different causative factors in different forms of schizophrenia. British Journal of Psychiatry 149, 1–6.CrossRefGoogle ScholarPubMed
Meltzer, E. S. & Kumar, R. (1985). Puerperal mental illness, clinical features and classification: a study of 142 mother and baby admissions. British Journal of Psychiatry 147, 647–654.Google Scholar
Platz, C. & Kendell, R. E. (1988). A matched control follow-up and family study of‘ puerperal psychosis’. British Journal of Psychiatry 153, 90–94.CrossRefGoogle Scholar
Protheroe, C. (1969). Puerperal psychosis: a long-term study 1927–1961. British Journal of Psychiatry 115, 9–30.CrossRefGoogle ScholarPubMed
Schopf, J., Bryois, C., Jonquiere, M. & Scharfetter, C. (1985). A family hereditary study of post partum psychoses. European Archives of Psychiatry and Neurological Science 235, 164–170.CrossRefGoogle ScholarPubMed
Schulz, B. (1936). Methodik der Medizinischen Erbforschung. George Thieme Verlag: LeipzigGoogle Scholar
Slater, E. & Cowie, V. (1971). The Genetics of Mental Disorders, pp. 354–356. Oxford University Press: London.Google Scholar
Smeraldi, E., Negri, R. & Melica, A. M. (1977). A genetic study of affective disorders. Acta Psychialrica Scandinavica 56, 382–398.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Endicott, J. & Robins, E. (1978). Research Diagnostic Criteria rationale and reliability. Archives of General Psychiatry 35, 73–82.Google Scholar
Thuwe, I. (1974). Genetic factors in puerperal psychosis. British Journal of Psychiatry 125, 378–385.CrossRefGoogle ScholarPubMed
Weinberg, W (1925). Methoden und Technik der Statistik mit besonderer benicksichtigung der soziale Biologie. In Handbuch der Sozialen Hygiene, Vol. 1 (ed. Gottersten, A.Scholssman, A. and Teleky, L.), p. 71. Berlin.Google Scholar
Whalley, L. J., Roberts, D. F., Wentzel, J. & Wright, A. F. (1982). Genetic factors in puerperal affective psychoses. Acta Psychiatrica Scandinavica 65, 180–195.CrossRefGoogle ScholarPubMed