The British Journal of Psychiatry (2006) 189: 468. doi: 10.1192/bjp.189.5.468
© 2006 The Royal College of Psychiatrists
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Correspondence

Acute and transient psychotic disorders and puerperal psychosis

J. Lewin

Coombe Wood Perinatal Service, Park Royal Centre for Mental Health, Central Way, London NW10 7NS, UK.

Correspondence: Email: jona.lewin{at}nhs.net

EDITED BY KIRIAKOS XENITIDIS and COLIN CAMPBELL

Marneros (2006) addresses an important issue in his editorial on the concept of acute and transient psychosis, which is a challenge to the Kraepelinian dichotomy. He argues that acute and transient psychoses are separate from schizophrenia, schizoaffective disorder or affective disorder, based on the clinical manifestations, but he did not mention puerperal or post-partum psychosis, which also lacks a consensus of definition (Kohl, 2004). Post-partum psychosis has been described as functional psychosis with good prognosis and clinical presentation similar to acute and transient psychosis (Kendell et al, 1987). Despite a varying symptomatology, women with schizophrenia rarely experience arousal of their symptoms after childbirth (Meltzer & Kumar, 1985). Puerperal psychosis appears to occupy a clinical position which is different from schizophrenia and affective disorder.

It is of interest that acute and transient psychosis mainly affects females (Marneros, 2006), and suggests a link between puerperal psychosis and acute and transient psychosis. I therefore suggest that the concept of puerperal psychosis should be included in discussions of the concept of acute and transient psychosis.

REFERENCES

  1. Kendell, R. E., Chalmers, C. J. & Platz, C. (1987) Epidemiology of puerperal psychoses. British Journal of Psychiatry, 150, 662 –673.[Abstract/Free Full Text]
  2. Kohl, C. (2004) Postpartum psychosis: closer to schizophrenia or the affective spectrum? Current Opinion in Psychiatry, 17, 87 –90.
  3. Marneros, A. (2006) Beyond the Kraepelinian dichotomy: acute and transient psychotic disorders and the necessity for clinical differentiation. British Journal of Psychiatry, 189, 1 –2.[Abstract/Free Full Text]
  4. Meltzer, E. S. & Kumar, P. (1985) Puerperal mental illness, clinical features and classification: a study of 142 mother-and-baby admissions. British Journal of Psychiatry, 147, 647 –654.[Abstract/Free Full Text]




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