A family hereditary study of post-partum “psychoses”

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A group of 80 women suffering from a severe psychiatric post-partum disorder and hospitalized for the first time in their lives was followed up between 4 and 35 years later. Besides the further evolution of psychic health of the patients, the occurrence of endogenous (i.e., functional) psychoses in first degree relatives was investigated. A global morbidity risk for endogenous psychoses of 10.9% was found, affective psychosis accounting for two-thirds of secondary cases. Subdivision of the sample according to the criterion of absence or presence of further psychotic episodes unrelated to childbirth revealed that first degree relatives of patients with exclusively puerperal decompensations had a low morbidity risk of 2.0%, but relatives of patients with later nonpuerperal episodes of illness one of 15.2%, the difference being statistically significant (P < 0.002). This suggests that severe psychiatric disorders occurring exclusively in the post-partum period are nosologically distinct from those followed by nonpuerperal psychotic episodes of illness. Only the latter seem to be related to the traditionally recognized subgroups of endogenous psychoses.