The Epidemiology of Mental and Emotional Disorders during Pregnancy and the Postpartum Period

  • Patricia A. Coble
  • Nancy L. Day


References to mental disturbances arising in association with the period of childbirth in women date back many centuries. Early, detailed clinical descriptions can be found in Hippocrates’ Third Book of Epidemics 1 written in about the fourth century B.C., in a chapter entitled “Mental Alienation of Those Recently Confined and of Nursing Women” in Esquirol’s Treatise on Insanity written in 1845,2 and in what is perhaps the most frequently cited work among those in this field: Treatise on Insanity in Pregnant, Puerperal and Lactating Women,3 written by Louis Mareé and published in 1858. In these early writings and in many following reports through about the middle of the twentieth century, these disorders were considered to be etiologically linked to the puerperium and to represent a discrete disease entity. Among the more distinctive features noted in many of these reports was the finding of very high rates of the presence of a toxic-confusional or delirious picture. Hence, terms such as puerperal fever or milk fever were frequently invoked in reference to these puerperal mental states. In an excellent review of the literature in this regard, Seager notes that, with the introduction and extensive use of antibiotics, these symptoms became much less frequently reported. Indeed, Seager indicates that reports published after the middle of the twentieth century typically note a very low incidence of infection and/or delirious reactions.4


Postpartum Period Postpartum Depression Hyperemesis Gravidarum Puerperal Fever Factitious Disorder 
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Copyright information

© Plenum Publishing Corporation 1988

Authors and Affiliations

  • Patricia A. Coble
  • Nancy L. Day
    • 1
  1. 1.Department of Psychiatry, Western Psychiatric Institute and ClinicUniversity of PittsburghPittsburghUSA

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