Long term follow-up of patients with postpartum psychosis

Objective: This research compared the demographic features, presence of confusion, and long-term follow-up results of women with postpartum psychosis to control subjects. Method: The study included 23 patients with symptoms that emerged in the six-month period after delivery who were followed-up between 1998 and 2006. The control group consisted of 25 age- and education level matched female patients experiencing their first psychotic episode. Data were collected with a sociodemographic questionnaire, the Clinical Global Impression Scale, and the Delirium Rating Scale. Final diagnoses were made according to DSM-IV. Results: Among the postpartum women, 73.9% developed psychosis during their first parturition. The postpartum psychosis and control groups were followed-up for 4.00 +/- 1.62 (range: 2-6) and 3.96 +/- 1.24 (range: 2-6) years, respectively. During the follow-up period, 21.7% of the postpartum patients developed a mood disorder and 77.9% developed schizophrenia and other psychotic disorders. Among those in the control group, 32.0% were diagnosed with a mood disorder and 68.0% with schizophrenia and other psychotic disorders. The distribution of final diagnoses in the 2 groups were similar. Patients with postpartum psychosis experienced more confusion than the control subjects. During the follow-up period, 65.2% of the patients with postpartum psychosis and 72% of the control patients had recurrence. Conclusion: The course of postpartum psychosis was similar to DSM-IV diagnostic criteria, except for the presence of confusion. During the follow-up period, most of the patients in both groups were diagnosed with schizophrenia and other psychotic disorders. This result indicated that there is no need for other diagnostic criteria for postpartum psychosis other than those presently contained in DSM-IV.