• postpartum psychosis;
  • DSM-IV;
  • non-psychotic postpartum depression


In this review we consider the literature on postpartum psychoses as well as on non-psychotic postpartum depression with a goal of determining how such disorders should be categorized in DSM-IV. We conclude that the majority of postpartum psychoses are affective in nature and that, despite the observation of “confusion” in many such presentations; the symptom picture is not sufficiently unique to warrant a separate diagnostic category. We could find no evidence of unique presentation of non-psychotic postpartum depression. Nonetheless, because of the unique complications associated with postpartum disorders (e.g., disruption of the mother-infant bond, infanticide), we recommend that postpartum presentations be given a more prominent place in the text of DSM-IV and that a course specifier, “postpartum onset,” be applied to major depressive or manic/hypomanic episodes in Bipolar I, Bipolar II, or Major Depressive Disorder, or to Acute Psychotic Disorder when appropriate. Depression 1:59–70 (1993). © 1993 Wiley-Liss, Inc.