Classification of postpartum psychosis: a study of 250 mother and baby admissions in The Netherlands.

The case registers of the patients admitted consecutively to the mother-and-baby unit of the Rotterdam University Hospital between 1967 and 1989 were studied in detail and classified according to the Research Diagnostic Criteria (RDC). The temporal relationship between delivery and the onset of symptoms for the different RDC categories is presented. A comparison is made with the classical concept of puerperal psychosis as it is held in the Netherlands. According to RDC, postpartum psychosis has 3 main phenomenological manifestations: affective, schizoaffective and unspecified functional psychosis. The classical concept of puerperal psychosis largely overlaps the RDC categories schizoaffective disorder and unspecified functional psychosis. The implications regarding the nosology of postpartum psychosis are discussed.