Predictive factors and treatment of postpartum mania: a representative case.

Postpartum mania and psychosis puts both the person giving birth and their child at significant risk, so predicting its onset and determining effective treatment is crucial. Here, a representative case is presented of a patient started on an antidepressant during her pregnancy who suffered a postpartum manic episode with psychosis. The case describes many of the risk factors and treatment issues faced by clinicians when caring for patients with these symptoms in the postpartum period.

Declining Clinical Course of Psychotic Disorders Over the Two Decades Following First Hospitalization: Evidence From the Suffolk County Mental Health Project.

Objective: Kraepelin considered declining course a hallmark of schizophrenia, but others have suggested that outcomes usually stabilize or improve after treatment initiation. The authors investigated this question in an epidemiologically defined cohort with psychotic disorders followed for 20 years after first hospitalization.

Method: The Suffolk County Mental Health Project recruited first-admission patients with psychosis from all inpatient units of Suffolk County, New York (response rate, 72%).