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Letters to the Editor |

Incidence of Hospitalization for Postpartum Psychotic and Bipolar Episodes

Ian Jones, PhD, MRCPsych; Jessica Heron, PhD; Emma Robertson Blackmore, PhD; Nick Craddock, PhD, FRCPsych
Arch Gen Psychiatry. 2008;65(3):356. doi:10.1001/archpsyc.65.3.356-a.
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The recent article by Harlow and colleagues1 undoubtedly adds to our understanding of the risk factors for severe postpartum disorders. The study reaffirms that women with a history of psychiatric admission are vulnerable to further episodes in relation to childbirth and finds that the number of previous episodes and time since last admission are important in determining the magnitude of an individual's risk.

In one important respect, however, the results presented give rise to misleading conclusions. The study suggests that the risk of postpartum psychosis is higher among women with a history of schizophrenia than women with previous episodes of bipolar disorder. This is in stark contrast to previous studies26 and to the experience of clinicians working in perinatal psychiatric services so it is imperative to consider what accounts for this difference.


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