The dramatic biological changes that occur after childbirth and symptoms like confusion have stimulated much theorizing about a central role for organic factors in the etiology of puerperal psychosis. In this article possible etiologic factors and the debate about puerperal psychosis as a nosological entity are discussed. The majority (two-thirds) of the puerperal psychiatric patients have a personal or family history of non-organic psychosis.

In the remainder the psychotic illness could be related to sudden changes in levels of hormones, neuropeptides and to a disorder of calcium homeostatis in the puerperium. The authors conclude that the literature does not provide enough support to distinguish these two etiologically different classes of post-puerperal disease.