To the Editor.
—I would like to comment on the article "Puerperal Psychosis: Phenomena and Diagnosis" by Brockington et al (Archives 1981; 38:829-833).In their study of this disorder, the authors found an "excess of manic symptoms in the puerperal group" as compared with a control group of nonpuerperal psychotic women. Brockington et al note that "in the Victorian literature, reports of 'mania' were frequent; however, they were written before the distinction between dementia praecox and manic-depressive insanity was drawn." The majority of the references from this period cited by Brockington and colleagues are of European origin, with only one American study from 1859 noted.1 I have recently come across an earlier study on this subject published in the American psychiatric literature in 1847 in which MacDonald2 reports on a group of 66 women with puerperal insanity. I should like to point out the "highlights" of this report
Sternbach H. Puerperal Psychosis in America—1847. Arch Gen Psychiatry. 1982;39(2):235-236. doi:10.1001/archpsyc.1982.04290020085017