Early-Onset and Delayed-Onset Postpartum Psychosis: A Case Series

Postpartum psychosis (PPP) is a rare but high-risk psychiatric emergency, with an estimated incidence of 1–2 in 1000 births. This study focuses on describing the characteristics of episodes occurring within the first postpartum year, specifically examining clinical, etiopathogenic, and prognostic differences between immediate- or early-onset PPP (≤15 days postpartum) and delayed-onset PPP (onset after several weeks). Data were collected from ten patients diagnosed with PPP during the first postpartum year, and a retrospective descriptive analysis was conducted. Five patients experienced immediate or early decompensation and five experienced delayed onset. None of the variables analyzed showed a significant association with the timing of decompensation (p > 0.05). The majority of deliveries were vaginal (n = 8), and most patients were primiparous (n = 9). The most frequent subsequent diagnosis was schizophrenia or a psychotic spectrum disorder (n = 6). The type of partner showed a non-significant trend (p = 0.15), which may warrant further investigation. Notably, the role of partner type deserves closer examination, as it may act as a protective factor against the development of mental disorders and could inform targeted support strategies within health care systems. The lack of descriptions of time to onset periods (staging) in PPP samples could be a gap in the literature.