The following aspects in the patients' history' may help to identify the emotionally high-risk patients and anticipation of puerperal psychosis:

• Family history of major psychologic illness of close relative e.g. mother

• Major emotional complications during and after a previous pregnancy

• “Reaction” of current pregnancy

• “Fear” of labour from a previous experience

• Traumatic childhood

• Deprivation of emotional support during adult life e.g. single mother

• Severe prolonged or multiple somatic symptoms with no apparent organic cause during current/or succeeding pregnancy

• Major sustained mood changes or repeated rapid mood swings or abnormal sleep patterns

• Refer to Mental Illness chapter for clinical features and management.