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The acute delirium psychosis affecting women in the 3 — 14 day period post partum is well-known. In describing this condition, Hamilton (1962) estimated that it occurred once in 1000 deliveries. The depressive reaction characterized by seemingly unaccountable tearfulness in the 3 — 10-day post-partum period is also well recognized, but a syndrome that appears not uncommonly in women and men during the first year and beyond following the birth of a child seems to elude the psychiatric attention it deserves.
The signs and symptoms we have observed in both sexes that define the syndrome include combinations of acute anxiety, depression, psychosomatic disorders, changes in affectional responses toward the spouse, changes in sexual behavior, the onset of various types of frigidity in the woman, potency difficulties in the man, an apparent loss of interest in the marriage, and the first involvement in extramarital relations often leading to divorce. Disturbances may also occur in work with the appearance of erratic patterns and a diminution of efficiency. Such symptoms may surface even before the post-partum period and appear when having a child is contemplated or during the pregnancy itself.
As far back as 1931, Zilboorg discussed the psychodynamics of post-partum depressions and referred to “parenthood psychosis” in a series of male and female patients who had developed depressive psychotic reactions following the birth of a child. Our clinical findings compare in most respects with Zilboorg's cases, although he did not delineate a phenomenological syndrome as such but concentrated instead on identifying psychodynamic factors. He emphasized the centrality of oedipal problems in the post-partum reactions of both sexes, underscoring the strong incestuous attachment to the opposite-sex parent and the fear of retaliation from