The maternal brain as a model for investigating mental illness

The idea that a particular type of severe mental illness, puerperal or post-partum psychosis, is a disease entity and that its causes lie in some kind of physiological disturbance of the reproductive process, can be traced back to antiquity. Epidemiological studies provide strong support for such an hypothesis, but, despite the powerful methodological attractions of using childbirth as a model for research, there has been surprisingly little neuroendocrine research into this subject. There have been preliminary reports of prospective research into women with histories of affective psychosis who are pregnant and who are at particularly high risk of recurrence of illness. This work suggests that it may be very fruitful to investigate interactions between the massive changes that occur in sex hormones around parturition and the activity of selected neurotransmitter systems. Because of the prospective research paradigm, it becomes possible to test whether the measures can predict who will become ill and who will stay well.