Talk:Postpartum psychosis/Archive 1

Multiple Names, Move Proposal
I feel the title may have chosen the incorrect name for this disorder. The following shows the number of hits for each term amoung scientific search sources:

Therefore, I propose it be moved to one of the second two terms.Legitimus (talk) 22:46, 20 June 2008 (UTC)
 * I agree. "Postpartum psychosis" was always how the media refered to Andrea Yates illness. I think wiki's audience will be more inclined to search for that particular term.71.251.185.217 (talk) 03:43, 27 June 2008 (UTC)

A paper in PLOS

 * Post-Partum Psychosis: Which Women Are at Highest Risk? - might be useful. -- C opper K ettle  15:59, 12 February 2009 (UTC)

Suggestions for major changes
As it stands the article seems to deal mainly with Andrea Yates, and does not take account of much recent research. I suggest the following modified introduction:

Postpartum psychosis (also called puerperal or postnatal psychosis) is a term that covers a group of mental illnesses with a rapid onset of psychotic symptoms following childbirth. In this group there are at least a dozen organic psychoses, which are described under another heading (see 'postpartum organic psychoses'). The relatively common non-organic form, still prevalent in Europe, North America and throughout the world, is sometimes called 'puerperal affective disorder' or 'puerperal bipolar disorder'. Some of these mothers, however, have symptoms atypical of manic depressive disorder, which come under the heading of acute polymorphic (cycloid) psychosis ('schizophreniform; in USA). These disorders were first clearly described by the German obstetrician Osiander in 1797, and have been the subject of over 2,000 works since then. They are endogenous, heritable illnesses with acute onset, benign episodic course and response to mood normalising and stabilising treatments. Under symptoms or clinical features, I would substitute the following (which I think gives a better grouping than the 12 headings at present listed):

These psychoses begin abruptly shortly after childbirth, rapidly reaching a climax of severity. Manic and acute polymorphic forms almost always start within two weeks, but depressive psychosis may start somewhat later. Some patients have typical manic symptoms - euphoria, overactivity, decreased need for sleep, loquaciousness, flight of ideas, increased sociability, disinhibition, irritability, violence and sometimes delusions (especially grandiose and religious in content); on the whole these symptoms are more severe than in mania occurring at other times, with highly disorganised speech and extreme excitement. Other patients have severe depression with psychotic features such as delusions, verbal hallucinations, mutism, stupor or transient swings into mania. Some switch from mania to depression within the same episode. Atypical features include perplexity and confusion, emotions like fear and ecstasy, catatonia and rapid changes of mental state with various transient delusional ideas: these are so striking that some authors have regarded them as a distinct, specific disease; but they are classic features of acute polymorphic (cycloid) psychoses that occur in other contexts (for example, menstrual psychosis - see annotation on this subject) and in men.

The heading 'treatment and prognosis' could be changed to 'course and treatment'. It is necessary to remove some sentences. Infanticide is extremely rare in puerperal mania. It occurs very infrequently (say, 1/10,000 cases) of severe depression usually some time after childbirth. Suicide is also rare. I suggest the following text: Without treatment, these psychoses can last many months. With modern therapy they usually resolve within a few weeks. A small minority follow a relapsing pattern, which may be related to the menstrual cycle (see annotation on menstrual psychosis). These mothers are liable to other manic depressive or acute polymorphic episodes, some of which occur after other children are born, some during pregnancy or after abortion, and some unrelated to childbearing. Puerperal recurrences occur after at least 20% of subsequent deliveries, or almost 100% if depressive episodes are included. Severe overactivity and delusions may require tranquilization by neuroleptic (antipsychotic) drugs, but they should be used with caution because of the danger of severe side-effects with include the neuroleptic malignant syndrome. Electro-convulsive (electroshock) treatment is highly effective. Mood stablising drugs such as lithium are also useful in treatment, and possibly also in the prevention of episodes in women at high risk (that is, women who have already experienced manic or puerperal episodes). The location of treatment is an issue. Hospitalization is disruptive to the family, and it is possible to treat moderately severe cases at home, where the sufferer can maintain her role as wife, homemaker and mother, and build up her relationship with the newborn. This requires the presence of competent adults (such as the baby's maternal grandmother) in the home full time, and frequent visits by professional staff. If hospital admission is necessary, there are advantages in conjoint mother and baby admission. Instead of the section headed 'epidemiology', I would have 'causes' (which includes epidemiology). Thus, Causes: These are world-wide disorders. Their incidence has been carefully measured in state-of-the art epidemiological studies, and is less than 1/1,000 deliveries. They are commoner in primipara (first time mothers). As recognized by Marce (1862), the link to menstruation is an important clue to the cause. Molecular genetic studies suggest that there is a specific heritable factor, and there is evidence of linkage to chromosome 16 (Jones, 2007).

Under notable cases, I think we need to include a typical case of puerperal mania, and one of acute polymorphic psychosis.

A lot more references need to be added, and I would suggest that some of those about Andrea Yates could be transferred to a website about that important legal case.

I am going to leave these suggestions on the discussion page for at least a month. I hope the authors of the current draft will comment, because it would be an advantage to proceed with agreement. In the meanwhile I will submit a separate annotation about postpartum organic psychoses, which I hope will be a companion to this one. son of fraser and joyce —Preceding unsigned comment added by Son of Fraser and Joyce (talk • contribs) 08:56, 26 May 2009 (UTC)


 * Now that 3 months have passed since I made my proposals for revision of this entry (and no protests have been made), I will make the major revisions I sketched out above. I have left in the 3 famous cases, although the evidence of postpartum psychosis has not been specified in the text.  There are many references to the important legal proceedings about Andrea Yates.  Since she has her own Wikipedia entry, I propose to remove some of them, which have been listed in the other website.  I will do this when I revisit this entry in 2-3 months time Son of Fraser and Joyce (talk) 07:57, 28 August 2009 (UTC)son of Fraser and Joyce August 26th 2009Son of Fraser and Joyce (talk) 07:57, 28 August 2009 (UTC)


 * I think that some of the famous cases need either trimming down (in the case of Yates) or some rewording, as they don't sound very well-written. I will do some of this myself.Legitimus (talk) 16:57, 27 August 2009 (UTC)


 * Thank you for this suggestion. What is really needed is some justification for their inclusion as 'puerperal psychoses'.  I looked up Melanie Blocker-Stokes and have replaced the term 'puerperal psychosis' by the evidence of a psychotic depression.  As for Andrea Yates, it appears that she believed she had the Devil inside her, and was saving the children by drowning them.  It would be well to insert this evidence, and omit all the legal and definitional arguments, which are probably dealt with in the Wikipedia entry devoted to her.  Otty Sanchez had a 'schizophrenic' illness, and became ill because she stopped taking her medication.  This is a cause of infanticide, as a complication of chronic delusional illness, not puerperal psychosis.  I would like to remove this case, but will wait 3 months for comments from others Son of Fraser and Joyce (talk) 07:57, 28 August 2009 (UTC)son of Fraser and Joyce August 28th 2009Son of Fraser and Joyce (talk) 07:57, 28 August 2009 (UTC).
 * I agree with you on those points. Specifically, I concur that Blocker-Stokes (based on the one source I had at the time) had symptoms more consistent with depression.  The OLPA source wasn't particularly helpful and it almost sounded like a mistake to call it postpartum psychosis, even though OLPA is part of NIH and is supposed to be reliable.  Then again, it is a legislative division of NIH, rather than medical per se.  The additional source makes it more clear.  Likewise, I also agree that Sanchez may not be appropriate for this article in that she obviously had a preexisting condition.
 * One caution I'd advise is that readers of this article (and wikipedia in general) are mostly laypersons. So just be careful about getting too technical with the tone of writing. In a similar vein, the high profile nature of Yates I feel warrants some commentary to the case's effect on popular perceptions.  I have touched on this already in my editing of her section, but of course post here what you think should be changed.Legitimus (talk) 12:23, 28 August 2009 (UTC)

Thank you, Legitimus. I have not made any further changes yet - will wait some months. I have just written an entry on organic pre- and postpartum psychoses, and corrected the title in this text. Son of Fraser and Joyce (talk) 06:53, 11 October 2009 (UTC)Son of Fraser and Joyce, October 11th 2009Son of Fraser and Joyce (talk) 06:53, 11 October 2009 (UTC)

New addition
Editor(s) are repeatedly adding information about Natachia Barlow Ramsey to this article. I can find no significant mention of her, except in local newspaper cases. There is no indication that this case had significant coverage or deserves encyclopedic reference here. Yobol (talk) 17:06, 30 July 2012 (UTC)

In the case of Natachia Barlow Ramsey; I suggest you are being lazy in regards to finding information or have a personal reason for not allowing it to be included. This was back in 1999 and she has only recently begun to talk and share her story more publicly of her own accord. Most of the articles were archived and in 1999 the access technology based articles was significantly lower than today. There is a huge upsurge just over the past six months in coverage on her. Her case set precedence on numerous counts and currently she is the only person I can find who suffered postpartum psychosis, killed her child, was found not criminally responsible, was released from the hospital after almost a decade but got custody of her other child back while still in custody and has finally started talking about it today. She wrote an article recently about "Forced Sterilization" while in the hospital on the website Surviving Postpartum Psychosis I suggest you read it. — Preceding Sedulous74 comment added by Sedulous74 (talk contribs) 17:51, 30 July 2012 (UTC)Sedulous74 (talk) 19:00, 30 July 2012 (UTC)
 * Please review our guideline on reliable sources. The only reliable sources I could find were old, small stories in local newspapers, certainly not enough to qualify as a "notable" case (note: www.survivingppp.com is not a reliable source). The burden is on you to provide high quality reliable sources establishing her case is notable. That has not happened so far. It doesn't matter what you or I feel is important, only what reliable sources say is important. Yobol (talk) 03:00, 31 July 2012 (UTC)

Odd "home test"
I removed this paragraph. I've had a look at as many websites about perinatal mental illness aimed at the general public as I can, and I haven't found this style of advice on any of them. I didn't want to put a [citation needed] tag on it, but if someone can find a reliable citation for it I guess it can go back in. "Those concerned that a loved one may have this illness might want to ask her to do math problems that would have been easy for her prior to pregnancy, ask her to read a few paragraphs of something out loud, or ask her to explain the "why" of something in detail. These tasks can be difficult for a woman experiencing postpartum psychosis.  The ability of the woman to perform these tasks does not mean she DOES NOT have postpartum psychosis, but the inability to do tasks she easily could do before indicates the need to seek medical help." DanBCDanBC (talk) 23:13, 11 January 2016 (UTC)

Course and treatment
Page used to say "Without treatment, these psychoses can last many months; but with modern therapy they usually resolve within a few weeks". I changed that final "weeks" to months. I used this as a source: http://www.rcpsych.ac.uk/healthadvice/problemsdisorders/postpartumpsychosis.aspx That says "It can take 6-12 months or more to recover from postpartum psychosis. The most severe symptoms tend to last 2 to 12 weeks." That's for treated postpartum psychosis. DanBCDanBC (talk) 23:20, 11 January 2016 (UTC)
 * thanks will use that! Jytdog (talk) 04:28, 27 October 2016 (UTC)

sections
User:Doc James - about these diffs by you. as you can see here i originally had regular MEDMOS sectioning, but in the course of doing symptoms, and distinguishing this from postpartum depression and baby blues, it made sense in the flow to pull epidemiology up into that section. This is rare (epidemiology and severe), depression is ~10% and not as bad but bad, and "baby blues" are very common and mild. It all just kind of fit there. Jytdog (talk) 00:46, 28 October 2016 (UTC)
 * This is separate from postpartum depression though may complicate depression. Do not see how the fact that it is rare directly relates to the symptom that occur? Doc James  (talk · contribs · email) 00:53, 28 October 2016 (UTC)
 * It is a key way it is different from the other two. Jytdog (talk) 01:03, 28 October 2016 (UTC)
 * The signs and symptoms differentiate the two. One cannot determine which a person has based on how common they are. And we mention that they are different in the classification system above the signs and symptoms section. Doc James  (talk · contribs · email) 01:08, 28 October 2016 (UTC)
 * yep that is true, not the point really. Jytdog (talk) 01:09, 28 October 2016 (UTC)
 * I find putting the two together confuses thing as we end up talking about unrelated things in the same paragraph. The the symptoms are severe definitely needs to be emphasized in the signs and symptoms section. Doc James  (talk · contribs · email) 01:12, 28 October 2016 (UTC)

Frequency
The article states:

It is a rare disease that only occurs within 1 out of 1,000 women after birthing a child.

Is it accurate to say, as a corollary, that of one thousand live births, there will (statistically) be one mother who experiences postpartum psychosis?

I assume that the births are live birth because of the phrase "after birthing a child".

An ambiguity that needs clarification: in the phrase "1 out of 1,000 women after birthing a child" are we talking about:


 * One thousand incidents of childbirth?
 * Or one thousand women over their lifetimes?

Karl gregory jones (talk) 18:48, 11 June 2019 (UTC)

Major revision
I am returning to Wikipedia after ten year's absence, during which I have written two books on this subject. I think I can help by some modifications of the present text. Son of Fraser and Joyce (talk) 19:34, 14 February 2020 (UTC)Son of Fraser and JoyceSon of Fraser and Joyce (talk) 19:34, 14 February 2020 (UTC)

I decided not to attempt a major revision, but to improve the present article. In the first place I would like to improve the paragraph on 'signs and symptoms' and to add a paragraph on 'history'. I will delay this for a week or two to enable other editor(s) to comment on this edit. 2A00:23C5:EC0A:5800:C0B4:74DD:A129:56DE (talk) 09:28, 2 March 2020 (UTC)Son of Fraser and Joyce2A00:23C5:EC0A:5800:C0B4:74DD:A129:56DE (talk) 09:28, 2 March 2020 (UTC), March 2nd 2020.

On further consideration, I think it best to alter the first sentence of this entry, simply to add "Postpartum (puerperal) psychosis is a term covering at least twenty severe mental disorders that start abruptly soon after childbirth. Of these, postpartum bipolar disorder is overwhelmingly the most common in high income nations.  This is a rare ... (continues as written).  I would add four main headings - History, Postpartum Bipolar disorder, Other Non-organic Psychoses and Organic Psychoses.  Most of the present major headings will be listed under Postpartum Bipolar Disorder.  Is this acceptable to other editors? Son of Fraser and Joyce (talk) 06:08, 6 March 2020 (UTC)Son of Fraser and JoyceSon of Fraser and Joyce (talk) 06:08, 6 March 2020 (UTC), March 6th 2020.

There has been no response from other editors. In the interest of achieving an agreed entry, I would have liked to alert the editors who altered the account published in 2009, but it was impossible to find out, from the history page, who they were. Tomorrow I will make make the change signalled on March 6th. 2A00:23C5:EC0A:5800:79CD:6229:914A:D007 (talk) 07:07, 8 March 2020 (UTC)Son of Fraser and Joyce2A00:23C5:EC0A:5800:79CD:6229:914A:D007 (talk) 07:07, 8 March 2020 (UTC)March 8th 2020.

I think I have taken all possible steps to seek agreement on these changes. As planned above, I have added a sentence to the introduction, and three main headings. Most other headings fall under 'postpartum bipolar disorders'. I added an introductory sentence under the other two main headings. I have advanced the section on 'History', which now comes after the introduction. I now propose, if there is no objection, to amplify this paragraph on the history. Son of Fraser and Joyce (talk) 07:26, 9 March 2020 (UTC)Son of Fraser and JoyceSon of Fraser and Joyce (talk) 07:26, 9 March 2020 (UTC), March 9th 2020.

As proposed a week ago, I have amplified the paragraph on the history of these disorders. I have also moved the major heading 'Society and Culture', because it belongs to the whole group, not just postpartum bipolar disorders. Next week I intend (subject to the views of other editors) to augment the paragraphs on 'Other non-organic postpartum psychoses' and 'Organic postpartum psychoses'. Son of Fraser and Joyce (talk) 06:47, 16 March 2020 (UTC)Son of Fraser and JoyceSon of Fraser and Joyce (talk) 06:47, 16 March 2020 (UTC), March 16th 2020.

I have put the History paragraph first because it applies to all three - postpartum bipolar disorder, other non-organic postpartum psychoses and organic postpartum psychoses. If Wikipedia wants it moved, it can be rewritten, dealing with the history of each separately. Son of Fraser and Joyce (talk) 17:42, 17 March 2020 (UTC)Son of Fraser and JoyceSon of Fraser and Joyce (talk) 17:42, 17 March 2020 (UTC), March 17th 2020.

I have augmented the paragraphs on other non-organic postpartum psychoses, and organic postpartum psychoses, as proposed last week. Next week, if acceptable to other editors, I will revise the paragraph on the signs and symptoms of postpartum bipolar disorder. Son of Fraser and Joyce (talk) 20:00, 23 March 2020 (UTC)Son of Fraser and JoyceSon of Fraser and Joyce (talk) 20:00, 23 March 2020 (UTC), March 23rd 2020.

I have augmented the paragraph on signs and symptoms, as proposed last week. Next week, if acceptable to other editors, I will add a paragraph on onset groups. Son of Fraser and Joyce (talk) 09:04, 30 March 2020 (UTC)Son of Fraser and JoyceSon of Fraser and Joyce (talk) 09:04, 30 March 2020 (UTC), March 30th 2020.

I have added a paragraph on onset groups, as proposed last week. Next week, if acceptable to other editors, I will add a paragraph on the course of the illness. Son of Fraser and Joyce (talk) 06:24, 6 April 2020 (UTC)Son of Fraser and JoyceSon of Fraser and Joyce (talk) 06:24, 6 April 2020 (UTC), April 6th 2020.

I have added two paragraphs on the course of the illness, as proposed last week. Next week, if acceptable to other editors, I will add paragraphs on management, treatment and prevention. Son of Fraser and Joyce (talk) 06:52, 13 April 2020 (UTC)Son of Fraser and JoyceSon of Fraser and Joyce (talk) 06:52, 13 April 2020 (UTC), April 13th 2020.

I have added a section on management, treatment and prevention, as proposed last week. This replaces the existing paragraph on management and the two separate paragraphs on treatment. Next week, if acceptable to other editors, I will contribute to the paragraph on research directions. Son of Fraser and Joyce (talk) 19:03, 20 April 2020 (UTC)Son of Fraser and JoyceSon of Fraser and Joyce (talk) 19:03, 20 April 2020 (UTC), April 20th 2020.

I have revised the paragraphs on research directions, but first it was necessary to revise the section on causes. I have temporally eliminated the reverence to guidelines from the Royal College of Psychiatrists (for which I apologise). I will reinstate them next week when I intend to improve some of the referencing. I will also revise the paregraphs on diagnosis. Son of Fraser and Joyce (talk) 08:12, 28 April 2020 (UTC)Son of Fraser and JoyceSon of Fraser and Joyce (talk) 08:12, 28 April 2020 (UTC), April 28th 2020.

I have revised the paragraph on diagnosis and moved it up, below signs and symptoms. I have transferred content from the sections on risk factors and screening to preconception counselling, where they belong. Next week I will improve the referencing and, in the next few weeks, subject to the views of other editors, amplify the section on organic postpartum psychoses. Son of Fraser and Joyce (talk) 05:46, 5 May 2020 (UTC)Son of Fraser and JoyceSon of Fraser and Joyce (talk) 05:46, 5 May 2020 (UTC), May 4th and 5th 2020. I have made three further minor edits, all improving the referencing. Son of Fraser and Joyce (talk) 19:14, 5 May 2020 (UTC)Son of Fraser and JoyceSon of Fraser and Joyce (talk) 19:14, 5 May 2020 (UTC), May 5th 2020.

I should explain the changes I have made to the references. The version of this article, which I found in February, had only 16 citations, but two of them were cited frequently. (1) Information provided by the British & Irish Royal College of Psychiatrists in 2014 under the title ‘Postpartum Psychosis’ was cited 18 times. This was written for those at risk, and includes a table with approximate risks (up to 50% for those with a previous postpartum psychosis). It has 17 references, 8 of which were to work from one of the British research groups. With so few roots in the literature, it did not seem an appropriate source for any statement about postpartum psychoses. Of its references to risk factors, those of Monk-Olsen (2014) and DiFlorio (2018) are concerned with more broadly defined psychiatric disorders; those of Blackburn (2013) and Wesseloo (2016) are directly relevant, and I have used them as replacements. (2) The other main source was a Lancet review of 2014, which was cited 12 times. This has 102 references of which 79 are relevant to postpartum psychosis; only 17 were written before 2000. The search strategy was to find systematic reviews written in the last 20 years and epidemiological or experimental studies in the last 3 years. This article covered about 3% of the literature, and much less than half the articles written in this century. There are better references for a general description of the disease, its differential diagnosis, its treatment and research directions, indeed every statement to which it was cited as a source. I have preserved it for the need for a reproductive plan for each individual, the value of continued psychotherapeutic support, and its opinion on the role of ICD-10 and DSM-5 in hindering research. It seemed better to use, as the main source, a monograph published more recently, covering 92% of the literature. Son of Fraser and Joyce (talk) 07:46, 12 May 2020 (UTC)Son of Fraser and JoyceSon of Fraser and Joyce (talk) 07:46, 12 May 2020 (UTC), May 12th 2020.

Next week, subject to the views of other editors, I will start amplifying the paragraphs on organic postpartum psychoses. Son of Fraser and Joyce (talk) 08:42, 13 May 2020 (UTC)Son of Fraser and JoyceSon of Fraser and Joyce (talk) 08:42, 13 May 2020 (UTC), May 13th 2020.

After a delay, due to the need to consult other editors, I have begun to amplify the paragraphs about organic postpartum psychoses. Son of Fraser and Joyce (talk) 06:25, 1 June 2020 (UTC)

I have completed the revision of the organic psychoses. Next week I will make some adjustments to the text and references. Son of Fraser and Joyce (talk) 06:26, 2 June 2020 (UTC)

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 7 January 2019 and 26 April 2019. Further details are available on the course page. Student editor(s): LaShaeDavis. Peer reviewers: Nicole6794.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 07:03, 17 January 2022 (UTC)

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 22 January 2019 and 16 May 2019. Further details are available on the course page. Student editor(s): Taissatati.

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Wiki Education assignment: WikiProject Medicine Winter 2023 UCF COM
— Assignment last updated by DLEMERGEBM (talk) 00:30, 27 January 2023 (UTC)

WikiProject Medicine - Draft Workplan
Hi everyone! I am a 4th year medical student with the University of Central Florida College of Medicine. This is my first time editing a Wikipedia article, and I’m very open to your feedback and suggestions to make sure that I do my best in elevating this page!

Thank you to all the previous authors and editors for establishing a great foundation for a challenging and ever-developing topic. I want to be very respectful of what’s been contributed, while also working with the guidelines to try and raise the status of this article so that it is an even better source of information for individuals and their families who have questions or personal experience with this disorder. My draft workplan is listed below:

- Overall, it seems that the original article is largely focused on postpartum bipolar disorder, which does have significant evidence suggesting an association between it and postpartum psychosis; however, given the nominative focus of this article, I’d like to try and redraw focus to the main topic of the page while untangling some of the current content that intermingles postpartum bipolar with postpartum psychosis. I intend to use more recent published reviews and the standard manual of style for medical disorders (classification, presentation, mechanism, diagnosis, screening, management, prognosis and outcomes, epidemiology) to complete these sections with specific relation to postpartum psychosis.

- For History and Research directions, I’d like to remove these out of the subsection of postpartum bipolar disorder, add to their content, and place them under the general topic of postpartum psychosis.

- I would like to add a new section about the differential that should be associated with postpartum psychosis, leading into the existing sections about non-organic and organic psychoses.

- Following the above, which is the bulk of what I intend to do, I’d like to go through the entire article and copy-edit to help improve the grammar and general flow of the article. I have seen a few statements that some might regard as biased or persuasive in nature, so I will try to rephrase those without altering too much of the original author’s work.

- If there is more time, I will add to the society and culture section to discuss current stances on the recognition of cases as well as stigmas regarding psychoses. I still need to determine if there is good references for this, but studies regarding racial bias and misdiagnosis may be appropriate in this section.

I look forward to your thoughts, comments, and suggestions - thank you! --Typemd21 (talk) 04:43, 13 January 2023 (UTC)


 * As described above - this week I completed major portions of the updated content reflecting PPP specifically, while using the lead to integrate the previously existing portions of Postpartum Bipolar Disorder.
 * Still to come: Treatment, Epidemiology, and an update to History. More images as they are applicable. Copyediting previous article contributions for grammar, context, and scrubbing of primary references.
 * Please let me know if you see any major problems with what I've updated or the changes to come! I'm open to your suggestions and concerns, and will be quick to reply! Thank you! --Typemd21 (talk) 19:23, 20 January 2023 (UTC)


 * Thanks for your edits, especially removal of primary source. There are a ton of remaining case studies, that per WP:MEDRS really should be replaced. You taken on a difficult article that needs a lot of cleanup.  Keep up the good work!  Cheers. Boghog (talk) 20:36, 20 January 2023 (UTC)
 * Hi, I looked over the article and you did amazing work! Really informative! My feedback is below.
 * 1)   Lead: The lead is very well done and has an introductory sentence before each paragraph which accurately describes the topic to the reader. There is a quality citation for every sentence and fact in the section. The only suggestion I have would be adding a sentence at the end of the lead that gives an overview of the content.
 * 2)   The content is relevant, and the layout of the article is appropriate and concise. The wording and grammar of the article are well done and accurately convey the information to readers in a palatable form. The information presented is very in-depth while still being concise. All sentences and facts have multiple quality citations that are secondary sources, and the citation links are working.
 * 3)   For the signs and symptoms section under Postpartum bipolar disorder, I would recommend possibly putting the second paragraph before the current first paragraph. That is the only suggestion I have as far as the content as you did a great and thorough job!
 * 4)   You do a great job at hyperlinking all relevant words or phrases that would allow readers to do more research on the topics within this article if necessary.
 * 5)   The article does a great job conveying the information without bias and letting the reader take in the information without influencing their thoughts.
 * Again, really amazing job! I learned a significant amount of information reading your article! Penn1992 (talk) 15:16, 31 January 2023 (UTC)
 * @Penn1992 Thank you so much for your comments and suggestions! I did go back to the lead and add a little more to make sure that major parts of the article were covered as a general overview, so thank you for that recommendation! While much of what was under postpartum bipolar disorder was from the original author of the article, your comment kickstarted me to do more in improving that section, so thank you - I did make the suggested change to reorder the paragraphs in signs and symptoms, and I also cleaned up a lot of the grammar and content to make it more readable and neutral. I took out a few sections that I thought were redundant in the article and were generally not backed by any references, and I also tried to add references where I could or suggest needed citations in places I couldn't find source material. Thank you again for your feedback and for helping me improve this article! Typemd21 (talk) 04:47, 3 February 2023 (UTC)
 * Again, really amazing job! I learned a significant amount of information reading your article! Penn1992 (talk) 15:16, 31 January 2023 (UTC)
 * @Penn1992 Thank you so much for your comments and suggestions! I did go back to the lead and add a little more to make sure that major parts of the article were covered as a general overview, so thank you for that recommendation! While much of what was under postpartum bipolar disorder was from the original author of the article, your comment kickstarted me to do more in improving that section, so thank you - I did make the suggested change to reorder the paragraphs in signs and symptoms, and I also cleaned up a lot of the grammar and content to make it more readable and neutral. I took out a few sections that I thought were redundant in the article and were generally not backed by any references, and I also tried to add references where I could or suggest needed citations in places I couldn't find source material. Thank you again for your feedback and for helping me improve this article! Typemd21 (talk) 04:47, 3 February 2023 (UTC)

Splitting proposal
I suggest that we split Postpartum Bipolar Disorder into its own page. what do you think? Moriwen (talk) 20:09, 8 March 2023 (UTC)

Merger
I added relevant content from the proposed merge - not sure how to redirect former page LegalSmeagolian (talk) 17:05, 7 September 2023 (UTC)