Postpartum Psychosis Panel Recommends New Diagnostic Category

An international group of women’s mental health experts published recommendations in October 2025 calling for postpartum psychosis to be classified as a separate diagnostic category in major psychiatric manuals. The proposal addresses how postpartum psychosis is currently categorized and suggests changes for future editions of the DSM and ICD.

The consensus statement, published in Biological Psychiatry and presented at the 38th European College of Neuropsychopharmacology Congress, outlines the need for a distinct diagnosis for postpartum psychosis. The panel stated that the condition is an acute psychiatric illness that typically develops within weeks after childbirth and often requires hospitalization due to its severity.

At present, postpartum psychosis does not have its own diagnostic code in the DSM-5 or ICD. Instead, clinicians use a “peripartum onset” specifier with other diagnoses such as bipolar disorder or brief psychotic disorder. The panel’s statement noted that this approach does not fully capture the unique features of the condition.

The expert group proposed new diagnostic criteria for postpartum psychosis, including onset within 12 weeks of childbirth and symptoms such as mania, delusions, hallucinations, disorganized speech or behavior, or depression with psychotic features. The criteria also require that symptoms be severe enough to impair functioning or require hospitalization.

What the numbers show

• Postpartum psychosis affects about 1–2 per 1,000 births
• Women with a first episode have a 50% risk of later bipolar disorder
• Recommendations were published on October 22, 2025

The panel highlighted evidence that postpartum psychosis has a genetic risk profile that overlaps with, but is distinct from, bipolar disorder. According to the experts, treatment with lithium and electroconvulsive therapy has shown excellent results for affected individuals.

Additional findings presented by the panel indicated that women who experience postpartum psychosis after childbirth have an increased risk of developing bipolar disorder later in life. The panel also reported that pregnant women with a history of bipolar disorder are at particularly high risk for postpartum psychosis.

A representative of the DSM-5 steering committee confirmed receipt of the expert panel’s recommendations and stated that postpartum psychosis is currently recognized as a distinct but non-codable category in the DSM-5-TR through a perinatal onset specifier. The representative emphasized that any new diagnosis would require a detailed multi-step review process before inclusion in future editions.

The recommendations are under consideration by relevant psychiatric classification committees, but any changes to the DSM or ICD will follow established review protocols. The panel’s consensus statement and supporting evidence have been published for ongoing evaluation by the mental health community.

* This article is based on publicly available information at the time of writing.