Skip to main content Accessibility help

Women Whose Mental Illnesses Recur after Childbirth and Partners' Levels of Expressed Emotion During Late Pregnancy

  • M. N. Marks (a1), A. Wieck (a1), A. Seymour (a1), S. A. Checkley (a2) and R. Kumar (a3)...


Expressed emotion (EE) in the partners of 25 pregnant women with a history of psychosis or severe depression and in 13 pregnant control subjects without any previous psychiatric disorder was assessed in the ninth month of pregnancy. At this time, no patient presented as a case according to RDC. Eleven subjects with a history of psychiatric disorder experienced a further episode of illness in the six months following delivery. Partners of women who became ill had made fewer critical and positive comments about their wives during the pregnancy than the partners of women who remained well. Poor self-rated social adjustment in the partners was also predictive of recurrence of illness after delivery.


Corresponding author

Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF


Hide All
Birtchnell, J. (1988) Depression and family relationships. A study of young, married women on a London housing estate. British Journal of Psychiatry, 153, 758769.
Brockington, I. F., Winokur, G. & Dean, C. (1982) Puerperal psychosis. In Motherhood and Mental Illness (eds Brockington, I. F. & Kumar, R.), pp. 3739. London: Academic Press.
Brown, G. W., Monck, E. M., Carstairs, G. M., et al (1962) Influences of family life on the course of schizophrenic illness. British Journal of Preventative and Social Medicine, 16, 5568.
Brown, G. W., Birley, J. L. T. & Wing, J. K. (1972) Influence of family life on the course of schizophrenic disorders: a replication. British Journal of Psychiatry, 121, 241258.
Clare, A. W. & Cairns, V. (1978) Design, development and use of a standardized interview to assess social maladjustment and dysfunction in community studies. Psychological Medicine, 8, 589605.
Corney, R. H. & Clare, A. W. (1985) The construction, development and testing of a self-report questionnaire to identify social problems. Psychological Medicine, 15, 637649.
Davidson, J. & Robertson, E. (1985) A follow-up study of postpartum ilness, 1946–1978. Acta Psychiatrica Scandinavica, 71, 451457.
Dean, C., Williams, J. R. & Brockington, I. F. (1989) Is puerperal psychosis the same as bipolar manic depressive disorder? A family study. Psychological Medicine, 19, 637647.
Endicott, J. & Spitzer, R. L. (1978) A diagnostic interview – the Schedule for Affective Disorders and Schizophrenia. Archives of General Psychiatry, 35, 837844.
Eysenck, H. J. & Eysenck, S. B. G. (1975) Manual of the Eysenck Personality Questionnaire. London: Hodder and Stoughton.
Hand, D. J. (1981) Discrimination and Classification. Chichester: John Wiley.
Hooley, J. M., Orley, J. & Teasdale, J. D. (1986) Levels of expressed emotion and relapse in depressed patients. British Journal of Psychiatry, 148, 642647.
Jacobs, B. (1943) Aetiological factors and reaction types in psychoses following childbirth. Journal of Mental Science, 89, 242256.
Jones, R. (1902) Puerperal insanity. British Medical Journal, i, 579586.
Kendell, R. E., Rennie, D., Clarke, J. A., et al (1981) The social and obstetric correlates of psychiatric admission in the puerperium. Psychological Medicine, 11, 341350.
Kendell, R. E., Chalmers, J. C. & Platz, C. (1987) Epidemiology of puerperal psychosis. British Journal of Psychiatry, 150, 662673.
Leff, J. P., Kuipers, L., Berkowitz, R., et al (1982) A controlled trial of social intervention in the families of schizophrenic patients. British Journal of Psychiatry, 141, 121134.
Leff, J. P., Wig, N. N., Bedi, H., et al (1990) Relatives' expressed emotion and the course of schizophrenia in Chandigarh. British Journal of Psychiatry, 156, 351356.
McCreadie, R. G. & Phillips, K. (1988) The Nithsdale schizophrenia survey. VII. Does relatives' high expressed emotion predict relapse? British Journal of Psychiatry, 152, 477481.
McCreadie, R. G. & Robinson, A. D. T. (1987) The Nithsdale schizophrenia survey. VI. Relatives' expressed emotion: prevalence, patterns and clinical assessment. British Journal of Psychiatry, 150, 640644.
MacMillan, J. F., Gold, A., Crow, T. J., et al (1986) The North wick Park study of first episodes of schizophrenia: IV. Expressed emotion and relapse. British Journal of Psychiatry, 148, 133143.
Merikangas, K. R. (1984) Divorce and assortative mating for depression. American Journal of Psychiatry, 141, 7476.
Miklowitz, D. J., Goldstein, M. J., Nuechterlein, K. H., et al (1988) Family factors and the course of bipolar affective disorder. Archives of General Psychiatry, 45, 225231.
Parker, G., Johnston, P. & Hayward, L. (1988) Parental ‘expressed emotion’ as a predictor of schizophrenic relapse. Archives of General Psychiatry, 45, 806813.
Parker, G., Hayward, L. & Johnston, P. (1989) Factorial validity of the EE scales. Psychological Medicine, 19, 435446.
Peter, H. & Hand, P. (1988) Patterns of patient-spouse interaction in agoraphobics: assessment by Camberwell Family Interview (CFI) and impact on outcome of self-exposure treatment. In Panic and Phobias 2: Treatment and Variables Affecting Course and Outcome (eds Hand, I. & Wittchen, H.), pp. 240251. Berlin: Springer-Verlag.
Reich, T., Rice, J., Andreason, N., et al (1980) A preliminary analysis of the segregation distribution of primary major depressive disorder. Psychological Bulletin, 16, 3436.
Schopf, J., Bryois, C., Jonquiere, M., et al (1984) On the nosology of severe psychiatric post-partum disorders. European Archives of Psychiatry and Neurological Sciences, 234, 5463.
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research Diagnostic Criteria: rationale and reliability. Archives of General Psychiatry, 35, 773782.
Tetlow, C. (1955) Psychoses of childbearing. Journal of Mental Science, 101, 629639.
Vaughn, C. E. & Leff, J. P. (1976) The influence of family and social factors on the course of psychiatric illness. British Journal of Psychiatry, 129, 125137.
Vaughn, C. E., Snyder, K. S., Jones, S., et al (1984) Family factors in schizophrenic relapse: replication in California of British research on expressed emotion. Archives of General Psychiatry, 41, 11691177.
Weissman, M. M. & Myers, J. K. (1978) Affective disorders in a US urban community. The use of Research Diagnostic Criteria in an epidemiological survey. Archives of General Psychiatry, 35, 13041311.
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. Cambridge: Cambridge University Press.


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Women Whose Mental Illnesses Recur after Childbirth and Partners' Levels of Expressed Emotion During Late Pregnancy

  • M. N. Marks (a1), A. Wieck (a1), A. Seymour (a1), S. A. Checkley (a2) and R. Kumar (a3)...
Submit a response


No eLetters have been published for this article.


Reply to: Submit a response

Your details

Conflicting interests

Do you have any conflicting interests? *