Postpartum Psychosis: Experts Seek a Distinct Category Within the DSM

Postpartum Support International’s Nicole Cirino, MD, co-authored a consensus statement recommending that postpartum psychosis be classified as its own category of mental illness in the DSM-5 and ICD 11.

PSI Board Chair, Faculty Member, and Postpartum Psychosis Task Force Member Nicole Cirino, MD, is part of an international expert consensus panel calling to classify postpartum psychosis.

The consensus statement summarizes scientific evidence, supporting postpartum psychosis as a distinct mental illness within the bipolar spectrum. Correct classification will improve detection and treatment, in turn saving the lives of mothers and babies.

“Postpartum psychosis is a severe psychiatric illness that is estimated to strike up to 2.6 out of every 1,000 women after they give birth. Symptoms can include mania, depression with psychotic features, impaired thinking, agitation and irritability. Left untreated, the condition can cause women to commit suicide or kill their babies. It is considered a psychiatric emergency and often requires hospitalization.

The condition is considered one of the most easily identified mental illnesses among women because of its rapid onset and distinctive symptoms, yet it is not recognized in two key resources used for medical treatment and billing: the Diagnostic and Statistical Manual, often called DSM-5, or the International Classification of Disease.”

The consensus statement in the scientific journal Biological Psychiatry includes a complete overview of the psychiatric literature on postpartum psychosis.

Veerle Bergink, Schahram Akbarian, Nancy Byatt, Prabha S. Chandra, Nicole Cirino, Paola Dazzan, Lot De Witte, Arianna Di Florio, Clare Dolman, Ian Jones, Astrid Kamperman, Behrang Mahjani, Samantha Meltzer-Brody, Trine Munk-Olsen, Sarah Nagle-Yang, Lauren M. Osborne, Natalie Rasgon, Thalia Robakis, Harish Thippeswamy, Simone N. Vigod, Jennifer L. Payne.

Postpartum Psychosis and Bipolar Disorder: Review of Neurobiology and Expert Consensus Statement on classification., Biological Psychiatry, 2025, ISSN 0006-3223, https://doi.org/10.1016/j.biopsych.2025.10.016.

(https://www.sciencedirect.com/science/article/pii/S0006322325015367)

About the Co-Author

Dr. Nicole Cirino

Dr. Nicole Cirino is a physician specializing in reproductive psychiatry clinical care, education, and research for women with perinatal, perimenstrual, and perimenopausal psychiatric conditions, as well as disorders of female sexual dysfunction, including postpartum depression, perinatal loss, sexual trauma related conditions, postpartum psychosis, perinatal OCD, PMDD, and other mental health conditions that occur during the reproductive life span. She holds a Professor appointment at Baylor College of Medicine, where she also serves as the Director of the Division of Reproductive Psychiatry in the Department of Obstetrics and Gynecology. She teaches the clinical aspects of reproductive psychiatry to more than 800 medical clinicians annually. She serves in leadership roles on many national committees, including the American Psychiatric Association (APA), the International Society of Reproductive Psychiatrists (ISRP), and the International Society for the Study of Women’s Sexual Health (ISSWSH).
Dr. Cirino received her MD from Loyola University of Chicago Stritch School of Medicine and completed her residency and fellowship at Northwestern University Feinberg School of Medicine. She lives in Houston, TX, with her husband Nick and their three teenage children.