86 cases of narrowly defined postpartum psychosis were investigated with regard to onset and course of symptomatology. The most frequent initial symptoms were restlessness, paranoid symptoms, catatonic excitement, anxiety, sleep disturbances and depressed mood. 16 patients had died at the time of follow-up. Concerning the further course of the disease 64% of the 61 women who were followed up (average 26 years from onset), had recurrences of illness. The most frequent longitudinal diagnosis, in 49% of the 61 cases, was 'schizoaffective disorder'; only 28% of patients were diagnosed as having schizophrenic disorders at follow-up.