Does steroid sulfatase deficiency influence postpartum psychosis risk?

Postpartum (or puerperal) psychosis (PP) occurs shortly after childbirth in 0.1–0.2% of women, and is characterised by delusions, mood swings, confused thinking, and disorganised behaviour. The condition is disturbing for patients and their family members and loved ones, and affected individuals may be at increased risk of harming themselves or their offspring. The features of PP indicate a substantial biological basis to its pathogenesis, although currently little is known about possible risk factors. Based on recent results from animal model and human studies, I propose that reduced function of the enzyme steroid sulfatase in the mother represents a unifying and physiologically plausible candidate mechanism for the neural and endocrinological disturbances seen in cases of PP.