Which of the following statements best reflects our current understanding of peripartum-onset mood disorders?
The answer is C. Half of peripartum mood episodes begin prior to delivery so vigilant monitoring of pregnant women is critical. In DSM-V, the postpartum specifier from DSM-IV was changed to peripartum-onset specifier; A is incorrect because this specifier requires that an episode begin during pregnancy or within 4 weeks of delivery (to best capture the effect of hormonal fluctuations). B and D are incorrect because postpartum psychosis has a 30-50% recurrence rate with each subsequent delivery and is more common in women with a personal or family history of bipolar disorder.