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Abstract: With the deinstitutionalization and the evolution of antipsychotic therapeutics, the life of psychotic women has changed. If issues related to desire, questioning and sexual life are globally similar to those of general population, this sexuality is more active with multiple sexual partners, with more unwanted and unplanned pregnancies, abortion, and sexual abuses. A review of literature reveals that limited published research exists on the subjective experiences of mothers with a psychotic illness and their desire for child. Furthermore, pregnancy of mentally-ill patients raises ethical questions for professionals who look after these women because of the illness, their environment, the social conditions of life, and their isolation. The desire of pregnancy does not fully coincide with the desire of a child. Some psychotic women want to be pregnant but do not want a child. Other women cannot establish a mother–child link because the imaginary child overrides the real baby. But, on the contrary, some are very good mothers, especially in the first months of life of the baby. How must we work with this desire of pregnancy with our psychotic patients to understand and to help them, and in order to ameliorate the preventive strategies of protection for the child in case of pregnancy? [Copyright &y& Elsevier]

Abstract: Post-partum psychosis occurs in one to two cases out of 1000 deliveries. Studies in prenatal psychiatry have improved our understanding of the symptoms. If the prognosis of the acute state is generally positive, the rate of recidivism remains important due to the risk of becoming chronic. Analysis of the data allows preventative work with mothers-to-be. From a psychodynamic perspective, pregnancy is a time of important psychological conflicts, identity crisis and awakening of infantile conflicts. The understanding of those psycho-emotional mechanisms related to pregnancy and the multidimensional approach appears to be indispensable in taking care of acute psychiatric post-partum states. The case of Mrs. O, hospitalised in adult psychiatrics for a post-partum manic episode shows how those theoretical models become relevant in order to elaborate intra-psychological conflicts. The anamnesis and the history of the patient revealed the existence of several risk factors for triggering the psychosis. The identification of the patient to her maternal lineage in association with revisiting her infantile past grounded the psychosis. We worked the issue of her place within her maternal lineage, with her husband and her place as a mother. The confusion about her own identity added to the patient''s generational confusion was gradually amended and a work of separation/individuation could then be undertaken. [Copyright &y& Elsevier]