[Severe postpartum depression and psychosis--when is electroconvulsive therapy the treatment of choice?].

Numerous reports indicate that severe depression responds well to electroconvulsive therapy. Four cases of severe postpartum depression are presented, three of which had psychotic features. All patients were successfully treated with electro-convulsive therapy. This form of therapy might be the treatment of choice for severe postpartum depressions and for all cases of postpartum psychosis where pharmacological therapy does not give a rapid restoration of the patient's function. A limited number of studies are published on this topic. Guidelines for treatment of these disorders are lacking, resulting in variable treatment practice.