Psicosis posparto

Psicosis posparto is the clinical explanation advanced for Alice Espanet’s actions and the hinge on which the criminal case turns. In the novel, it is not presented as an uncontested diagnosis: expert testimony describes a grave loss of contact with reality, but the timing of Alice’s symptoms and the evidence supporting the diagnosis remain disputed. That uncertainty gives the condition both medical and legal force, making it a way to interpret her conduct and a battleground over whether she could be held criminally responsible.

Clinical distinction and progression

At Alice’s trial, Dr. Leclercq, the Belgian psychiatrist who had treated her throughout the year, explains a progression from ordinary postnatal distress to illness. He distinguishes the Baby blues, which he says affect about eighty percent of mothers after birth, from a more persistent condition. The blues are associated with the immediate hormonal imbalance of the postpartum period and worsened by exhaustion and sleep deprivation; sadness, unexplained crying, anxiety, guilt, and feeling overwhelmed may accompany them. They generally resolve within weeks. If difficulties persist or worsen after two or three months, he argues, the mother needs a fuller assessment.

That assessment, in Dr. Leclercq’s account, should consider the mother’s history and social circumstances and include tests to rule out physical causes. Depresión posparto is more serious: treatment may combine psychiatric medication and psychotherapy, and recovery can take years. In some cases the condition may develop into Psicosis posparto, which he describes as involving a real risk that the mother will harm herself or the baby. Because of that danger, he says, immediate hospital admission and round-the-clock care are often required. His explanation stresses that these states are not interchangeable stages of ordinary tiredness or sadness, but conditions with distinct severity and consequences.

The testimony about Alice

Dr. Leclercq’s central distinction concerns the character of a harmful thought. A mother with depression might think about injuring her child, but the impulse would conflict with her values and produce guilt and shame. In a psychotic state, by contrast, the thought may not disturb the mother; she may experience it as something she ought to do. He calls this a loss of contact with reality and considers it possible for such an impulse to be acted upon during an acute phase. Asked why he believed Alice had been in that phase, he points to her account: she felt the impulse and, rather than resisting it, followed it.

The diagnosis therefore rests substantially on interpretation of Alice’s conduct and her own account, rather than on an observable test establishing the condition. When the prosecutor presses him on that basis, Dr. Leclercq accepts that these are the foundations of his diagnosis. The account makes the patient’s narrative clinically consequential: what Alice says happened becomes evidence not only about the acts but about her mental state when she committed them. The jury appears receptive to the explanation, with most members nodding after the exchange.

The evidence also reaches back beyond the period after the birth. Dr. Leclercq says Alice reported past symptoms of bulimia and depression, although the prosecutor emphasizes that these had never received an official diagnosis. The doctor maintains that the reported history is consistent with his recent evaluations. This leaves a distinction between symptoms in Alice’s account and conditions formally established at the time; the trial does not erase that evidentiary gap even as the defense uses her history to support its case.

Disputed timing and competing accounts

The court-appointed psychiatrists who examined Alice shortly after the events challenge Dr. Leclercq’s conclusion. They report finding no sign of Psicosis posparto and not even depression. In their view, the condition occurs in the weeks immediately after childbirth, whereas Alice’s actions took place ten months after the birth. Their timing argument makes the interval itself a source of suspicion: the defense must explain why a condition commonly associated with the immediate postpartum period would account for events much later.

The experts reinforce their position by recounting other infanticide cases in which psychosis had been certified, including incidents involving very young babies. Carmela Basaguren objects that these examples do not establish what happened to Alice. Her challenge exposes a tension in expert testimony: comparison can illustrate a clinical pattern, but it can also shift attention from the particular patient to other cases with different timelines. The opposing accounts thus leave the jury to weigh a treating psychiatrist’s longitudinal relationship with Alice and her own reported experience against examinations that found no psychosis and a sharply different view of when it occurs.

Motherhood, responsibility, and law

The book places this dispute alongside the social difficulty of admitting that motherhood has not brought happiness. Dr. Leclercq says that very few mothers seek help for Depresión posparto—about fifteen percent, according to the research he cites—and describes the illness as taboo. A mother may find it difficult to acknowledge to herself, her family, or medical authority that she feels sunk rather than fulfilled. This context does not establish Alice’s diagnosis, but it helps explain why the absence of earlier treatment cannot by itself settle whether she was ill.

The defense translates the diagnosis into a question of criminal responsibility. Carmela Basaguren invokes Article 20.1 of the Spanish Criminal Code, which exempts a person from criminal responsibility when a mental disorder prevents them, at the time of the offense, from understanding its unlawfulness or acting in accordance with that understanding. In her closing argument she recalls the defense’s account of Alice’s depression, psychosis, hallucinations, paranoia, sudden violent reactions, and loss of control. These are presented as circumstances relevant to responsibility, not as a medical finding that removes the horror of what happened or the loss suffered by the children.

The verdict’s consequences make that distinction concrete. The judge follows the jury’s decision by replacing imprisonment with psychiatric treatment, but orders outpatient care rather than admission to a psychiatric hospital. The book presents this outcome as part of a wider debate about how the criminal system handles mental illness: whether treatment is available, who supervises it, and how judgments balance public protection, punishment, and the circumstances of an individual case. Psicosis posparto remains the contested explanation at the center of that debate—not a simple synonym for maternal distress, and not an uncontested answer to the question of responsibility.