Psychosis with an acute postpartum onset is much rarer and much more severe than either depression or the "blues". It has a prevalence of approximately one in 500-1,000 births, and a rapid onset within the first few days to 2-3 weeks postpartum, but the risk remains high for several months. Risk factors for postpartum psychosis include a family or personal history of psychiatric illness. Usually, women will go on to have a clinical course consistent with manic-depressive illness. However, many of these women have additional symptoms which resemble an acute organic brain syndrome ( confusion, distractibility, attention deficits, bewilderment, perplexity, or even a mild delirious state). In most cases, it severely impairs the woman's ability to function. In the extreme, the risk of suicide or infanticide are high, requiring admission (at times involuntarily) to a psychiatric hospital.