The occurrence of postpartum psychosis in a male patient after the birth of a child is described in this case report. An association with the phenomenon of the couvade syndrome that is observed in all cultures is made. Also, the stressful life event of pregnancy in a partner related to the onset and development of psychotic disturbance is reported. Emotional disorders which develop in women during pregnancy are compared and contrasted with the variable responses which men manifest. Signs and symptoms heralding the onset of a more pathological pregnancy response in men are offered. The authors suggest that the experience of couvade be defined as a spectrum disorder of pathological responses in males ranging from physical symptoms to psychosis as a reaction to pregnancy. This case represents the extreme end of that spectrum and suggestions are made for early identification and treatment.