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Mood Disorders and Parity - a Clue to the Aetiology of the Postpartum Trigger

Di Florio, A. and Jones, Lisa and Forty, L. and Gordon-Smith, Katherine and Robertson-Blackmore, E. and Heron, J. and Craddock, N. and Jones, I. (2014) Mood Disorders and Parity - a Clue to the Aetiology of the Postpartum Trigger. Journal of Affective Disorders, 154 (100). pp. 334-339. ISSN Online: 0165-0327

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Abstract

BACKGROUND: Episodes of postpartum psychosis have been associated with first pregnancies in women with bipolar I disorder. It is unclear, however, if the effect extends to episodes at other times in relation to childbirth and to women with other mood disorders such as major depression and bipolar II disorder. This primiparity effect, which is also seen in other pregnancy related conditions such as pre-eclampsia, is a potentially important clue to the aetiology of childbirth related mood episodes. METHODS: Participants were interviewed and case notes reviewed. Best-estimate diagnoses were made according to DSM-IV criteria. Data on the occurrence of episodes in pregnancy and the postpartum were available on 3345 full term deliveries from 1667 participants, 934 with bipolar I disorder (BD-I), 278 with bipolar II disorder (BD-II) and 455 with recurrent major depression (RMD). RESULTS: Onsets of psychosis/mania within 6 weeks of childbirth were overrepresented in primiparae (p=0.007) with BD-I. Although primiparity was not associated with perinatal bipolar depression, there was an association with the onset of depression within 6 weeks in women with RMD (p=0.035). Whilst women experiencing a postpartum episode were less likely to go on to have further children, this did not account for the association with primiparity. LIMITATIONS: Data were collected retrospectively. Information on pharmacological treatment was not available. CONCLUSIONS: Primiparity is associated not only with postpartum psychosis/mania in BD-I, but also with postpartum depression in RMD. Psychosocial factors and biological differences between first and subsequent pregnancies may play a role and are candidates for examination in further studies.

Item Type: Article
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Uncontrolled Keywords: women mental health, postpartum mood disorders, bipolar disorder, recurrent major depression
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Divisions: Academic Departments > Institute of Health and Society
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Copyright Info: Open Access article
Depositing User: Lisa Jones
Date Deposited: 05 Nov 2015 12:12
Last Modified: 05 Nov 2015 12:12
URI: https://eprints.worc.ac.uk/id/eprint/4031

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