Perinatal mood episodes in fathers with bipolar disorder

Highlights

• First study examining perinatal mood episodes (PMEs) in fathers with bipolar disorder (BD)

• Over one-third of fathers with BD reported experiencing a PME.

• Differences observed in rate, timing and onset of PMEs between fathers and mothers with BD

• Fathers most commonly reported PMEs during pregnancy and after 6 weeks postpartum.

• Preponderance of high/mixed/psychotic PMEs seen in mothers not observed in fathers

Background
No published research into perinatal mood episodes (PMEs) among fathers with bipolar disorder (BD) exists despite the perinatal period being a time of high-risk for mothers with BD. This study aims to determine the frequency, polarity and timing of onset of PMEs in a large sample of fathers with BD.

Method
Data on PMEs were collected from 196 fathers with a DSM diagnosis of BD. Participants were asked via a self-report questionnaire about the occurrence, type and timing of PMEs during pregnancy up to 6 months postpartum. Findings were compared to data on PMEs collected from mothers with BD using the same method (n = 597).

Results
36.2 % of fathers with BD reported experiencing PMEs, with similar proportions reporting depression and high/mixed mood/psychosis (17 % and 18.6 % respectively). Episode onset was most common during pregnancy (41.9 %) (compared to within 1-week, 1 to 6-weeks, and 6 weeks to 6 months postpartum respectively). Rate of PME in mothers was higher (73.0 %), with high/mixed mood/psychosis more common than depression (44.5 % v 28.1 %), and most common onset within 1-week postpartum (41.3 %).

Limitations
Rates of paternal PMEs in BD in this study are likely inflated due to methodology.

Conclusions
PMEs were commonly reported among fathers with BD. Fathers do not undergo the same biological changes as mothers during the perinatal period which may partly explain the different patterns observed in the type and timings of PMEs between fathers and mothers with BD. Prospective longitudinal studies are needed to explore specific potential risk factors.