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Post-partum psychiatric episodes may be associated with risk of developing bipolar disorder

Dec. 9, 2011

By Maria Serraino

Experiencing a psychiatric episode within 30 days after childbirth may be associated with an increased risk of developing bipolar disorder, according to a study in JAMA: Archives of General Psychiatry.

According to background information in the study, childbirth may influence how bipolar disorder develops. Previous studies show that it often takes years for a woman to be diagnosed with bipolar disorder following an initial episode taking place after childbirth.  

Researchers in Denmark believe that the psychiatric episodes triggered during and immediately following childbirth may be a marker of underlying bipolar disorder. The aim of the study was to see to what extent non-bipolar episodes occurring after childbirth develop into bipolar disorder over time.

The researchers collected data on 120,378 women born in Denmark who had a history of a first-time psychiatric disorder, not including bipolar disorder. Of these, 2,870 women had their initial psychiatric episode within the first year after having their first child.

During a 15-year followup, researchers found that 3,062 women received diagnoses of bipolar disorder, of which 132 had their initial psychiatric episode within 12 months after childbirth.

After adjusting for potential confounders, the researchers found that the rate of diagnosis shifting from non-bipolar to bipolar disorder was significantly higher in women who had their initial episode within a month of giving birth.

During followup, researchers found that approximately 14 per cent of women experienced this shift in diagnosis, compared with five per cent who were diagnosed with bipolar disorder within 31 to 365 days after childbirth, and four per cent of women who were diagnosed at other points unrelated to childbirth.

Further analysis including a 22-year followup showed that almost 19 per cent of women who had their initial episode immediately after childbirth had converted to bipolar disorder. Only six per cent who had their episode within the year after giving birth and five per cent of women with onset at other points had converted to bipolar disorder after 22 years.

According to the researchers, the study shows that there may be a link between mental illness in the early period after childbirth and underlying bipolarity. They suggest that women presenting signs of mental illness or experiencing psychiatric episodes in the immediate period after giving birth should be assessed.

The study was published online on JAMA: Archives of General Psychiatry on Dec. 5.

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  • A publication of:
  • Women's College Hospital