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Objective: For the onset of illness and possible recurrence during the childbearing period, women with bipolar disorder (BD) are at a higher risk. The aim of this study was to evaluate the impact of clinical and psychosocial factors associated with pregnancy and the postpartum period on the course of BD. Methods: The childbearing and illness history of 72 women with BD were assessed to determine mood episodes related to the childbearing period. Data was analyzed to evaluate the risk factors (clinical, obstetric and psychosocial factors) related with mood episodes during pregnancy and the postpartum period. Results: Data of 252 pregnancies and childbirths of 72 women with BD were included in the analysis. Twenty-three (32%) women with BD reported at least one mood episode during pregnancy or within 1 month after childbirth (childbearing-related episode, CBRE). Subjects with CBREs mean age at onset of illness and mean age at the time of assessment were significantly younger than subjects with N-CBRE. A lower number of women who experienced a postpartum episode after the birth of the first child chose to have the second one. Psychosocial factors during pregnancy and the postpartum period and method of delivery did not predict the first postpartum episode. Onset of illness at an early age, experiencing episode during the first pregnancy and experiencing physical problems during pregnancy predicted a mood episode during the first postpartum period. Conclusions: Interpretation of the results of the study is limited with the retrospective nature of data collection. Within the limitations, we may suggest that psychosocial factors do not play a significant role in the genesis of CBREs in women with BD.
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- Purnine D, Frank E: Should postpartum mood disorders be given a more prominent or distinct place in DSM-IV? In Widiger et al (eds): DSM-IV Sourcebook. Washington, American Psychiatric Association, 1996, vol 2, pp 261–279.
- Marks MN, Wieck A, Checkley S, Kumar R: Contribution of psychological and social factors to psychotic and non-psychotic relapse after childbirth in women with previous histories of affective disorder. J Affect Disord 1992;29:253–264.
- Hunt N, Trevor S: Does puerperal illness distinguish a subgroup of bipolar patients? J Affect Disord 1995;34:101–107.
- Grof P, Robbins W, Alda M, Berghoefer A, Vojtechovsky M, Nillson A, Robertson C: Protective effect of pregnancy in women with lithium-responsive bipolar disorder. J Affect Disord 2000;61:31–39.
- Viguera AC, Nonacs R, Cohen LS, Tondo L, Murray A, Baldessarini RJ: Risk of recurrence of bipolar disorder in pregnant and nonpregnant women after discontinuing lithium maintenance. Am J Psychiatry 2000;157:179–184.
- Steiner M, Tam WYK: Postpartum depression in relation to other psychiatric disorders; in Miller LJ (ed): Postpartum Mood Disorders. Washington, American Psychiatric Press, 1999, pp 47–63.
- Danaci AE, Dinc G, Deveci A, Sen FS, Icelli I: Postnatal depression in Turkey: Epidemiological and cultural aspects. Soc Psychiatry Psychiatr Epidemiol 2002;37:125–129.
- Corapcioglu A, Aydemir O, Yildiz M: Reliability of Turkish version of structured clinical assessment according to DSM-IV axis I mental disorders (in Turkish). J Drug Treatment 1999;12:33–36.
- Reich T, Winokur G: Postpartum psychoses in patients with manic-depressive disease. J Nerv Ment Dis 1970;151:60–68.
- Ambelas A: Life events and mania: A special relationship? Br J Psychiatry 1987;501:235–240.
- Blehar MC, DePaulo R, Gershon ES, Reich T, Simpson SG, Nurnberger JI: Women with bipolar disorder: Findings from the NIMH genetics initiative sample. Psychopharmacol Bull 1998;34:239–243.
- Freeman MP, Smith KW, Freeman SA, McElroy SL, Kmetz GF, Wright R, Keck PE: The impact of reproductive events on the course of bipolar disorder in women. J Clin Psychiatry 2002;63:284–287.
- Kendell RE, Rennie D, Clarke JA, Dean C: The social and obstetric correlates of psychiatric admission in the puerperium. Psychol Med 1981;11:341–350.
- Freeman MP, Keck PE, McElroy SL: Postpartum depression with bipolar disorder. Am J Psychiatry 2001;158:652.
- Wisner KL, Peindl K, Hanusa BH Relationship of psychiatric illness to childbearing status: A hospital-based epidemiologic study. J Affect Disord 1993;28:39–50.
- Marks M, Wieck A, Checkley S, Kumar C: How does marriage protect women with histories of affective disorder from post-partum relapse? Br J Med Psychol 1996;69:329–342.
- Saisto T, Salmela-Aro K, Nurmi JE, Halmesmaki E: Psychosocial predictors of disappointment with delivery and puerperal depression. Acta Obstet Gynecol Scand 2001;80:39–45.
- Josefsson A, Angelsioo L, Berg G, Ekstrom CM, Gunnervik C, Nordin C, Sydsjo G: Obstetric, somatic and demographic risk factors for postpartum depressive symptoms. Obstet Gynecol 2002;99:223–228.
- Davenport YB, Adland ML: Postpartum psychoses in female and male bipolar manic-depressive patients. Am J Orthopsychiatry 1982;52:288–297.