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Bipolar disorder in pregnancy and the postpartum

Di Florio, Arianna 2012. Bipolar disorder in pregnancy and the postpartum. PhD Thesis, Cardiff University.
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In the first part of my PhD I explored the link between childbirth and mood disorders in a retrospective sample of over 1500 parous women with mood disorders, recruited as part of ongoing molecular generic studies. Around two thirds of participants reported at least one episode of illness during pregnancy or the postpartum. Women with bipolar I disorder reported an approximately 50% risk of a perinatal major affective episode. Risks were lower in recurrent major depression and bipolar II disorder at around 40%. The majority of perinatal episodes occurred within 4 weeks of childbirth. Episodes of mania or psychosis had an earlier onset than those of depression. For bipolar II disorder, onsets of psychiatric episodes were more spread out over the perinatal period with more onsets in pregnancy and later in the postpartum. Moreover, childbirth did not seem to be a specific trigger for the majority of perinatal episodes of bipolar II disorder. Primiparity was associated with postpartum mania/psychosis and unipolar postpartum depression in women who experienced their first lifetime episode within 6 weeks postpartum. My findings raise the possibility of a relationship between postpartum mood disorders and other disorders influenced by parity, such as pre-eclampsia. In the second part of my PhD I designed and piloted a prospective study aimed i) to replicate and ii) to extend the findings on the retrospective sample, exploring the influence of a range of variables on the vulnerability to develop an episode of severe illness in pregnancy or the postpartum. Over 14 months of recruitment 19 women completed the follow-up assessment. To capture the clinical complexity of bipolar disorder in pregnancy and the postpartum period very large scale longitudinal studies are needed. These studies must be based on a strong collaboration with the NHS.

Item Type: Thesis (PhD)
Status: Unpublished
Schools: Medicine
MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Subjects: R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
R Medicine > RG Gynecology and obstetrics
Funders: Welsh Government Health Studentship
Date of First Compliant Deposit: 30 March 2016
Last Modified: 17 Jun 2017 07:37

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