Bipolar disorder, miscarriage, and termination

Authors

  • Arianna Di Florio,

    1. National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff
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  • Lisa Jones,

    1. Department of Psychiatry, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK
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  • Liz Forty,

    1. National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff
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  • Katherine Gordon-Smith,

    1. National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff
    2. Department of Psychiatry, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK
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  • Nick Craddock,

    1. National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff
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  • Ian Jones

    Corresponding author
    1. National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff
    • Corresponding author:

      Professor Ian Jones

      National Centre for Mental Health

      MRC Centre for Neuropsychiatric Genetics and Genomics

      Cardiff University

      Hadyn Ellis Building, Maindy Road

      Cathays

      Cardiff CF24 4HQ

      UK

      E-mail: jonesir1@cf.ac.uk

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Abstract

Objectives

To compare rates of bipolar episodes following miscarriage and termination with those occurring in the postpartum period.

Methods

Information in relation to pregnancy and childbirth was gathered retrospectively for 1,283 women with broadly defined bipolar disorder by interview and case-notes review.

Results

Rates of mania or affective psychosis were significantly higher after full-term delivery than after termination (p < 0.001) or miscarriage (p < 0.001). Rates of non-psychotic major depression were similar following full-term deliveries, miscarriages (p = 0.362), and terminations (p = 0.301).

Conclusions

While women with bipolar disorder and their clinicians should be aware of the possible onset of depression in the weeks following miscarriage or termination, episodes of mania or affective psychosis are less common in comparison with the high rates observed in the postpartum period.

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