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A longitudinal study of hypomania and depression symptoms in pregnancy and the postpartum period

Authors

  • Jessica Heron,

    1. Perinatal Research Programme, Birmingham and Solihull Mental Health NHS Foundation Trust
    2. Department of Primary Care and General Practice
    3. Department of Psychiatry, University of Birmingham, Birmingham
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  • Sayeed Haque,

    1. Department of Primary Care and General Practice
    2. Department of Psychiatry, University of Birmingham, Birmingham
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  • Femi Oyebode,

    1. Perinatal Research Programme, Birmingham and Solihull Mental Health NHS Foundation Trust
    2. Department of Psychiatry, University of Birmingham, Birmingham
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  • Nick Craddock,

    1. Department of Psychiatry, University of Birmingham, Birmingham
    2. Department of Psychological Medicine, University of Cardiff, Cardiff, UK
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  • Ian Jones

    1. Department of Psychiatry, University of Birmingham, Birmingham
    2. Department of Psychological Medicine, University of Cardiff, Cardiff, UK
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  • The authors of this paper do not have any commercial associations that might pose a conflict of interest in connection with this manuscript.

Corresponding author:
Dr. Jessica Heron
Birmingham and Solihull Mental Health NHS Foundation Trust
Perinatal Research Programme
The Barberry, 25 Vincent Drive
Birmingham B15 2FG, UK
Fax: 0121 301 2351
e-mail: j.c.heron@bham.ac.uk

Abstract

Objectives:  Childbirth is a potent precipitant of severe episodes of bipolar disorder. We investigate mood longitudinally through pregnancy and the postpartum period, using the Highs Scale and the Edinburgh Postnatal Depression Scale (EPDS), to examine if the postpartum period is a time of increased risk for hypomanic symptoms in the general population.

Methods:  A total of 446 women were recruited at 12 weeks of pregnancy from the Birmingham Women’s Hospital and four midwife-led community clinics. Women completed the Highs Scale and the Edinburgh Postnatal Depression Scale at 12 weeks of pregnancy, one week postpartum, and eight weeks postpartum.

Results:  Cases of probable depression, as defined by an EPDS score of 13 or greater, did not significantly increase from pregnancy to the postpartum period. The prevalence of ‘the highs’ was eightfold higher in the postpartum week than during pregnancy.

Conclusions:  Consistent with the increased rates of severe manic illness following childbirth, we find that more minor hypomanic states are also increased. We consider the clinical relevance of postpartum hypomanic symptoms and the implications of these findings for research into postpartum-onset mood symptoms.

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