Screening for Bipolar Disorder in Women With Postpartum Depression

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A correct diagnosis of bipolar disorder postpartum could improve outcomes for the mother, reduce risk for psychiatric hospitalization, and provide a safer environment for the family.
A correct diagnosis of bipolar disorder postpartum could improve outcomes for the mother, reduce risk for psychiatric hospitalization, and provide a safer environment for the family.

Bipolar postpartum depression might often be misdiagnosed as major depressive disorder, according to research published in Medical Hypotheses.1

Many women are diagnosed with postpartum depression for a depressive episode within a year after childbirth. This depressive episode might actually be a component of bipolar disorder rather than major depressive disorder. One study found that 20.5% of women diagnosed with postpartum depression also had hypomania symptoms shortly after childbirth.2 Another study completed by this study's lead investigator found that 54% of women with suspected postpartum depression actually met criteria for bipolar disorder.3 Munk-Olsen and colleagues found that 14% of women who sought treatment for a psychiatric concern the first month after childbirth were diagnosed with bipolar disorder within the next 15 years.4

Screening for bipolar disorder after childbirth has its own set of challenges; excitement over the new baby could mask hypomania, and a current depressive state could alter accurate descriptions of previous hypomania. A correct diagnosis of bipolar disorder postpartum could improve outcomes for the mother, reduce risk for psychiatric hospitalization, and provide a safer environment for the family.

Future research needs to analyze postpartum hypomania, the relationship childbirth might play in triggering bipolar disorder, and effective methods of diagnosing bipolar disorder postpartum.

Researchers conclude that it is important to screen women with postpartum depression for a bipolar disorder in order to obtain an accurate diagnosis, which would lead to proper management and disorder specific treatment.

Reference

  1. Sharma V, Al-Farayedhi M, Doobay M, Baczynski C. Should all women with postpartum depression be screened for bipolar disorder? Med Hypotheses. 2018; 118:26-28. doi: 10.1016/j.mehy.2018.06.016
  2. Hannah P, Cody D, Glover V, Adams D, Kumar R, Sandler M. The tyramine test is not a marker for postnatal depression: early postpartum euphoria may beJ Psychosom Obstet Gynecol. 1993; 14(4):295–304
  3. Sharma V, Khan M, Corpse C, et al. Missed bipolarity and psychiatric comorbidity in women with postpartum depressionBipolar Disord. 2008; 10(6):742–7. doi: 10.1111/j.1399-5618.2008.00606.x
  4. Munk-Olsen T, Laursen TM, Meltzer-Brody S, et al. Psychiatric disorders with postpartum onset: possible early manifestation of bipolar affective disordersArch Gen Psychiatry. 2011; 69(4):428–34. doi: 10.1001/archgenpsychiatry.2011.157
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