Is the perimenopause a time of increased risk of recurrence in women with a history of bipolar affective postpartum psychosis? A case series
First Online: 18 February 2008 Received: 06 December 2006 Accepted: 07 November 2007 DOI:
Cite this article as: Robertson Blackmore, E., Craddock, N., Walters, J. et al. Arch Womens Ment Health (2008) 11: 75. doi:10.1007/s00737-008-0215-2 Summary
There is increasing awareness of the influence of female reproductive life events on the course of bipolar disorder. Here, we describe the case histories of 5 women diagnosed with postpartum psychosis who subsequently experienced major mood disorders in relation to the perimenopause. This case series suggests that (a) the perimenopause may be a time of increased risk for women who experienced postpartum bipolar episodes and (b) periods of hormonal change represent a major trigger for bipolar episodes in some women.
Keywords: Bipolar disorder; menopause; relapse; postpartum psychosis; perimenopause
Correspondence: Ian Jones Ph.D., MRCPsych, Department of Psychological Medicine, Henry Wellcome Building for Biomedical Research in Wales, Cardiff University, Heath Park, Cardiff CF14 4XN, U.K.
References APA 1994Diagnostic and statistical manual of mental disorders3 American Psychiatric Association Washington, DC Blehar, MC, DePaulo, JJ, Gershon, ES, Reich, T, Simpson, SG, Nurnberger, JIJ 1998 Women with bipolar disorder: findings from the NIMH genetics initiative sample Psychopharmacol Bull 34 239 243 PubMed Bloch, M, Schmidt, PJ, Danaceau, M, Murphy, J, Nieman, L, Rubinow, DR 2000 Effects of gonadal steroids in women with a history of postpartum depression Am J Psychiatry 157 924 930 PubMed CrossRef Freeman, MP, Smith, KW, Freeman, SA, McElroy, SL, Kmetz, GF, Wright, R, Keck, PE, Jr 2002 The impact of reproductive events on the course of bipolar disorder in women J Clin Psychiatry 63 284 287 PubMed Harlow, BL, Cohen, LS, Otto, MW, Spiegelman, D, Cramer, DW 1999 Prevalence and predictors of depressive symptoms in older premenopausal women: the Harvard study of moods and cycles Arch Gen Psychiatry 56 418 424 PubMed CrossRef Harlow, BL, Wise, LA, Otto, MW, Soares, CN, Cohen, LS 2003 Depression and its influence on reproductive endocrine and menstrual cycle markers associated with perimenopause: the Harvard study of moods and cycles Arch Gen Psychiatry 60 29 36 PubMed CrossRef Jones, I, Craddock, N 2005 Bipolar disorder and childbirth: the importance of recognising risk Br J Psychiatry 186 453 454 PubMed CrossRef Jones, I, Lendon, C, Coyle, N, Robertson, E, Brockington, I, Craddock, N 2001 Molecular genetic approaches to puerperal psychosis Prog Brain Res 133 321 331 PubMed CrossRef Robertson, E, Jones, I, Benjamin, J, Murdoch, C, Pelios, G, Brockington, I, Craddock, N 2000 Approaches to the ascertainment, recruitment and clinical assessment of women with puerperal psychosis Arch Womens Ment Health 3 59 64 CrossRef Rubinow, DR, Schmidt, PJ 1995 The treatment of premenstrual syndrome – forward into the past N Engl J Med 332 1574 1575 PubMed CrossRef Soares, CN, Cohen, LS, Otto, MW, Harlow, BL 2001 Characteristics of women with premenstrual dysphoric disorder (PMDD) who did or did not report history of depression: a preliminary report from the Harvard study of moods and cycles J Womens Health Gend Based Med 10 873 878 PubMed CrossRef Wing, JK, Babor, T, Brugha, T, Burke, J 1990 SCAN: schedules for clinical assessment in neuropsychiatry Arch Gen Psychiatry 47 589 593 PubMed