Archives of Women's Mental Health

, Volume 17, Issue 2, pp 137–143 | Cite as

Mania and depression in the perinatal period among women with a history of major depressive disorders

  • Angela J. Inglis
  • Catriona L. Hippman
  • Prescilla B. Carrion
  • William G. Honer
  • Jehannine C. AustinEmail author
Original Article


Women with a history of major depressive disorder (MDD) have increased risks for postpartum depression, but less is known about postpartum mania in this population. The objectives of this study were to prospectively determine the frequency with which mania occurs in the postpartum among women who have a history of MDD and to explore temporal relationships between onset of mania/hypomania and depression. We administered the Structured Clinical Interview for DSM IV disorders (SCID) to pregnant women with a self-reported history of MDD to confirm diagnosis and exclude women with any history of mania/hypomania. Participants completed the Edinburgh Postnatal Depression Scale and Altman Self-Rating Mania Scale (ASRM) once during the pregnancy (∼26 weeks) and 1 week, 1 month, and 3 months postpartum. Among women (n = 107) with a SCID-confirmed diagnosis of MDD, 34.6 % (n = 37) experienced mania/hypomania (defined by an ASRM score of ≥6) at ≥1 time point during the postpartum, and for just over half (20/37, 54 %), onset was during the postpartum. The highest frequency of mania/hypomania (26.4 %, n = 26) was at 1 week postpartum. Women who experienced mania/hypomania at 1 week postpartum had significantly more symptoms of mania/hypomania later in the postpartum. A substantive proportion of women with a history of MDD may experience first onset of mania/hypomania symptoms in the early postpartum, others may experience first onset during pregnancy. Taken with other recent data, these findings suggest a possible rationale for screening women with a history of MDD for mania/hypomania during the early postpartum period, but issues with screening instruments are discussed.


Postpartum Depression Mania Postnatal Hypomania Women 



The authors are grateful to the participants, the physicians and staff at the BC Reproductive Mental Health Program, the volunteers who assisted with the data entry for this study, Wayne Su M.A., MSc. for the IT support, and Boris Kuzeljevic M.A. for his help with the statistical analyses.

Sources of financial support

This study was funded by the Canadian Institutes of Health Research. JA was supported by the Canada Research Chairs Program, the Michael Smith Foundation for Health Research, and BC Mental Health and Addictions Services.


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Copyright information

© Springer-Verlag Wien 2014

Authors and Affiliations

  • Angela J. Inglis
    • 1
  • Catriona L. Hippman
    • 2
    • 3
  • Prescilla B. Carrion
    • 2
  • William G. Honer
    • 2
  • Jehannine C. Austin
    • 1
    • 2
    • 4
    Email author
  1. 1.Department of Medical GeneticsUniversity of British ColumbiaVancouverCanada
  2. 2.Department of PsychiatryUniversity of British ColumbiaVancouverCanada
  3. 3.Women’s Health Research InstituteBC Women’s Hospital & Health CentreVancouverCanada
  4. 4.VancouverCanada

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