TY - JOUR
T1 - Identifying features of bipolarity in patients with first-episode postpartum depression
T2 - Findings from the international BRIDGE study
AU - Azorin, Jean Michel
AU - Angst, Jules
AU - Gamma, Alex
AU - Bowden, Charles L.
AU - Perugi, Giulio
AU - Vieta, Eduard
AU - Young, Allan
N1 - Funding Information:
CB has acted as consultant for Pfizer, Bristol-Myers-Squibb, Repligen, and Merck. He has served on an advisory board of Sanofi-Aventis. He has received grant support from NIMH, Johnson and Johnson, and Bristol-Myers-Squibb.
Funding Information:
This study was supported by an unrestricted grant from Sanofi-Aventis, CNS Department, Paris, France. Sanofi-Aventis had no further role in study design, in the collection and analysis of data, in the writing of the report, and in the decision to submit the paper for publication.
PY - 2012/2
Y1 - 2012/2
N2 - Objectives: The aims of this study were to assess rates of bipolar spectrum disorders in women experiencing their first episode of postpartum depression, and to find out features indicative of bipolarity in these patients. Methods: As part of the international BRIDGE study designed to detect hypo/mania in patients with a major depressive episode, 52 (5.85%) were found to experience a first episode of postpartum (FEPP) depression, whereas 833 (94.13%) had a first episode of nonpostpartum (FENPP) depression. Hypo/mania was assessed using varying definitions of bipolarity, and the two groups compared on sociodemographic, family history and clinical characteristics. Results: Compared to FENPP depressive patients, women with FEPP depression had higher rates of bipolar disorders, with more hypo/mania in first degree relatives. Psychotic symptoms, atypical features, mixed depression, younger age at onset, high number of prior episodes, episodes of short duration, switches on antidepressants, seasonality of mood episodes as well as mood episodes with free intervals were found to be more frequent in FEPP depressives. Limitations: The following are the limitations of this study: centres not randomly selected, recall bias, cross-sectional design, and limited training of participating psychiatrists. Conclusions: This study confirms, in women experiencing a first depressive episode, high rates (15 to 50%) of bipolar disorders during the postpartum period and is the first to systematically assess and demonstrate the higher prevalence of identifying features of bipolarity in FEPP versus FENPP depression. Early recognition of bipolarity in these patients may help prevent the harmful consequences of this illness.
AB - Objectives: The aims of this study were to assess rates of bipolar spectrum disorders in women experiencing their first episode of postpartum depression, and to find out features indicative of bipolarity in these patients. Methods: As part of the international BRIDGE study designed to detect hypo/mania in patients with a major depressive episode, 52 (5.85%) were found to experience a first episode of postpartum (FEPP) depression, whereas 833 (94.13%) had a first episode of nonpostpartum (FENPP) depression. Hypo/mania was assessed using varying definitions of bipolarity, and the two groups compared on sociodemographic, family history and clinical characteristics. Results: Compared to FENPP depressive patients, women with FEPP depression had higher rates of bipolar disorders, with more hypo/mania in first degree relatives. Psychotic symptoms, atypical features, mixed depression, younger age at onset, high number of prior episodes, episodes of short duration, switches on antidepressants, seasonality of mood episodes as well as mood episodes with free intervals were found to be more frequent in FEPP depressives. Limitations: The following are the limitations of this study: centres not randomly selected, recall bias, cross-sectional design, and limited training of participating psychiatrists. Conclusions: This study confirms, in women experiencing a first depressive episode, high rates (15 to 50%) of bipolar disorders during the postpartum period and is the first to systematically assess and demonstrate the higher prevalence of identifying features of bipolarity in FEPP versus FENPP depression. Early recognition of bipolarity in these patients may help prevent the harmful consequences of this illness.
KW - Bipolar disorder
KW - Bipolarity
KW - First episode
KW - Postpartum depression
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U2 - 10.1016/j.jad.2011.10.003
DO - 10.1016/j.jad.2011.10.003
M3 - Article
C2 - 22044629
AN - SCOPUS:84857361665
VL - 136
SP - 710
EP - 715
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
SN - 0165-0327
IS - 3
ER -