Risk of puerperal and non-puerperal recurrence of illness following bipolar affective puerperal (post-partum) psychosis.
The clinical value of information on the risk of future psychiatric illness in women who have experienced puerperal (post-partum) psychosis has been limited by inconsistencies in terminology and nosology. Here we report rates of subsequent puerperal and non-puerperal episodes, in a well characterised sample of women diagnosed with clearly defined bipolar affective puerperal psychosis (n=103). Out of 54 women having further children, 31(57%; 95% CI 44-69) experienced an additional puerperal psychotic episode, and 64 of 103 women (62%; 95% CI 52-71) experienced a non-puerperal affective episode during the follow-up period (mean duration 9 years). A history of bipolar episodes prior to the puerperal psychosis did not predict risk following subsequent pregnancies, but positive family history of mental illness predicted shorter time to non-puerperal relapse.
Robertson
Emma
E
Neuropsychiatric Genetics Unit, Department of Psychological Medicine, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, Wales, UK.
Jones
Ian
I
Haque
Sayeed
S
Holder
Roger
R
Craddock
Nick
N
D000328:Adult; D001714:Bipolar Disorder / Q000209:etiology* / Q000235:genetics; D019052:Depression, Postpartum / Q000209:etiology* / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease; D006801:Humans; D011379:Prognosis; D012008:Recurrence; D018570:Risk Assessment / Q000379:methods; D016019:Survival Analysis