title: Screening mixed depression and bipolarity in the postpartum period at a primary health care center.
abstract: Mixed depression is a clinical condition accompanied by the symptoms of (hypo)mania and is considered to be a predictor for bipolar disorder. Compared to pure major depression, mixed depression is worse in progress. There are limited data on the prevalence of mixed depression since it is a relatively new entity. Therefore, the present study aimed to investigate the prevalence of mixed depression during the postpartum period which is risky for mood disorders.
  
  
  
  The study included 63 postpartum women. The participants were administered Beck Depression Scale, Edinburgh Postnatal Depression Scale (EPDS), Mood Disorders Questionnaire (MDQ), and Modified Hypomania Symptom Checklist-32 (mHCL-32).
  
  
  
  The MDQ scores of the women with expected depression according to the EPDS cut-off scores, were significantly higher than the women with lower EPDS scores (t=-4.968; p<0.001). The modified hypomania scores were significantly higher in the women with higher depression scores compared to the women under EPDS cut-off scores (t=-4.713; p<0.001). According to the EPDS and BDS results, 27 (42.9%) and 14 (22.2%) women needed additional clinical examination for depression, respectively. In addition, 3 (4.8%) women require additional clinical examination for bipolar disorder. The scores for the first item of MDQ were above the cut-off value in 11 (17.5%) women. According to the mHCL-32 results, 50 (79.4%) women had at least 1 symptom, 45 (71.4%) women had at least 3 symptoms, and 43 (68.3%) women had at least 5 symptoms of mixed depression.
  
  
  
  Postpartum mixed depression should be promptly diagnosed by using appropriate diagnostic tools, particularly by primary health care physicians. Patients with mixed depression should be closely monitored to avoid manic switch.
authors.affiliation: 11. Family Health Center, Batman,Turkey.
authors.forename: Sercan Bulut
authors.initials: SB
authors.lastname: Çelik
authors.affiliation: Department of Family Medicine, Dicle University Medical School, Diyarbakır, Turkey.
authors.forename: Gamze Erten
authors.initials: GE
authors.lastname: Bucaktepe
authors.affiliation: Department of Family Medicine, Canakkale Onsekiz Mart University Medical School, Canakkale, Turkey.
authors.forename: Ayşegül
authors.initials: A
authors.lastname: Uludağ
authors.affiliation: 5. Family Health Center, Batman, Turkey.
authors.forename: İbrahim Umud
authors.initials: İU
authors.lastname: Bulut
authors.affiliation: Kayapınar Peyas, Family Health Center, Diyarbakır, Turkey.
authors.forename: Özgür
authors.initials: Ö
authors.lastname: Erdem
authors.affiliation: Department of Psychiatry, Canakkale Onsekiz Mart University Medical School, Canakkale, Turkey. Electronic address: kursataltinbas@gmail.com.
authors.forename: Kürşat
authors.initials: K
authors.lastname: Altınbaş
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D019052:Depression, Postpartum / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult