The Experts below are selected from a list of 1455 Experts worldwide ranked by ideXlab platform
Veerle Bergink - One of the best experts on this subject based on the ideXlab platform.
-
Functional Recovery After Postpartum Psychosis: A Prospective Longitudinal Study
The Journal of clinical psychiatry, 2016Co-Authors: Karin M. Burgerhout, Steven A. Kushner, Mijke P. Lambregtse-van Den Berg, Astrid M. Kamperman, Sabine J. Roza, Kathelijne M. Koorengevel, Witte J.g. Hoogendijk, Veerle BerginkAbstract:__Objective:__ Postpartum Psychosis is an acute and severe mood disorder. Although the prognosis is generally good, Postpartum Psychosis is a highly stressful life-event presumed to have a major impact on functioning and well-being beyond the acute stage of the illness. We studied functional recovery, including psychosocial functioning and the presence of psychological distress, in patients with a recent diagnosis of Postpartum Psychosis. __Methods:__ Seventy-eight patients with Postpartum Psychosis consecutively admitted for inpatient hospitalization between 2005 and 2011 were assessed 9 months Postpartum. Included were patients with DSM-IV-TR diagnoses of psychotic disorder not otherwise specified, brief psychotic disorder, or mood disorder with psychotic features, each requiring the additional specifier “with Postpartum onset.” Functioning was assessed in 4 domains by the Longitudinal Interval Follow-up Evaluation–Range of Impaired Functioning Tool (LIFE-RIFT). Symptomatology was measured by the Brief Symptom Inventory and compared to a matched population-based cohort. __Results:__ Nine months Postpartum, 74% (58/78) of women with Postpartum Psychosis reported good functioning on the domains of work, interpersonal relations, recreation, and global satisfaction. Moreover, 88% (69/78) of patients with Postpartum Psychosis had resumed their premorbid employment and household responsibilities. Compared to the general population, patients with Postpartum Psychosis reported a higher burden of depression and anxiety (effect sizes r ≤ 0.14). Patients who had a relapse episode (18%) experienced considerable functional impairments across several domains. __Conclusions:__ Nine months Postpartum, the majority of patients with Postpartum Psychosis reported good functional recovery. Our relatively improved functional outcomes compared to nonPostpartum onset could be attributed to the Postpartum onset and/or more favorable risk factor profile.
-
Postpartum Psychosis madness mania and melancholia in motherhood
American Journal of Psychiatry, 2016Co-Authors: Veerle Bergink, Natalie L Rasgon, Katherine L. WisnerAbstract:Objective:Psychosis or mania after childbirth is a psychiatric emergency with risk for suicide and infanticide.Method:The authors reviewed the epidemiologic and genetic research and physiological Postpartum triggers (endocrine, immunological, circadian) of Psychosis. They also summarized all systematic reviews and synthesized the sparse clinical studies to provide diagnostic recommendations, treatment options, and strategies for prevention.Results:The incidence of first-lifetime onset Postpartum Psychosis/mania from population-based register studies of psychiatric admissions varies from 0.25 to 0.6 per 1,000 births. After an incipient episode, 20%−50% of women have isolated Postpartum Psychosis. The remaining women have episodes outside the perinatal period, usually within the bipolar spectrum. Presumably, the mechanism of onset is related to physiological changes after birth (e.g., hormonal, immunological, circadian), which precipitate disease in genetically vulnerable women. Some women have treatable ca...
-
The birth of a psychiatric orphan disorder: Postpartum Psychosis
The Lancet Psychiatry, 2016Co-Authors: Arianna Di Florio, Trinne Munk-olsen, Veerle BerginkAbstract:Feb 29 is officially marked as Rare Disease Day. Hitherto, more than 5800 rare diseases have been officially recognised, but none of these is an adult psychiatric disorder. In this leap year (2016), Postpartum Psychosis is included, for the first time, in the list curated by Orphanet, the reference portal for information on rare diseases.
-
risk of Postpartum relapse in bipolar disorder and Postpartum Psychosis a systematic review and meta analysis
American Journal of Psychiatry, 2015Co-Authors: Richard Wesseloo, Steven A. Kushner, Victor J.m. Pop, Astrid M. Kamperman, Trine Munkolsen, Veerle BerginkAbstract:Objective:Women with a history of bipolar disorder, Postpartum Psychosis, or both are at high risk for Postpartum relapse. The aim of this meta-analysis was to estimate the risk of Postpartum relapse in these three patient groups.Method:A systematic literature search was conducted in all public medical electronic databases, adhering to the PRISMA guidelines. Studies were included if they reported Postpartum relapse in patients diagnosed with bipolar disorder and/or a history of Postpartum Psychosis or mania according to DSM or ICD criteria or the Research Diagnostic Criteria.Results:Thirty-seven articles describing 5,700 deliveries in 4,023 patients were included in the quantitative analyses. The overall Postpartum relapse risk was 35% (95% CI=29, 41). Patients with bipolar disorder were significantly less likely to experience severe episodes Postpartum (17%, 95% CI=13, 21) than patients with a history of Postpartum Psychosis (29%, 95% CI=20, 41). Insufficient information was available to determine relaps...
-
Autoimmune Encephalitis in Postpartum Psychosis
The American journal of psychiatry, 2015Co-Authors: Veerle Bergink, Thaís Armangue, Maarten J. Titulaer, Sander Markx, Josep Dalmau, Steven A. KushnerAbstract:Objective:Significant immunological alterations have been observed in women with first-onset affective Psychosis during the Postpartum period. Recent studies have highlighted the possibility that a subset of patients with first-onset severe psychiatric episodes might suffer from undiagnosed autoimmune encephalitis. Therefore, the authors performed a three-step immunohistochemistry-based screening for CNS autoantibodies in a large cohort of patients with Postpartum Psychosis and matched Postpartum comparison subjects.Method:Ninety-six consecutive patients with Postpartum Psychosis and 64 healthy Postpartum women were included. Screening for antibodies in patient serum was performed using immunohistochemistry. Samples showing any staining were further examined by immunocytochemistry using live hippocampal neurons and cell-based assays to test for anti-N-methyl-d-aspartate (NMDA) receptor antibodies. Cell-based assays for all other known CNS antigens were performed in those samples with immunocytochemistry l...
K. Sundquist - One of the best experts on this subject based on the ideXlab platform.
-
High lifelong relapse rate of psychiatric disorders among women with Postpartum Psychosis
Nordic journal of psychiatry, 2012Co-Authors: A. Nager, L.-m. Johansson, Robert Szulkin, Sven-erik Johansson, K. SundquistAbstract:Nager A, Szulkin R, Johansson S-E, Johansson L-M, Sundquist K. High lifelong relapse rate of psychiatric disorders among women with Postpartum Psychosis. Nord J Psychiatry 2013;67:53-58. Background: The relapse rate for psychiatric disorders after Postpartum Psychosis is high. Apart from subsequent puerperal periods, previous studies have not examined when relapses in psychiatric disorders occur. In addition, little is known about the impact of certain individual factors on the risk of non-puerperal readmission among women with previous Postpartum Psychosis. Aims: The first aim was to examine the association between non-puerperal readmission due to psychiatric disorders and years of follow-up (in total, 30 years) in women with Postpartum Psychosis. The second aim was to examine the impact of age, type of Psychosis, previous hospitalization for psychiatric disorders and level of education on the risk of non-puerperal readmission due to psychiatric disorders. Methods: All Swedish women aged 20-44 with Postpartum Psychosis (n = 3140) were followed between 1975 and 2004 for non-puerperal readmission due to psychiatric disorders. A Cox frailty regression model was used to estimate hazard ratios for non-puerperal readmission. Results: The risk of non-puerperal readmission, although gradually decreasing with time, remained high many years after the Postpartum Psychosis. The risk of non-puerperal readmission was significantly higher among women with schizophrenia, lower levels of education and previous psychiatric hospitalization. Conclusions: Postpartum Psychosis is often part of a lifelong recurrent psychiatric disorder. Women with schizophrenia, lower levels of education and hospitalization due to a psychiatric disorder prior to Postpartum Psychosis have a higher risk of non-puerperal readmission. Clinical implications: The findings constitute important knowledge for all healthcare workers encountering women with a previous Postpartum Psychosis. (Less)
-
Obstetric complications and Postpartum Psychosis: a follow-up study of 1.1 million first-time mothers between 1975 and 2003 in Sweden.
Acta psychiatrica Scandinavica, 2007Co-Authors: A. Nager, K. Sundquist, V. Ramírez-león, L. M. JohanssonAbstract:Objective: The severity of Postpartum Psychosis calls for further research on the association between obstetric variables and this psychiatric disorder. Method: A total of 1 133 368 Swedish first-time mothers were included during a 29-year period yielding 1413 hospitalized cases of Postpartum Psychosis. Several obstetric variables were analysed separately after adjustment for possible confounders. Results: Respiratory disorder in the neonate, severe birth asphyxia, preterm birth, caesarean section, perinatal death and SGA infant were associated with an increased risk of Postpartum Psychosis. After adjustment for previous hospitalization for psychiatric disorder only preterm birth and acute caesarean section remained significant risk factors for Postpartum Psychosis (relative risks were 1.20 and 1.31 respectively). The relative risk of Postpartum Psychosis among first-time mothers with previous hospitalization for psychiatric disorder was increased more than 100-fold. Conclusion: Careful clinical risk assessments of Postpartum Psychosis are crucial among women with a history of psychiatric disorder whereas obstetric variables have a minor importance.
-
Neighborhood socioeconomic environment and risk of Postpartum Psychosis
Archives of Women's Mental Health, 2006Co-Authors: A. Nager, L.-m. Johansson, K. SundquistAbstract:Objective: To examine the hypothesized association between the neighborhood socioeconomic environment and Postpartum Psychosis, after adjustment for individual sociodemographic characteristics. Method: All Swedish women aged 20–44 years who became first-time mothers from 1 January 1986 to 30 September 1998 (N = 485,199) were followed for first hospital admissions due to Postpartum Psychosis. Neighborhood income was divided into three groups according to the proportions of individuals with low income in the neighborhood. Cox regression was used to estimate hazard ratios for Postpartum Psychosis. Results: Women living in the poorest neighborhoods exhibited a significantly higher risk of first hospital admissions due to Postpartum Psychosis than women living in the richest neighborhoods, HR = 1.49 (95% CI = 1.15–2.91, p = 0.002). Conclusion: Decision makers and health care workers should be aware that living in a poor neighborhood socioeconomic environment might contribute to the development of Postpartum Psychosis.
-
Neighborhood socioeconomic environment and risk of Postpartum Psychosis
Archives of women's mental health, 2005Co-Authors: A. Nager, L.-m. Johansson, K. SundquistAbstract:Objective: To examine the hypothesized association between the neighborhood socioeconomic environment and Postpartum Psychosis, after adjustment for individual sociodemographic characteristics.
-
are sociodemographic factors and year of delivery associated with hospital admission for Postpartum Psychosis a study of 500 000 first time mothers
Acta Psychiatrica Scandinavica, 2005Co-Authors: A. Nager, L.-m. Johansson, K. SundquistAbstract:Objective: To examine the association between first hospital admissions due to Postpartum Psychosis and the explanatory variables age, educational level, marital status and year of delivery. Method: All Swedish first-time mothers (n = 502 767) were included during a 12-year period and followed for first hospital admissions due to Postpartum Psychosis. Cox regression was used to estimate hazard ratios, adjusted for the explanatory variables. Results: Older age and being a single mother implied an increased risk of first hospital admissions due to Postpartum Psychosis among first-time mothers. Educational level was not associated with first hospital admissions due to Postpartum Psychosis. During the 1990s, when a reduction in psychiatric beds occurred, first hospital admissions due to Postpartum Psychosis decreased significantly. Conclusion: Certain sociodemographic factors are associated with first hospital admissions due to Postpartum Psychosis. Untreated Postpartum Psychosis due to fewer psychiatric beds could have hazardous effects on mothers and their children.
Ian Jones - One of the best experts on this subject based on the ideXlab platform.
-
Phenomenology, Epidemiology and Aetiology of Postpartum Psychosis: A Review.
Brain sciences, 2021Co-Authors: Amy Perry, Katherine Gordon-smith, Lisa Jones, Ian JonesAbstract:Postpartum psychoses are a severe form of postnatal mood disorders, affecting 1–2 in every 1000 deliveries. These episodes typically present as acute mania or depression with Psychosis within the first few weeks of childbirth, which, as life-threatening psychiatric emergencies, can have a significant adverse impact on the mother, baby and wider family. The nosological status of Postpartum Psychosis remains contentious; however, evidence indicates most episodes to be manifestations of bipolar disorder and a vulnerability to a puerperal trigger. While childbirth appears to be a potent trigger of severe mood disorders, the precise mechanisms by which Postpartum Psychosis occurs are poorly understood. This review examines the current evidence with respect to potential aetiology and childbirth-related triggers of Postpartum Psychosis. Findings to date have implicated neurobiological factors, such as hormones, immunological dysregulation, circadian rhythm disruption and genetics, to be important in the pathogenesis of this disorder. Prediction models, informed by prospective cohort studies of high-risk women, are required to identify those at greatest risk of Postpartum Psychosis.
-
Postpartum Psychosis in bipolar disorder: no evidence of association with personality traits, cognitive style or affective temperaments.
BMC psychiatry, 2019Co-Authors: Amy Perry, Ian Jones, Katherine Gordon-smith, A. Di Florio, Nicholas John Craddock, I. Webb, E. Fone, Lisa JonesAbstract:Bipolar disorder has been associated with several personality traits, cognitive styles and affective temperaments. Women who have bipolar disorder are at increased risk of experiencing Postpartum Psychosis, however little research has investigated these traits and temperaments in relation to Postpartum Psychosis. The aim of this study is to establish whether aspects of personality, cognitive style and affective temperament that have been associated with bipolar disorder also confer vulnerability to Postpartum Psychosis over and above their known association with bipolar disorder. Personality traits (neuroticism, extraversion, schizotypy and impulsivity), cognitive styles (low self-esteem and dysfunctional attitudes) and affective temperaments (including cyclothymic and depressive temperaments) were compared between two groups of parous women with DSM-IV bipolar I disorder: i) 284 with a lifetime history of Postpartum Psychosis within 6 weeks of delivery (PP group), ii) 268 without any history of mood episodes with onset during pregnancy or within 6 months of delivery (no perinatal mood episode, No PME group). After controlling for current mood state, and key demographic, clinical and pregnancy-related variables, there were no statistically significant differences between the PP and No PME groups on any of the personality, cognitive style or affective temperament measures. Personality traits, cognitive styles and affective temperaments previously shown to be associated with bipolar disorder in general were not specifically associated with the occurrence of Postpartum Psychosis. These factors may not be relevant for predicting risk of Postpartum Psychosis in women with bipolar disorder.
-
The impact of Postpartum Psychosis on partners.
BMC pregnancy and childbirth, 2018Co-Authors: Nia Holford, Sue Channon, Jessica Heron, Ian JonesAbstract:Postpartum Psychosis is a severe mental health condition following childbirth, with a Psychosis and associated mood disturbance. Research to date has primarily focused on mothers’ experiences, and on identifying risk factors, aetiology, and intervention efficacy. Within both research and clinical communities, there has been little acknowledgement of partners’ experiences of Postpartum Psychosis, nor the important support role that partners can provide. The aim of this study was to consider the lived experiences of partners of women who have had Postpartum Psychosis, and the impact that it has had on their lives and relationships. Participants (N = 8) were partners recruited through the charity Action on Postpartum Psychosis. Partners completed an in-depth, semi-structured interview regarding their experiences of Postpartum Psychosis. Interpretative Phenomenological Analysis was used to analyse the interview transcripts. Seven superordinate themes emerged from the interview data: loss; powerlessness; united vs. individual coping; hypothesising and hindsight; barriers to accessing care and unmet needs; managing multiple roles; and positive changes from Postpartum Psychosis. These findings provide a rich illustration of the experiences of partners, including some previously unidentified findings relating to partner hypervigilance to signs of relapse and positive changes in their attitudes and relationships. Areas where support could be provided for partners are also highlighted.
-
Qualitative exploration of the effect of a television soap opera storyline on women with experience of Postpartum Psychosis.
BJPsych open, 2018Co-Authors: Lewis Roberts, Jessica Heron, Ian Jones, Lisa Jones, Giles Berrisford, Clare Dolman, Deirdre A. LaneAbstract:Background Postpartum Psychosis has recently been the focus of an in-depth storyline on a British television soap opera watched by millions of viewers. Aims This research explored how the storyline and concomitant increase in public awareness of Postpartum Psychosis have been received by women who have recovered from the condition. Method Nine semistructured, one-to-one interviews were conducted with women who had experienced Postpartum Psychosis. Thematic analysis consistent with Braun and Clarke's six-step approach was used to generate themes from the data. Results Public exposure provided by the Postpartum Psychosis portrayal was deemed highly valuable, and its mixed reception encompassed potentially therapeutic benefits in addition to harms. Conclusions Public awareness of Postpartum Psychosis strongly affects women who have experienced Postpartum Psychosis. This research highlights the complexity of using television drama for public education and may enable mental health organisations to better focus future practices of raising Postpartum Psychosis awareness. Declaration of interest GB is chair of action on Postpartum Psychosis. JH is director of action on Postpartum Psychosis. IJ is a trustee of action on Postpartum Psychosis and was a consultant to the BBC (television company) on the EastEnders storyline. CD is a trustee of action on Postpartum Psychosis, a trustee of BIPOLAR UK, vice chair of the Maternal Mental Health Alliance, and was a consultant to the BBC (television company) on the EastEnders storyline.
-
The impact of Postpartum Psychosis on partners
BMC, 2018Co-Authors: Nia Holford, Sue Channon, Jessica Heron, Ian JonesAbstract:Abstract Background Postpartum Psychosis is a severe mental health condition following childbirth, with a Psychosis and associated mood disturbance. Research to date has primarily focused on mothers’ experiences, and on identifying risk factors, aetiology, and intervention efficacy. Within both research and clinical communities, there has been little acknowledgement of partners’ experiences of Postpartum Psychosis, nor the important support role that partners can provide. The aim of this study was to consider the lived experiences of partners of women who have had Postpartum Psychosis, and the impact that it has had on their lives and relationships. Methods Participants (N = 8) were partners recruited through the charity Action on Postpartum Psychosis. Partners completed an in-depth, semi-structured interview regarding their experiences of Postpartum Psychosis. Interpretative Phenomenological Analysis was used to analyse the interview transcripts. Results Seven superordinate themes emerged from the interview data: loss; powerlessness; united vs. individual coping; hypothesising and hindsight; barriers to accessing care and unmet needs; managing multiple roles; and positive changes from Postpartum Psychosis. Conclusions These findings provide a rich illustration of the experiences of partners, including some previously unidentified findings relating to partner hypervigilance to signs of relapse and positive changes in their attitudes and relationships. Areas where support could be provided for partners are also highlighted
Lisa Jones - One of the best experts on this subject based on the ideXlab platform.
-
Phenomenology, Epidemiology and Aetiology of Postpartum Psychosis: A Review.
Brain sciences, 2021Co-Authors: Amy Perry, Katherine Gordon-smith, Lisa Jones, Ian JonesAbstract:Postpartum psychoses are a severe form of postnatal mood disorders, affecting 1–2 in every 1000 deliveries. These episodes typically present as acute mania or depression with Psychosis within the first few weeks of childbirth, which, as life-threatening psychiatric emergencies, can have a significant adverse impact on the mother, baby and wider family. The nosological status of Postpartum Psychosis remains contentious; however, evidence indicates most episodes to be manifestations of bipolar disorder and a vulnerability to a puerperal trigger. While childbirth appears to be a potent trigger of severe mood disorders, the precise mechanisms by which Postpartum Psychosis occurs are poorly understood. This review examines the current evidence with respect to potential aetiology and childbirth-related triggers of Postpartum Psychosis. Findings to date have implicated neurobiological factors, such as hormones, immunological dysregulation, circadian rhythm disruption and genetics, to be important in the pathogenesis of this disorder. Prediction models, informed by prospective cohort studies of high-risk women, are required to identify those at greatest risk of Postpartum Psychosis.
-
Postpartum Psychosis in bipolar disorder: no evidence of association with personality traits, cognitive style or affective temperaments.
BMC psychiatry, 2019Co-Authors: Amy Perry, Ian Jones, Katherine Gordon-smith, A. Di Florio, Nicholas John Craddock, I. Webb, E. Fone, Lisa JonesAbstract:Bipolar disorder has been associated with several personality traits, cognitive styles and affective temperaments. Women who have bipolar disorder are at increased risk of experiencing Postpartum Psychosis, however little research has investigated these traits and temperaments in relation to Postpartum Psychosis. The aim of this study is to establish whether aspects of personality, cognitive style and affective temperament that have been associated with bipolar disorder also confer vulnerability to Postpartum Psychosis over and above their known association with bipolar disorder. Personality traits (neuroticism, extraversion, schizotypy and impulsivity), cognitive styles (low self-esteem and dysfunctional attitudes) and affective temperaments (including cyclothymic and depressive temperaments) were compared between two groups of parous women with DSM-IV bipolar I disorder: i) 284 with a lifetime history of Postpartum Psychosis within 6 weeks of delivery (PP group), ii) 268 without any history of mood episodes with onset during pregnancy or within 6 months of delivery (no perinatal mood episode, No PME group). After controlling for current mood state, and key demographic, clinical and pregnancy-related variables, there were no statistically significant differences between the PP and No PME groups on any of the personality, cognitive style or affective temperament measures. Personality traits, cognitive styles and affective temperaments previously shown to be associated with bipolar disorder in general were not specifically associated with the occurrence of Postpartum Psychosis. These factors may not be relevant for predicting risk of Postpartum Psychosis in women with bipolar disorder.
-
Qualitative exploration of the effect of a television soap opera storyline on women with experience of Postpartum Psychosis.
BJPsych open, 2018Co-Authors: Lewis Roberts, Jessica Heron, Ian Jones, Lisa Jones, Giles Berrisford, Clare Dolman, Deirdre A. LaneAbstract:Background Postpartum Psychosis has recently been the focus of an in-depth storyline on a British television soap opera watched by millions of viewers. Aims This research explored how the storyline and concomitant increase in public awareness of Postpartum Psychosis have been received by women who have recovered from the condition. Method Nine semistructured, one-to-one interviews were conducted with women who had experienced Postpartum Psychosis. Thematic analysis consistent with Braun and Clarke's six-step approach was used to generate themes from the data. Results Public exposure provided by the Postpartum Psychosis portrayal was deemed highly valuable, and its mixed reception encompassed potentially therapeutic benefits in addition to harms. Conclusions Public awareness of Postpartum Psychosis strongly affects women who have experienced Postpartum Psychosis. This research highlights the complexity of using television drama for public education and may enable mental health organisations to better focus future practices of raising Postpartum Psychosis awareness. Declaration of interest GB is chair of action on Postpartum Psychosis. JH is director of action on Postpartum Psychosis. IJ is a trustee of action on Postpartum Psychosis and was a consultant to the BBC (television company) on the EastEnders storyline. CD is a trustee of action on Postpartum Psychosis, a trustee of BIPOLAR UK, vice chair of the Maternal Mental Health Alliance, and was a consultant to the BBC (television company) on the EastEnders storyline.
-
Adverse childhood life events and Postpartum Psychosis in bipolar disorder.
Journal of affective disorders, 2016Co-Authors: Amy Perry, Katherine Gordon-smith, A. Di Florio, Liz Forty, Nicholas John Craddock, Lisa Jones, Ian JonesAbstract:Background Women with bipolar disorder are at increased risk of Postpartum Psychosis. Adverse childhood life events have been associated with depression in the Postpartum period, but have been little studied in relation to Postpartum Psychosis. In this study we investigated whether adverse childhood life events are associated with Postpartum Psychosis in a large sample of women with bipolar I disorder. Methods Participants were 432 parous women with DSM-IV bipolar I disorder recruited into the Bipolar Disorder Research Network (www.BDRN.org). Diagnoses and lifetime psychopathology, including perinatal episodes, were obtained via a semi-structured interview (Schedules for Clinical Assessment in Neuropsychiatry; Wing et al., 1990) and case-notes. Adverse childhood life events were assessed via self-report and case-notes, and compared between women with Postpartum Psychosis (n=208) and those without a lifetime history of perinatal mood episodes (n=224). Results There was no significant difference in the rate of any adverse childhood life event, including childhood sexual abuse, or in the total number of adverse childhood life events between women who experienced Postpartum Psychosis and those without a lifetime history of perinatal mood episodes, even after controlling for demographic and clinical differences between the groups. Limitations Adverse childhood life events were assessed in adulthood and therefore may be subject to recall errors. Conclusions We found no evidence for an association between adverse childhood life events and the occurrence of Postpartum Psychosis. Our data suggest that, unlike Postpartum depression, childhood adversity does not play a significant role in the triggering of Postpartum Psychosis in women with bipolar disorder.
-
Postpartum Psychosis in Bipolar Disorder: No Association with Personality, Cognitive Style and Temperament
2016Co-Authors: I. Webb, Ian Jones, Amy Perry, Katherine Gordon-smith, Liz Forty, Christine Fraser, N. Craddck, Lisa JonesAbstract:Background and Aims: Bipolar disorder has been associated with a number of personality traits, cognitive styles and affective temperaments. Women who have bipolar disorder are at increased risk of experiencing Postpartum Psychosis, however no previous research has investigated these traits in relationship to Postpartum episodes. Our aim was to establish whether aspects of personality, cognitive style and affective temperament, that have been associated with bipolar disorder, confer vulnerability to Postpartum Psychosis over and above their known association with bipolar disorder. Methods: Participants were 552 parous women with DSM-IV bipolar I disorder recruited into the Bipolar Disorder Research Network (www.bdrn.org). Postpartum Psychosis group: lifetime episode of Postpartum Psychosis within 6 weeks of delivery (N = 284). Non-Postpartum Psychosis group: no history of any perinatal mood episodes (N = 268). Bipolar disorder-associated personality traits (neuroticism, extraversion, schizotypy and impulsivity), cognitive styles (low self-esteem and dysfunctional attitudes) and affective temperaments were measured using well validated self-report questionnaire measures. Results: After controlling for key demographic, clinical and pregnancy-related variables, and measures of current mood state, there were no statistically significant differences between the Postpartum Psychosis group and non-Postpartum Psychosis group on any of the personality, cognitive style or affective temperament measures. Conclusions: Personality traits, cognitive styles and affective temperaments associated with the bipolar disorder diathesis in general were not associated with the onset of Postpartum Psychosis specifically. We have found no evidence that these traits should play a key role when evaluating risk of Postpartum Psychosis in women with bipolar I disorder considering pregnancy.
A. Nager - One of the best experts on this subject based on the ideXlab platform.
-
High lifelong relapse rate of psychiatric disorders among women with Postpartum Psychosis
Nordic journal of psychiatry, 2012Co-Authors: A. Nager, L.-m. Johansson, Robert Szulkin, Sven-erik Johansson, K. SundquistAbstract:Nager A, Szulkin R, Johansson S-E, Johansson L-M, Sundquist K. High lifelong relapse rate of psychiatric disorders among women with Postpartum Psychosis. Nord J Psychiatry 2013;67:53-58. Background: The relapse rate for psychiatric disorders after Postpartum Psychosis is high. Apart from subsequent puerperal periods, previous studies have not examined when relapses in psychiatric disorders occur. In addition, little is known about the impact of certain individual factors on the risk of non-puerperal readmission among women with previous Postpartum Psychosis. Aims: The first aim was to examine the association between non-puerperal readmission due to psychiatric disorders and years of follow-up (in total, 30 years) in women with Postpartum Psychosis. The second aim was to examine the impact of age, type of Psychosis, previous hospitalization for psychiatric disorders and level of education on the risk of non-puerperal readmission due to psychiatric disorders. Methods: All Swedish women aged 20-44 with Postpartum Psychosis (n = 3140) were followed between 1975 and 2004 for non-puerperal readmission due to psychiatric disorders. A Cox frailty regression model was used to estimate hazard ratios for non-puerperal readmission. Results: The risk of non-puerperal readmission, although gradually decreasing with time, remained high many years after the Postpartum Psychosis. The risk of non-puerperal readmission was significantly higher among women with schizophrenia, lower levels of education and previous psychiatric hospitalization. Conclusions: Postpartum Psychosis is often part of a lifelong recurrent psychiatric disorder. Women with schizophrenia, lower levels of education and hospitalization due to a psychiatric disorder prior to Postpartum Psychosis have a higher risk of non-puerperal readmission. Clinical implications: The findings constitute important knowledge for all healthcare workers encountering women with a previous Postpartum Psychosis. (Less)
-
Obstetric complications and Postpartum Psychosis: a follow-up study of 1.1 million first-time mothers between 1975 and 2003 in Sweden.
Acta psychiatrica Scandinavica, 2007Co-Authors: A. Nager, K. Sundquist, V. Ramírez-león, L. M. JohanssonAbstract:Objective: The severity of Postpartum Psychosis calls for further research on the association between obstetric variables and this psychiatric disorder. Method: A total of 1 133 368 Swedish first-time mothers were included during a 29-year period yielding 1413 hospitalized cases of Postpartum Psychosis. Several obstetric variables were analysed separately after adjustment for possible confounders. Results: Respiratory disorder in the neonate, severe birth asphyxia, preterm birth, caesarean section, perinatal death and SGA infant were associated with an increased risk of Postpartum Psychosis. After adjustment for previous hospitalization for psychiatric disorder only preterm birth and acute caesarean section remained significant risk factors for Postpartum Psychosis (relative risks were 1.20 and 1.31 respectively). The relative risk of Postpartum Psychosis among first-time mothers with previous hospitalization for psychiatric disorder was increased more than 100-fold. Conclusion: Careful clinical risk assessments of Postpartum Psychosis are crucial among women with a history of psychiatric disorder whereas obstetric variables have a minor importance.
-
Neighborhood socioeconomic environment and risk of Postpartum Psychosis
Archives of Women's Mental Health, 2006Co-Authors: A. Nager, L.-m. Johansson, K. SundquistAbstract:Objective: To examine the hypothesized association between the neighborhood socioeconomic environment and Postpartum Psychosis, after adjustment for individual sociodemographic characteristics. Method: All Swedish women aged 20–44 years who became first-time mothers from 1 January 1986 to 30 September 1998 (N = 485,199) were followed for first hospital admissions due to Postpartum Psychosis. Neighborhood income was divided into three groups according to the proportions of individuals with low income in the neighborhood. Cox regression was used to estimate hazard ratios for Postpartum Psychosis. Results: Women living in the poorest neighborhoods exhibited a significantly higher risk of first hospital admissions due to Postpartum Psychosis than women living in the richest neighborhoods, HR = 1.49 (95% CI = 1.15–2.91, p = 0.002). Conclusion: Decision makers and health care workers should be aware that living in a poor neighborhood socioeconomic environment might contribute to the development of Postpartum Psychosis.
-
Neighborhood socioeconomic environment and risk of Postpartum Psychosis
Archives of women's mental health, 2005Co-Authors: A. Nager, L.-m. Johansson, K. SundquistAbstract:Objective: To examine the hypothesized association between the neighborhood socioeconomic environment and Postpartum Psychosis, after adjustment for individual sociodemographic characteristics.
-
are sociodemographic factors and year of delivery associated with hospital admission for Postpartum Psychosis a study of 500 000 first time mothers
Acta Psychiatrica Scandinavica, 2005Co-Authors: A. Nager, L.-m. Johansson, K. SundquistAbstract:Objective: To examine the association between first hospital admissions due to Postpartum Psychosis and the explanatory variables age, educational level, marital status and year of delivery. Method: All Swedish first-time mothers (n = 502 767) were included during a 12-year period and followed for first hospital admissions due to Postpartum Psychosis. Cox regression was used to estimate hazard ratios, adjusted for the explanatory variables. Results: Older age and being a single mother implied an increased risk of first hospital admissions due to Postpartum Psychosis among first-time mothers. Educational level was not associated with first hospital admissions due to Postpartum Psychosis. During the 1990s, when a reduction in psychiatric beds occurred, first hospital admissions due to Postpartum Psychosis decreased significantly. Conclusion: Certain sociodemographic factors are associated with first hospital admissions due to Postpartum Psychosis. Untreated Postpartum Psychosis due to fewer psychiatric beds could have hazardous effects on mothers and their children.