Hypomanic Symptoms Common in the Immediate Postpartum Period

June 1, 2009

British researchers have found that hypomanic symptoms are common in the postpartum period, with rates increased significantly over those seen among the general population.

According to study results published in the journal Bipolar Disorders, British researchers found that hypomanic symptoms are common in the postpartum period, with rates increased significantly over those seen among the general population. The team followed 446 women from week 12 of pregnancy, asking them to complete the Highs Scale and the Edinburgh Postnatal Depression Scale (EPDS) at baseline, 1 week, and 8 weeks postpartum.

Early postpartum instances of hypomanic symptoms were significantly increased, with the number of cases of “the highs” seen more in the immediate postpartum period compared with 8 weeks postpartum and during pregnancy.

“Our findings indicate that childbirth is a potent trigger not only of episodes of severe mania in women with vulnerability to bipolar disorder, but also of hypomanic symptoms in women from the normal population,” said Jessica Heron, University of Birmingham, UK, and her co-authors. “The prevalence of postpartum week 1 highs found in this study is consistent with previous studies.”

The researchers explain that their findings don’t reflect a tendency of hypomanic women to be particularly motivated in responding to the questionnaires, as those who scored highly during pregnancy weren’t as likely to respond to all time points.

Using an EPDS score of 13 to define cases of probable depression, the team found no significant increases of such cases from pregnancy to postpartum periods, with a trend toward reduced numbers of cases from baseline through postpartum weeks 1 and 8 (19.0%, 14.6%, 13.3%, respectively).

“It must be remembered, however, that although we show no postnatal increase in depression in the general population, the perinatal period is likely a period of high risk for specific groups of women, particularly those with a previous psychiatric history,” they note. “Further work must be conducted to investigate hypomanic symptoms in the postpartum period if the concept of ‘the highs’ is to be firmly accepted into the portfolio of postpartum symptomatology.”