Positive screening rates for bipolar disorder in pregnant and postpartum women and associated risk factors
Department of Psychiatry; Implementation Science and Practice Advances Research Center; Department of Obstetrics and Gynecology; Graduate School of Biomedical Sciences; Department of Population and Quantitative Health Sciences
Diagnosis | Health Services Administration | Health Services Research | Mental and Social Health | Obstetrics and Gynecology | Psychiatry | Psychiatry and Psychology | Reproductive and Urinary Physiology | Women's Health
OBJECTIVE: Bipolar disorder affects 2-8% of pregnant and postpartum women; untreated illness is associated with poor outcomes. This study aimed to describe bipolar disorder screening rates in obstetric settings and associated characteristics.
METHOD: Women were recruited during pregnancy through three months postpartum from 14 obstetric clinics in Massachusetts. The Mood Disorder Questionnaire (MDQ) was used to screen for bipolar disorder; a subset previously diagnosed with bipolar was also examined. Differences in characteristics by screening outcome were tested using chi-square and t-tests.
RESULTS: Of 574 participating women, 18.8% screened positive for bipolar disorder. Compared to those with negative, those with positive bipolar screens had 18.5-times the prevalence of positive substance use screens (11.1% vs. 0.6%, p < 0.001) and 3.4-times reported feeling they were not receiving adequate psychiatric help (24.0 vs. 7.0%, p < 0.001). Less than half of those with positive bipolar screens (42.0%) and 61.3% with pre-existing bipolar reported receiving current psychiatric care.
CONCLUSIONS: Almost one in five perinatal women screened positive for bipolar disorder. Positive screenings were associated with comorbid substance use and low treatment rates. This study highlights the importance of screening for bipolar disorder during the perinatal period and the need for systematic approaches to ensure adequate assessment and follow-up.
CLINICAL TRIALS REGISTRATION: ClinicalTrials.gov identifier: NCT02760004.
Bipolar disorder, Mood Disorder Questionnaire, Perinatal, UMCCTS funding
DOI of Published Version
Gen Hosp Psychiatry. 2019 Nov - Dec;61:53-59. doi: 10.1016/j.genhosppsych.2019.09.002. Epub 2019 Oct 22. Link to article on publisher's site
General hospital psychiatry
Masters GA, Brenckle L, Sankaran P, Person SD, Allison JJ, Moore Simas TA, Ko JY, Robbins CL, Marsh WK, Byatt N. (2019). Positive screening rates for bipolar disorder in pregnant and postpartum women and associated risk factors. Psychiatry Publications. https://doi.org/10.1016/j.genhosppsych.2019.09.002. Retrieved from https://escholarship.umassmed.edu/psych_pp/920