Results from a Spanish study suggest that postpartum mood episodes (PMEs) do not influence disease course and prognosis in women with bipolar disorder (BD).

“Postpartum mood symptoms show well-defined clinical features and appear to be mainly influenced by genetic predisposition and family-related factors and not as much by psychosocial factors,” explain Eduard Vieta (University Clinic Hospital of Barcelona, Spain) and team.

“However, [their] influence on the outcome of BD remains unclear, as there is little data showing differences on illness outcome according to the lifetime history of postpartum onset.”

To address this, the researchers assessed data on 200 women with BD who were enrolled in the Bipolar Disorders Program at the University Clinic Hospital of Barcelona for at least 10 years.

In total, 43 women had a history of PMEs, defined as the occurrence of a mood episode within 4 weeks postpartum, and 137 did not. The remaining 20 women were excluded from the study due to lack of agreement between the two independent psychiatrists as to their history of mood episodes.

The researchers found that there were no significant differences between women with and without a history of PMEs regarding clinical features, such as rapid cycling (18.6 vs 20.9%), Axis I comorbidity (26.2 vs 24.6%), and Axis II comorbidity (30.2 vs 31.8%).

The proportion of patients with a family history of psychiatric disorders and affective disorder was also similar between the groups, at 72.1% and 75.8%, and 65.1% and 62.9%, respectively.

Furthermore, both groups were similar in terms of occupational status, mood episode frequency, and functionality.

The only significant difference found between women with and without a history of PMEs was duration of bipolar illness, with PME patients showing a longer duration of the illness, at 20.16 versus 15.02 years in non-PME patients.

Vieta and team conclude in the Journal of Affective Disorders: “Course and prognosis of bipolar disorder with and without PME hardly differ.”

They add: “This result may suggest reconsideration of PME as a proper course modifier.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

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