Women with bipolar disorder are at significant risk for recurrent illness during the postpartum period.  After miscarriage, an event which is associated with both hormonal changes and psychological complexity, is the risk for recurrent illness also increased?

This question was addressed by researchers with a retrospective review of 1,283 women with “broadly defined bipolar disorder”.  Rates of mania/affective psychosis were significantly higher after a live birth (n = 320, 12.5%) than after a termination (4.3%) or miscarriage (5.5%).  However, rates of non-psychotic major depression were similar following full-term deliveries(18.9%), miscarriage (14.6%), and termination (15.9%).

Based on these findings, women with bipolar disorder and their clinicians should be aware of the possible emergence of depression in the weeks following miscarriage or termination.

Ruta Nonacs, MD PhD

Di Florio A, Jones L, Forty L, Gordon-Smith K, Craddock N, Jones I.  Bipolar disorder, miscarriage, and termination.  Bipolar Disord. 2015 Feb; 17(1):102-5.

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