Skip to main content
SpringerLink
Log in

Screening for bipolar disorder during pregnancy

  • Original Article
  • Published:
Archives of Women's Mental Health Aims and scope Submit manuscript

Abstract

Bipolar disorder is a high-risk condition during pregnancy. In women receiving prenatal care, this study addresses the proportion screening positive for bipolar disorder with or without also screening positive for depression. This is a pilot study using chart abstraction of Edinburgh Postnatal Depression Scale (EPDS) and Mood Disorder Questionnaire (MDQ) scores from patients’ initial prenatal visits. Among 342 participants, 289 (87.1 %) completed the EPDS, 277 (81.0 %) completed the MDQ, and 274 (80.1 %) completed both. Among EPDS screens, 49 (16.4 %) were positive. Among MDQ screens, 14 (5.1 %) were positive. Nine (21.4 %) of the 42 participants with a positive EPDS also had a positive MDQ. Of the 14 patients with a positive MDQ, five (35.7 %) had a negative EPDS. The prevalence of positive screens for bipolar disorder in an obstetric population is similar to gestational diabetes and hypertension, which are screened for routinely. Without screening for bipolar disorder, there is a high risk of misclassifying bipolar depression as unipolar depression. If only women with current depressive symptoms are screened for bipolar disorder, approximately one third of bipolar disorder cases would be missed. If replicated, these findings support simultaneous screening for both depression and bipolar disorder during pregnancy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig 1

Similar content being viewed by others

References

  • Buckley BS, Harreiter J, Damm P, Corcoy R, Chico A, Simmons D, Vellinga A, Dunne F, Group DCI (2012) Gestational diabetes mellitus in Europe: prevalence, current screening practice and barriers to screening. A review. Diabet Med 29(7):844–854. doi:10.1111/j.1464-5491.2011.03541.x

    Article  CAS  PubMed  Google Scholar 

  • Buist AE, Barnett BE, Milgrom J, Pope S, Condon JT, Ellwood DA, Boyce PM, Austin MP, Hayes BA (2002) To screen or not to screen—that is the question in perinatal depression. Med J Aust 177(Suppl):S101–S105

    PubMed  Google Scholar 

  • Cerimele JM, Chwastiak LA, Dodson S, Katon WJ (2014) The prevalence of bipolar disorder in general primary care samples: a systematic review. Gen Hosp Psychiatry 36(1):19–25. doi:10.1016/j.genhosppsych.2013.09.008

    Article  PubMed  Google Scholar 

  • Chung KF, Tso KC, Chung RT (2009) Validation of the Mood Disorder Questionnaire in the general population in Hong Kong. Compr Psychiatry 50(5):471–476. doi:10.1016/j.comppsych.2008.10.001

    Article  PubMed  Google Scholar 

  • Davalos DB, Yadon CA, Tregellas HC (2012) Untreated prenatal maternal depression and the potential risks to offspring: a review. Arch Womens Ment Health 15(1):1–14. doi:10.1007/s00737-011-0251-1

    Article  PubMed  Google Scholar 

  • Dodd S, Williams LJ, Jacka FN, Pasco JA, Bjerkeset O, Berk M (2009) Reliability of the Mood Disorder Questionnaire: comparison with the Structured Clinical Interview for the DSM-IV-TR in a population sample. Aust N Z J Psychiatry 43(6):526–530. doi:10.1080/00048670902873706

    Article  PubMed  Google Scholar 

  • Freeman MP, Smith KW, Freeman SA, McElroy SL, Kmetz GE, Wright R, Keck PE Jr (2002) The impact of reproductive events on the course of bipolar disorder in women. J Clin Psychiatry 63(4):284–287

    Article  PubMed  Google Scholar 

  • Frey BN, Simpson W, Wright L, Steiner M (2012) Sensitivity and specificity of the Mood Disorder Questionnaire as a screening tool for bipolar disorder during pregnancy and the postpartum period. J Clin Psychiatry 73(11):1456–1461. doi:10.4088/JCP.12m07856

    Article  PubMed  Google Scholar 

  • Ghaemi SN, Hsu DJ, Soldani F, Goodwin FK (2003) Antidepressants in bipolar disorder: the case for caution. Bipolar Disord 5(6):421–433

    Article  CAS  PubMed  Google Scholar 

  • Ghaemi SN, Rosenquist KJ, Ko JY, Baldassano CF, Kontos NJ, Baldessarini RJ (2004) Antidepressant treatment in bipolar versus unipolar depression. Am J Psychiatry 161(1):163–165

    Article  PubMed  Google Scholar 

  • Grigoriadis S, VonderPorten EH, Mamisashvili L, Tomlinson G, Dennis CL, Koren G, Steiner M, Mousmanis P, Cheung A, Radford K, Martinovic J, Ross LE (2013) The impact of maternal depression during pregnancy on perinatal outcomes: a systematic review and meta-analysis. J Clin Psychiatry 74(4):e321–e341. doi:10.4088/JCP.12r07968

    Article  PubMed  Google Scholar 

  • Haddad B, Sibai BM (1999) Chronic hypertension in pregnancy. Ann Med 31(4):246–252

    Article  CAS  PubMed  Google Scholar 

  • Hirschfeld RM, Cass AR, Holt DC, Carlson CA (2005) Screening for bipolar disorder in patients treated for depression in a family medicine clinic. J Am Board Fam Pract 18(4):233–239

    Article  PubMed  Google Scholar 

  • Hirschfeld RM, Holzer C, Calabrese JR, Weissman M, Reed M, Davies M, Frye MA, Keck P, McElroy S, Lewis L, Tierce J, Wagner KD, Hazard E (2003) Validity of the Mood Disorder Questionnaire: a general population study. Am J Psychiatry 160(1):178–180

    Article  PubMed  Google Scholar 

  • Hirschfeld RM, Williams JB, Spitzer RL, Calabrese JR, Flynn L, Keck PE Jr, Lewis L, McElroy SL, Post RM, Rapport DJ, Russell JM, Sachs GS, Zajecka J (2000) Development and validation of a screening instrument for bipolar spectrum disorder: the Mood Disorder Questionnaire. Am J Psychiatry 157(11):1873–1875

    Article  CAS  PubMed  Google Scholar 

  • Hoertel N, Le Strat Y, Angst J, Dubertret C (2013) Subthreshold bipolar disorder in a U.S. national representative sample: prevalence, correlates and perspectives for psychiatric nosography. J Affect Disord 146(3):338–347. doi:10.1016/j.jad.2012.09.016

    Article  PubMed  Google Scholar 

  • Lee HC, Lin HC (2010) Maternal bipolar disorder increased low birthweight and preterm births: a nationwide population-based study. J Affect Disord 121(1–2):100–105. doi:10.1016/j.jad.2009.05.019

    Article  PubMed  Google Scholar 

  • Merikangas KR, Akiskal HS, Angst J, Greenberg PE, Hirschfeld RM, Petukhova M, Kessler RC (2007) Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey Replication. Arch Gen Psychiatry 64(5):543–552. doi:10.1001/archpsyc.64.5.543

    Article  PubMed Central  PubMed  Google Scholar 

  • Miller LJ, Gupta R, Scremin AM (2011) The evidence for perinatal depression screening and treatment. In: Hadler A (ed) Reducing racial/ethnic disparities in reproductive and perinatal outcomes: the evidence from population-based interventions. Springer Science + Business Media, pp 301–327

  • Pignone MP, Gaynes BN, Rushton JL, Burchell CM, Orleans CT, Mulrow CD, Lohr KN (2002) Screening for depression in adults: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 136(10):765–776

    Article  PubMed  Google Scholar 

  • Sharma V, Khan M, Corpse C, Sharma P (2008) Missed bipolarity and psychiatric comorbidity in women with postpartum depression. Bipolar Disord 10(6):742–747. doi:10.1111/j.1399-5618.2008.00606.x

    Article  PubMed  Google Scholar 

  • Sharma V, Xie B (2011) Screening for postpartum bipolar disorder: validation of the Mood Disorder Questionnaire. J Affect Disord 131(1–3):408–411. doi:10.1016/j.jad.2010.11.026

    Article  PubMed  Google Scholar 

  • Vance YH, Huntley Jones S, Espie J, Bentall R, Tai S (2008) Parental communication style and family relationships in children of bipolar parents. Br J Clin Psychol 47(Pt 3):355–359. doi:10.1348/014466508X282824

    Article  PubMed  Google Scholar 

  • Viguera AC, Whitfield T, Baldessarini RJ, Newport DJ, Stowe Z, Reminick A, Zurick A, Cohen LS (2007) Risk of recurrence in women with bipolar disorder during pregnancy: prospective study of mood stabilizer discontinuation. Am J Psychiatry 164(12):1817–1824. doi:10.1176/appi.ajp.2007.06101639, quiz 1923

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, Newton Wellesley Hospital, Newton, MA, USA

    Lindsay Merrill

  2. Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Leena Mittal

  3. Department of Psychology, Stony Brook University, Stony Brook, NY, USA

    Jennifer Nicoloro

  4. Department of Psychology, Marquette University, Milwaukee, WI, USA

    Christina Caiozzo

  5. Department of Radiology, Weill Cornell Medical College, New York, NY, USA

    Paul K. Maciejewski

  6. Edward Hines Jr. VA Hospital, 5000 S. 5th Ave., Bldg. 228, Rm. 1016, Hines, IL, 60141, USA

    Laura J. Miller

Authors
  1. Lindsay Merrill
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Leena Mittal
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jennifer Nicoloro
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Christina Caiozzo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Paul K. Maciejewski
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Laura J. Miller
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Laura J. Miller.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Merrill, L., Mittal, L., Nicoloro, J. et al. Screening for bipolar disorder during pregnancy. Arch Womens Ment Health 18, 579–583 (2015). https://doi.org/10.1007/s00737-015-0527-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00737-015-0527-y

Keywords

Search

Navigation