Bipolar I Disorder, Postpartum Onset

Bipolar I Disorder, is a description of a clinical course which is characterized by the occurrence of one or more manic episode or mixed episodes; often one or more major depressive episode is also found. The disorder is subclassified in the fourth digit of the diagnostic code according to whether the individual is experiencing a first episode or whether it is recurrent; recurrence is indicated by a shift in the polarity of the episode or an interval between episodes of at least two months without manic symptoms. A shift in polarity is defined as a clinical course where a major depressive episode evolves into a manic episode or mixed episode, or where a manic episode or a mixed episode evolves into a major depressive episode. Specifiers used to describe the current episode include: mild, moderate, severe without psychotic features, severe with psychotic features, in partial remission, or in full remission; with catatonic features; and, with postpartum onset. A single episode of Bipolar I Disorder, with mixed features and postpartum onset, would be indicated as 296.0x Bipolar I Disorder, single Manic Episode, Mixed, With Postpartum Onset (DSM-IV, 1994).

Social and obstetric factors have been implicated in the cause of psychosis after childbirth. A stressful life event has been found to be associated with mild postpartum depressive states (Hunt & Silverstone, 1995).

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em neuronal transmission combined with psychosocial factors and a history of psychiatric disorder, may result in puerperal illness (Cohen, Sichel, Robertson, Heckscher, & Rosenbaum, 1995). Twin and adoption studies demonstrate a genetic influence for Bipolar I Disorder (4 to 24 percent). Differential incidence of Bipolar I Disorder based on race or ethnicity have not been found. Community samples demonstrate that lifetime prevalence of the disorder vary from .4 to 1.6 percent. Epidemiological studies in the United States demonstrate that the illness is approximately equally common among men and women; gender seems to be related to the order of appearance of manic and depressive episodes (females are likely to be depressed first). It has been found that women with Bipolar I Disorder have an increased chance of developing future episodes, often psychotic, in the immediate postpartum period. Some women have their first episode during this period (DSM-IV, 1994; Leibenluft, 1996). Wisner, Peindl, and Hanusa (1995) report that mothers of young children frequently have childbearing-related onset illness, and are very likely to have mood disorders and to be misdiagnosed if they are less than 25 years or have three or more pregnanci
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Approximate Word count = 2086
Approximate Pages = 8 (250 words per page)

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