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Mild Hypomania (the Highs) can be a Feature of the First Postpartum Week

Association with Later Depression

Published online by Cambridge University Press:  02 January 2018

Vivette Glover ,
Peter Liddle ,
Alyx Taylor ,
Diana Adams  and
Merton Sandler
Vivette Glover*
Affiliation:
Department of Chemical Pathology, Queen Charlotte's and Chelsea Hospital, Goldhawk Road, London W6 0XG
Peter Liddle
Affiliation:
Department of Psychological Medicine, Hammersmith Hospital, Ducane Road, London W12 0HS
Alyx Taylor
Affiliation:
Department of Chemical Pathology, Queen Charlotte's and Chelsea Hospital, Goldhawk Road, London W6 0XG
Diana Adams
Affiliation:
Department of Chemical Pathology, Queen Charlotte's and Chelsea Hospital, Goldhawk Road, London W6 0XG
Merton Sandler
Affiliation:
Department of Chemical Pathology, Queen Charlotte's and Chelsea Hospital, Goldhawk Road, London W6 0XG
*
∗Correspondence
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Abstract

About 10% of women show elation and associated features of hypomania in the first 5 days following childbirth. These symptoms can be detected using a self-rating scale (the ‘Highs’) based on SADS-L criteria. This phenomenon has been confirmed using the observer-rated Comprehensive Psychopathological Rating Scale, which also revealed a high degree of related irritability. Significantly more women scoring ⩾ 8 on the Highs scale at 3 days postpartum went on to manifest depression at 6 weeks than did subjects with no psychopathology in the early puerperium. It is suggested that the ‘highs’ followed by depression may be a mild and common form of bipolar disorder.

Type
Papers
Information
The British Journal of Psychiatry , Volume 164 , Issue 4 , April 1994 , pp. 517 - 521
Copyright
Copyright © 1994 The Royal College of Psychiatrists 

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References

Asberg, M., Montgomery, S., Perris, C., et al (1978) Comprehensive Psychopathological Rating Scale. Acta Psychiatrica Scandinavica (suppl. 271), 5–27.CrossRefGoogle Scholar
Ballinger, C. B., Kay, D. S. G., Naylor, G. J., et al (1982) Some biochemical findings during pregnancy and after delivery in relation to mood change. Psychological Medicine, 12, 549–556.CrossRefGoogle ScholarPubMed
Brinsmead, M., Smith, R., Singh, B., et al (1985) Peripartum concentrations of beta endorphin and cortisol and maternal mood states. Australian and New Zealand Journal of Obstetrics & Gynaecology, 25, 194–197.CrossRefGoogle ScholarPubMed
Brockington, I. F., Cernik, K. F., Schofield, E. M., et al (1981) Puerperal psychosis. Archives of General Psychiatry, 38, 829–833.CrossRefGoogle ScholarPubMed
Brockington, I. F., Winokur, G. & Dean, C. (1982) Puerperal psychosis. In Motherhood and Mental Illness (eds Brockington, I. F. & Kumar, R.), pp. 37–68. London: Academic Press.Google Scholar
Cox, J. L., Holden, J. M. & Saoovsky, R. (1987) Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782–786.CrossRefGoogle ScholarPubMed
Endicott, J. & Spitzer, R. L. (1978) A diagnostic interview. The schedule for affective disorders and schizophrenia. Archives of General Psychiatry, 35, 837–844.CrossRefGoogle ScholarPubMed
Gordon, J. H., Borison, R. L. & Diamond, B. I. (1980) Modulation of dopamine receptor sensitivity by estrogen. Biological Psychiatry, 15, 389–396.Google ScholarPubMed
Handley, S. L., Dunn, T. L., Baker, J. M., et al (1977) Mood changes in puerperium and plasma tryptophan and cortisol concentrations. British Medical Journal, ii, 18–22.CrossRefGoogle Scholar
Handley, S. L., Dunn, T. L., Waldron, G., et al (1980) Tryptophan, cortisol and puerperal mood. British Journal of Psychiatry, 136, 498–508.CrossRefGoogle ScholarPubMed
Hannah, P., Cody, D., Glover, V., et al (1993) The tyramine test is not a marker for postnatal depression: early postpartum euphoria might be. Journal of Psychosomatic Obstetrics and Gynaecology, 14, 295–304.CrossRefGoogle ScholarPubMed
Kennerley, H. & Gath, D. (1989) Maternity Blues. I. Detection and measurement by questionnaire. British Journal of Psychiatry, 155, 356–362.CrossRefGoogle ScholarPubMed
Newnham, J. P., Dennett, P. M., Ferron, S. A., et al (1984) A study of the relationship between circulating α-endorphin-like immunoreactivity and post partum ‘Blues’. Clinical Endocrinology, 20, 169–177.CrossRefGoogle Scholar
Okano, T. & Nomura, J. (1992) Endocrine study of the maternity Blues. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 16, 921–932.CrossRefGoogle ScholarPubMed
Owens, P. C., Smith, R., Brinsmead, M. W., et al (1987) Postnatal disappearance of the pregnancy-associated reduced sensitivity of plasma cortisol to feedback inhibition. Life Sciences, 41, 1745–1750.CrossRefGoogle ScholarPubMed
Smith, R., Cubis, J., Brinsmead, M., et al (1990) Mood changes, obstetric experience and alterations in plasma cortisol, beta-endorphin and corticotrophin releasing hormone during pregnancy and the puerperium. Journal of Psychosomatic Research, 34, 53–69.CrossRefGoogle ScholarPubMed
Stein, G. (1982) The maternity Blues. In Motherhood and Mental Illness (eds Brockington, I. F. & Kumar, R.), Vol. 1, pp. 119–154. London: Academic Press.Google Scholar
Stein, G., Milton, F., Bebbington, P., et al (1976) Relationship between mood disturbances and free and total plasma tryptophan in postpartum women. British Medical Journal, ii, 457.CrossRefGoogle Scholar
Wicki, W. & Angst, J. (1991) The Zurich Study. X. Hypomania in a 28 to 30 year old cohort. European Archives of Psychiatry and Clinical Neuroscience, 240, 339–348.CrossRefGoogle Scholar
Wieck, A., Kumar, R., Hirst, A. D., et al (1991) Increased sensitivity of dopamine receptors and recurrence of affective psychosis after childbirth. British Medical Journal, 303, 613–616.CrossRefGoogle ScholarPubMed
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