Document Detail


Protective effect of pregnancy in women with lithium-responsive bipolar disorder.
MedLine Citation:
PMID:  11099738     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Recent psychiatric literature, while indicating a high incidence of postpartum depression, contains a few clinical reports which support our observations that women with episodic bipolar disorder often remain well without treatment during pregnancy. Our retrospective study statistically examines the clinical course of 28 women with RDC typical bipolar disorder, type I, who became pregnant prior to receiving successful lithium prophylaxis. METHODS: We derived all data from the International Group for the Study of Lithium-treated Patients (IGSLI) database of excellent lithium responders. Data were compared both intraindividually, using data from three 9-month periods - immediately prior to pregnancy, pregnancy and postpartum - and interindividually, using never-pregnant women as controls. RESULTS: Intraindividual data show that women with typical bipolar disorder, type I, experience significantly fewer and shorter recurrences during pregnancy than either before or after. Interindividual comparisons indicate that the recurrence risk during pregnancy is markedly lower than the clinical course would predict. Moreover, the few recurrences observed during pregnancy all took place in the last 5 weeks. Limitations: Limiting cases to lithium responsive patients could have reduced heterogeneity and perhaps generalizability. CONCLUSIONS: The findings, nonetheless, indicate a marked improvement of the clinical course of typical bipolar disorder, type I, lithium-responsive, during pregnancy. Exploring the underlying protective mechanisms may lead to new understanding of the pathophysiology of mood disorders and to new approaches to treatment and prevention.
Authors:
P Grof; W Robbins; M Alda; A Berghoefer; M Vojtechovsky; A Nilsson; C Robertson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of affective disorders     Volume:  61     ISSN:  0165-0327     ISO Abbreviation:  J Affect Disord     Publication Date:  2000 Dec 
Date Detail:
Created Date:  2001-01-24     Completed Date:  2001-01-26     Revised Date:  2009-09-28    
Medline Journal Info:
Nlm Unique ID:  7906073     Medline TA:  J Affect Disord     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  31-9     Citation Subset:  IM    
Affiliation:
Department of Psychiatry, University of Ottawa, Ottawa, Canada. pgrof@rohcg.on.ca
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MeSH Terms
Descriptor/Qualifier:
Adult
Antimanic Agents / therapeutic use*
Bipolar Disorder / physiopathology*,  prevention & control*
Depression, Postpartum / physiopathology
Female
Humans
Lithium Carbonate / therapeutic use*
Middle Aged
Pregnancy
Pregnancy Complications / physiopathology*
Recurrence
Retrospective Studies
Chemical
Reg. No./Substance:
0/Antimanic Agents; 554-13-2/Lithium Carbonate
Comments/Corrections
Comment In:
J Affect Disord. 2002 Oct;72(1):107-8; author reply 103-5   [PMID:  12204325 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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