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Postpartum Psychosis Could Return at Menopause, Researchers Say

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Women who suffer a severe form of postnatal depression, known as postpartum psychosis, could be at greater risk of becoming unwell when they reach menopause, researchers say.

The links between these two significant times in a woman’s life are being explored for the first time, in an attempt to understand the causes and ultimately provide interventions.

“There has been anecdotal evidence around for a long time that women who have been severely mentally unwell after giving birth are more likely to become unwell around the time of menopause but there has been very little research,” said Professor Lisa Jones, of the University of Worcester.

Professor Lisa Jones and her team of researchers at Worcester are working in partnership with Professor Ian Jones, of Cardiff University, and his team, which collectively makes up the national Bipolar Disorder Research Network (BDRN), to explore the links.

They recently presented some new research at the International Society for Bipolar Disorders Conference in Amsterdam to show that women who experience postpartum psychosis are at increased risk of becoming unwell again around the menopause.

“Our systematic research data strongly support this association by looking at a sample of over 330 postmenopausal women who have Bipolar Disorder,” said Professor Lisa Jones. “The data is strengthened even more by showing that there is a strong relationship between not only experiencing postpartum psychosis and having an episode of illness at menopause, but also with experiencing severe premenstrual syndrome.

“This suggests that there is a subgroup of women who are particularly sensitive to reproductive life events triggering mood illness episodes throughout their lifespan. Now we need further research to understand the reasons for this, which are likely to involve biological factors, such as sensitivity to major hormonal fluctuations, in addition to psychological factors associated with adjustment to changes in female self-identity for example.”

Symptoms of postpartum psychosis can appear within days or even hours after childbirth and can include extreme feelings of elation, anxiousness or confusion, plus hallucinations. It is considered a medical emergency and, for the majority of women, treatment will involve medication and admission to hospital.

Research conducted by the BDRN shows that women with Bipolar Disorder are at far greater risk of postpartum psychosis.

Professor Ian Jones, who is also a Consultant Psychiatrist, said: “If we can identify when particular patients with severe mood disorders are at high risk of relapse we can put measures in place to help prepare and support them and their families, and hopefully alleviate some of the suffering that all too often accompanies severe mood illness episodes. Our research suggests that women who have had postpartum psychosis, and their families and clinicians, should be vigilant for signs of mental ill-health during the perimenopausal period and where necessary treatment can be commenced as early as possible.”

Professor Ian Jones was recently interviewed on BBC Radio 4's Women's Hour, discussing the research. You can listen to his interview here http://www.bbc.co.uk/programmes/b086kxwm 

The research group is looking for volunteers who have Bipolar Disorder to participate in their research, and would be especially keen to hear from women who have experienced postpartum psychosis, women who have experienced a severe episode of mental illness around the time of menopause, and women who have bipolar disorder and are currently pregnant. You can contact them on 01905 542 880 or moodresearch@worc.ac.uk

For more information about the University of Worcester’s research into mood disorders see http://www.worc.ac.uk/discover/ihs-mood-disorders-research-group.html