Postpartum depression: bipolar or unipolar? Analysis of 434 Polish postpartum women

Objective: To assess the prevalence of soft bipolar features in a sample of women with postpartum depressive symptoms, as well as to compare the sociodemographic and obstetric characteristics of subjects with bipolar or unipolar postpartum depressive symptomatology. Methods: Four hundred and thirty-four participants were enrolled in this cross-sectional study. Postpartum depression (PPD) symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS), while the Mood Disorder Questionnaire (MDQ) was used to screen for bipolarity features. Results: Of the 434 participants, 66 (15.2%) scored ≥ 13 points on the EPDS, thus fulfilling the screening criteria, and 103 scored ≥ 7 points on the MDQ. In comparison with non-depressed subjects, the women who scored positively on the EPDS were significantly more likely to exhibit symptoms of bipolar spectrum disorders (38 vs. 21%; chi-square test, p = 0.015). Women with bipolar PPD symptomatology were significantly younger than those exhibiting unipolar PPD symptoms (31.0±4.8 years vs. 28.5±4.1 years; t-test, p = 0.03). The groups did not differ in terms of obstetric characteristics. Conclusion: Our findings suggest that patients with PPD symptomatology may be more likely to exhibit soft bipolarity features as compared with non-depressed women.

The Biological Rhythms Interview of Assessment in Neuropsychiatry in patients with bipolar disorder: correlation with affective temperaments and schizotypy

Objective: To assess the relationship of biological rhythms, evaluated by the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN), with affective temperaments and schizotypy. Methods: The BRIAN assessment, along with the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire (TEMPS-A) and the Oxford-Liverpool Inventory for Feelings and Experiences (O-LIFE), was administered to 54 patients with remitted bipolar disorder (BD) and 54 healthy control (HC) subjects. Results: The TEMPS-A cyclothymic temperament correlated positively and the hyperthymic temperament correlated negatively with BRIAN scores in both the BD and HC groups, although the correlation was stronger in BD subjects. Depressive temperament was associated with BRIAN scores in BD but not in HC; conversely, the irritable temperament was associated with BRIAN scores in HC, but not in BD. Several positive correlations between BRIAN scores and the schizotypal dimensions of the O-LIFE were observed in both BD and HC subjects, especially with cognitive disorganization and less so with unusual experiences and impulsive nonconformity. A correlation with introversion/anhedonia was found only in BD subjects. Conclusion: Cyclothymic and depressive temperaments predispose to disturbances of biological rhythms in BD, while a hyperthymic temperament can be protective. Similar predispositions were also found for all schizotypal dimensions, mostly for cognitive disorganization.

Estilo específico de pensamiento genérico y el curso de la depresión mayor en hombres y mujeres: un estudio de tres años en Polonia / Gender specific thinking style and the longitudinal course of major depression in men and women: a three year follow-up study in Poland

El presente estudio tiene por objeto evaluar los cambios en el tiempo de algunas variables clave de hombres y mujeres en el diagnóstico de depresión mayor; 40 pacientes hospitalizados que cumplieron con los criterios del DSM III-R para la depresión (21 mujeres y 19 hombres) fueron sometidos a un estudio prospectivo de tres años de duración. Se realizaron evaluaciones estandarizadas al inicio y al final de la hospitalización, y posteriormente, al primer, segundo y tercer años después del alta. Un año después del alta las mujeres se encontraban marcadamente más deprimidas, tenían un nivel de autoestima inferior y un estilo atribucional más negativo. Estas diferencias aumentaron a través del tiempo, alcanzando significación estadística al tercer años después del alta. Las mujeres tendieron a estar crónicamente deprimidas, mostraron un marcado deterioro funcional, y requirieron de intervenciones farmacológicas, mientras que los hombres tendieron a manifestar una mejoría en el estilo de pensamiento, menos depresión y necesitaron de menor medicación. El presente estudio proporciona más evidencia sobre las diferencias específicas de género en el curso longitudinal de la depresión mayor y apoya firmemente la utilización de escalas de calificación objetivas en el manejo clínico de los pacientes deprimidos