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Pregnancy and Bipolar Disorder
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Pregnancy and Bipolar Disorder

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (1 May 2021) | Viewed by 16532

Special Issue Editor

Dr. Erik Roj Larsen

E-Mail Website
Guest Editor
1. Mental Health Department, Odense University Clinic, Mental Health Service, Region of Southern Denmark, 5000 Odense, Denmark
2. Department of Clinical Research, University of Southern Denmark, 5230 Odense, Denmark
Interests: mood disorders; risk factors for mania and depression; medical treatment in mood disorders (DUAG group); non-medical treatments; transcranial electromagnetic field therapy (T-PEMF) for depression; casein glycomacropeptide (CGMP) for mania; pregnancy and psychiatric disorders

Special Issue Information

Dear Colleagues,

Bipolar disorder in pregnancy may be difficult to treat. One dilemma is whether women should continue medication throughout pregnancy, and maybe accept a minor risk to harm their unborn child, or lower the dose or discontinue medication and increase the risk of recurrence, which can lead to maternal morbidity, thereby endangering themselves and their fetus. What is the best procedure when treating a pregnant bipolar woman with lithium, lamotrigine, second-generation antipsychotics, or antidepressants? How should therapeutic drug monitoring be done? Who is responsible? The GP, the obstetrician, or the psychiatrist? What are the potential obstetric, fetal, and neonatal risks associated with pharmacotherapy? Is there any long-term side-effect on the fetus? Is electroconvulsive treatment safe in pregnancy? The choice of medication may be influenced by the woman’s choice of breastfeeding her child. What should we recommend? How do we treat sleeping problems in pregnancy and during the postpartum period? Are there any risk factors of relapse that must be taken care of during pregnancy and postpartum? How should other family members be involved? When should bipolarity be considered during pregnancy? What is the risk of transferring a bipolar disorder to the fetus?

Dr. Erik Roj Larsen
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • pregnancy
  • bipolar disorder
  • pharmacotherapy
  • ECT
  • lithium
  • lamotrigine
  • antipsychotics
  • antidepressants
  • sleeping problems

Published Papers (3 papers)

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Research

14 pages, 864 KiB  
Article
Machine Learning-Based Predictive Modeling of Postpartum Depression
by Dayeon Shin, Kyung Ju Lee, Temidayo Adeluwa and Junguk Hur
J. Clin. Med. 2020, 9(9), 2899; https://doi.org/10.3390/jcm9092899 - 08 Sep 2020
Cited by 42 | Viewed by 5978
Abstract
Postpartum depression is a serious health issue beyond the mental health problems that affect mothers after childbirth. There are no predictive tools available to screen postpartum depression that also allow early interventions. We aimed to develop predictive models for postpartum depression using machine [...] Read more.
Postpartum depression is a serious health issue beyond the mental health problems that affect mothers after childbirth. There are no predictive tools available to screen postpartum depression that also allow early interventions. We aimed to develop predictive models for postpartum depression using machine learning (ML) approaches. We performed a retrospective cohort study using data from the Pregnancy Risk Assessment Monitoring System 2012–2013 with 28,755 records (3339 postpartum depression and 25,416 normal cases). The imbalance between the two groups was addressed by a balanced resampling using both random down-sampling and the synthetic minority over-sampling technique. Nine different ML algorithms, including random forest (RF), stochastic gradient boosting, support vector machines (SVM), recursive partitioning and regression trees, naïve Bayes, k-nearest neighbor (kNN), logistic regression, and neural network, were employed with 10-fold cross-validation to evaluate the models. The overall classification accuracies of the nine models ranged from 0.650 (kNN) to 0.791 (RF). The RF method achieved the highest area under the receiver-operating-characteristic curve (AUC) value of 0.884, followed by SVM, which achieved the second-best performance with an AUC value of 0.864. Predictive modeling developed using ML-approaches may thus be used as a prediction (screening) tool for postpartum depression in future studies. Full article
(This article belongs to the Special Issue Pregnancy and Bipolar Disorder)
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10 pages, 1141 KiB  
Article
Mother-to-Infant Bonding in Women with Postpartum Psychosis and Severe Postpartum Depression: A Clinical Cohort Study
by Janneke Gilden, Nina M. Molenaar, Anne K. Smit, Witte J. G. Hoogendijk, Anna-Sophie Rommel, Astrid M. Kamperman and Veerle Bergink
J. Clin. Med. 2020, 9(7), 2291; https://doi.org/10.3390/jcm9072291 - 19 Jul 2020
Cited by 30 | Viewed by 7142
Abstract
Mother-to-infant bonding is important for long-term child development. The aim of this study was to investigate bonding in women admitted to a Mother and Baby Unit with postpartum depression (PD, n = 64) and postpartum psychosis (PP, n = 91). Participants completed the [...] Read more.
Mother-to-infant bonding is important for long-term child development. The aim of this study was to investigate bonding in women admitted to a Mother and Baby Unit with postpartum depression (PD, n = 64) and postpartum psychosis (PP, n = 91). Participants completed the Postpartum Bonding Questionnaire (PBQ), the Edinburgh Postnatal Depression Scale (EPDS) and the Young Mania Rating Scale (YMRS) weekly during admission. At admission, 57.1% of women with PD had impaired bonding, compared to only 17.6% of women with PP (p-value < 0.001). At discharge, only 18.2% of women with PD and 5.9% of women with PP still experienced impaired bonding (p-value = 0.02). There was a strong association between decrease of depressive and manic symptoms and improved bonding over an eight-week admission period. In a small group of women (5.7%) impaired bonding persisted despite being in remission of their psychiatric disorder. The results from our study show that impaired bonding is a more present and evidently severe problem in postpartum depression but not so much in postpartum psychosis. Treatment of depressive symptoms will improve bonding in almost all women, but clinicians should assess if impaired bonding is still present after remission because for a small group special care and treatment focused on bonding might be required. Full article
(This article belongs to the Special Issue Pregnancy and Bipolar Disorder)
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5 pages, 190 KiB  
Article
Lithium Use during Pregnancy and the Risk of Miscarriage
by Eline M. P. Poels, Astrid M. Kamperman, Annabel Vreeker, Janneke Gilden, Marco P. Boks, René S. Kahn, Roel A. Ophoff and Veerle Bergink
J. Clin. Med. 2020, 9(6), 1819; https://doi.org/10.3390/jcm9061819 - 11 Jun 2020
Cited by 9 | Viewed by 2804
Abstract
Recent studies have provided new data on the teratogenicity of lithium. Less is known about the risk of miscarriage after lithium use during pregnancy. The aim of this study was to investigate the association between lithium use during pregnancy and miscarriage. Participants were [...] Read more.
Recent studies have provided new data on the teratogenicity of lithium. Less is known about the risk of miscarriage after lithium use during pregnancy. The aim of this study was to investigate the association between lithium use during pregnancy and miscarriage. Participants were women with bipolar I disorder and one or more pregnancies, of which information on medication use and pregnancy outcome was available (n = 443). The unadjusted odds ratios for miscarriage after lithium use during pregnancy was calculated. Multilevel logistic regression was used to calculate the odds ratio, adjusted for the age at conception and the clustering of pregnancies per woman. Miscarriages occurred in 20.8% of the lithium-exposed pregnancies (16/77), compared with 10.9% of the unexposed pregnancies (40/366) (OR = 2.14; 95% CI: 1.13–4.06). The adjusted odds ratio of miscarriage after lithium use during pregnancy was 2.94 (95% CI: 1.39–6.22). Lithium use during pregnancy may increase the risk of miscarriage. Full article
(This article belongs to the Special Issue Pregnancy and Bipolar Disorder)
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