Borderline personality traits are differently associated with postpartum psychosis and postpartum depression episodes in women with bipolar disorder.


Journal

Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073

Informations de publication

Date de publication:
01 05 2023
Historique:
received: 24 06 2022
revised: 14 01 2023
accepted: 30 01 2023
pubmed: 5 2 2023
medline: 15 3 2023
entrez: 4 2 2023
Statut: ppublish

Résumé

Women with bipolar disorder have approximately 40 %-50 % chance of having a perinatal bipolar recurrence. Knowing the factors associated will be beneficial for the prediction and prevention of episodes. We aim to establish if borderline personality disorder traits, as measured by the BEST (Borderline Evaluation of Severity over Time) scale, are associated with perinatal psychiatric outcomes. We recruited women with bipolar disorder as part of the BDRN (Bipolar Disorder Research Network) study. Women were interviewed and we collected their demographic and clinical information. Participants subsequently completed the BEST questionnaire. We analysed the association of BEST scores with lifetime presence/absence of perinatal bipolar relapse and, employing multinomial logistic regression, with different subtypes of perinatal outcomes: postpartum psychosis; postpartum depression, and other episodes. In our sample of 807, although there was no significant association between the BEST total score and perinatal episodes as a whole (adjustedOR 1.01 CI95% [0.99, 1.03], p = 0.204), we found significant differing associations with different subtypes of episodes. Women scoring highly on BEST were less likely to experience a postpartum psychotic episode (RRR 0.96 CI95% [0.94, 0.99], p = 0.005) but more likely to experience a non-psychotic depressive episode (RRR 1.03 CI95% [1.01, 1.05], p = 0.007) than no relapse. This study is limited by its cross-sectional design and self-report nature of BEST. In women with bipolar disorder, borderline traits differentiate the risk of postpartum depression and postpartum psychosis, emphasise the importance of considering risk factors for these perinatal episodes separately, and may help individualise the risk for women in the perinatal period.

Sections du résumé

BACKGROUND
Women with bipolar disorder have approximately 40 %-50 % chance of having a perinatal bipolar recurrence. Knowing the factors associated will be beneficial for the prediction and prevention of episodes. We aim to establish if borderline personality disorder traits, as measured by the BEST (Borderline Evaluation of Severity over Time) scale, are associated with perinatal psychiatric outcomes.
METHODS
We recruited women with bipolar disorder as part of the BDRN (Bipolar Disorder Research Network) study. Women were interviewed and we collected their demographic and clinical information. Participants subsequently completed the BEST questionnaire. We analysed the association of BEST scores with lifetime presence/absence of perinatal bipolar relapse and, employing multinomial logistic regression, with different subtypes of perinatal outcomes: postpartum psychosis; postpartum depression, and other episodes.
RESULTS
In our sample of 807, although there was no significant association between the BEST total score and perinatal episodes as a whole (adjustedOR 1.01 CI95% [0.99, 1.03], p = 0.204), we found significant differing associations with different subtypes of episodes. Women scoring highly on BEST were less likely to experience a postpartum psychotic episode (RRR 0.96 CI95% [0.94, 0.99], p = 0.005) but more likely to experience a non-psychotic depressive episode (RRR 1.03 CI95% [1.01, 1.05], p = 0.007) than no relapse.
LIMITATIONS
This study is limited by its cross-sectional design and self-report nature of BEST.
CONCLUSIONS
In women with bipolar disorder, borderline traits differentiate the risk of postpartum depression and postpartum psychosis, emphasise the importance of considering risk factors for these perinatal episodes separately, and may help individualise the risk for women in the perinatal period.

Identifiants

pubmed: 36739003
pii: S0165-0327(23)00142-8
doi: 10.1016/j.jad.2023.01.124
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

81-86

Subventions

Organisme : Wellcome Trust
ID : 078901
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/R017557/1
Pays : United Kingdom

Informations de copyright

Copyright © 2023. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Conflict of interest None.

Auteurs

Marisa Casanova Dias (M)

National Centre for Mental Health, Cardiff University School of Medicine, Cardiff, UK; Section of Women's Mental Health, King's College London, London, UK. Electronic address: casanovadiasm@cardiff.ac.uk.

Mark Kelson (M)

University of Exeter, Faculty of Environment, Science and Economy, Department of Mathematics and Statistics, Exeter, UK.

Katherine Gordon-Smith (K)

Psychological Medicine, University of Worcester, Worcester, UK.

Amy Perry (A)

Psychological Medicine, University of Worcester, Worcester, UK.

Nick Craddock (N)

National Centre for Mental Health, Cardiff University School of Medicine, Cardiff, UK.

Lisa Jones (L)

Psychological Medicine, University of Worcester, Worcester, UK.

Arianna Di Florio (A)

National Centre for Mental Health, Cardiff University School of Medicine, Cardiff, UK.

Ian Jones (I)

National Centre for Mental Health, Cardiff University School of Medicine, Cardiff, UK.

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