Predictors of response to antidepressants in women with postpartum depression: a systematic review.

Antidepressants are the mainstay of drug treatment for moderate or severe postpartum depression. Knowledge of predictors of response could help optimize treatment and reduce the adverse consequences of postpartum depression. The purpose of this systematic review was to ascertain predictors of response or remission to antidepressant treatment in women with postpartum depression.

A closer look at the nosological status of the highs (hypomanic symptoms) in the postpartum period.

Studies from several countries have reported occurrence of the highs (hypomanic symptoms) immediately after childbirth; however, questions remain about the relationship of the highs with mood disorders. This systematic review aims to clarify this relationship, critically review important aspects of the highs, and make treatment recommendations and suggestions for future research. The electronic databases of MEDLINE/PubMed, PsycINFO, CINAHL, Cochrane Database of Systematic Reviews, and Evidence-Based Medicine Reviews (EBMR) were searched using the keywords and their combinations: postpartum, euphoria, hypomania, and baby pinks.

Revisiting the association between endometriosis and bipolar disorder.

Objective: We sought to study the association between endometriosis and bipolar disorder.

Methods: Using the Structured Clinical Interview for DSM-IV Axis I Disorders, the prevalence of bipolar disorder was compared in 27 patients with endometriosis and 12 women with pelvic pain not related to endometriosis who were seen at a specialty gynaecology clinic for women with chronic pelvic pain.

Results: A significantly greater proportion of women in the endometriosis group were found to have bipolar disorder and a poorer quality of life than women with pelvic pain not related to endometriosis.

Identification of bipolar disorder in women with postpartum depression.

Objective: No studies to date have assessed the pharmacological management of treatment-resistant postpartum depression. We reviewed the pharmacological treatment of postpartum depression in patients diagnosed with treatment-resistant 'unipolar' depression.

Methods: We conducted a chart review of patients treated consecutively at a perinatal clinic.

Missed bipolarity and psychiatric comorbidity in women with postpartum depression.

Objective: To investigate the diagnostic profile of women referred for postpartum depression.

Methods: Fifty-six women seen consecutively with the referral diagnosis of postpartum depression were administered structured instruments to gather information about their DSM-IV Axis I diagnoses.

Results: In terms of frequency of occurrence, the primary diagnoses in this sample were: major depressive disorder (46%), bipolar disorder not otherwise specified (29%), bipolar II disorder (23%), and bipolar I disorder (2%).

Role of lamotrigine in the management of treatment-resistant bipolar II depression: a chart review.

Objectives: We report the results of a retrospective, naturalistic study of lamotrigine in the management of treatment-resistant bipolar II depression.

Methods: Hospital charts of 31 patients treated at a mood disorders clinic, who had been on lamotrigine for at least six months after failing to show an adequate response to a combination of two mood stabilizers or a mood stabilizer and an antidepressant, were reviewed using the Clinical Global Impression-Improvement (CGI) rating scale.

Results: Patients were seen for an average of 19.

A closer look at treatment resistant depression: is it due to a bipolar diathesis?

Background: Treatment resistant depression is a common clinical problem. Studies have shown that a large number of patients with depression do not have a satisfactory clinical outcome in spite of adequate trials of antidepressant drugs. In this study, we investigated demographic and clinical characteristics, diagnostic subtypes, and illness outcome of patients with resistant depression and a history of escape of response to adequate trials of at least two antidepressants for a previous episode.

The relationship between duration of labour, time of delivery, and puerperal psychosis.

Background: Puerperal psychosis is the most serious psychiatric disorder after childbirth. Despite the ongoing debate regarding its diagnostic status, there is increasing evidence that it is related to bipolar or schizoaffective disorder. Although a well-recognized precipitant of mania, the role of sleep loss has not been systematically studied in the onset of puerperal psychosis.