New research out of St. Joseph’s Healthcare into the relationship between bipolar disorder and pregnancy has the potential to save lives.
For a year and a half, the staff at St. Joe’s Women’s Health Concern Clinic used a simple questionnaire to gauge the risk for bipolar disorder in their pregnant patients. Previous research has shown that one in four bipolar women relapse in symptoms when pregnant and bipolar women are at an increased risk for postpartum depression and postpartum psychosis.
"If you miss someone who is bipolar, then you are not going to prescribe the correct treatment and therefore the risk [of depression] is increased," Dr. Benicio Frey, one of the lead researchers on the study, explained.
How does the questionnaire work?
The patient responds to five questions, but the most important is the first. It asks about a list of 13 behaviours, such as getting little sleep but not really missing it. If a patient identifies with seven or more of the behaviours, they are at risk for bipolar disorder.
The free questionnaire — called the Mood Disorder Questionnaire or MDQ for short — is filled out by the patient and takes only a few minutes to complete, but Frey said the results were remarkable.
The researchers found the questionnaire was able to identify bipolar disorder with 80 per cent accuracy and, just as important, detect negative screening for the disorder with 98 per cent accuracy.
Though not used to diagnose bipolar disorder in patients — that requires a more in-depth interview process, Frey said — the MDQ serves as a screening tool to help identify patients who are most at risk of the illness.
"If a patient of ours scored negative in that screening tool, we have 98 per cent certainty that that patient is someone who does not have bipolar disorder," he said. "This is very, very significant."
But if a patient scores positive on the screening tool, they can undergo further analysis and, if diagnosed as bipolar, receive the proper treatment in order to mitigate their risk of postpartum depression, Frey said.
Currently, it’s not common practice to use the questionnaire in maternity care, but that’s something Frey wants to see changed.
"We are encouraging health professionals to use the questionnaire widely because this is one of the problems, in terms of people missing a diagnosis," Frey said. "They just don’t ask the proper questions. But if you have a questionnaire that can do that for you, it will flag those with whom you need to dig deeper."
And it’s more than just avoiding the "baby blues." Bipolar disorder is the second-most leading cause of suicide in women, according to Frey.
It is also linked to the rare and shocking incidents of mothers who murder or attempt to murder their own children, he said. About two thirds of mothers arrested for these crimes were later diagnosed with bipolar disorder.
"Imagine if those women had been diagnosed correctly and given proper treatment," he said.
"The lives of those children could have been spared."