Screening for postpartum bipolar disorder: validation of the Mood Disorder Questionnaire.

BACKGROUND

Despite the prevalent nature of postpartum depression in women with bipolar disorder, there are currently no screening instruments designed specifically for bipolar disorder in the postpartum period.

METHODS

Women with histories of major depressive disorder or bipolar disorder (type I or II) attending an outpatient perinatal clinic were administered the Mood Disorder Questionnaire during the first month after delivery. An experienced research coordinator, blind to the Mood Disorder Questionnaire results, conducted a face to face diagnostic interview using the Structured Clinical Interview for DSM-IV.

RESULTS

A total of 57 women with bipolar disorder (30 with bipolar II disorder and 27 with bipolar I disorder) and 68 women with major depressive disorder completed the Mood Disorder Questionnaire between two to four weeks after delivery. The traditional scoring criteria yielded a sensitivity of 75.44% [95%CI: 62.24%-85.87%] and a specificity of 86.76% [95%CI: 76.36%-93.77%]. The optimal cut-off score was eight or more endorsed symptoms without the supplementary questions (a sensitivity of 87.72% [95% CI: 76.32%-94.92%] and a specificity of 85.29% [95%CI: 74.61%-92.72%]).

CONCLUSIONS

The Mood Disorder Questionnaire with alternate scoring is a useful screening instrument for bipolar disorder in the postpartum period.