Bipolar and Postpartum Psychosis: PREP Study
Research type
Research Study
Full title
Bipolar and Postpartum Psychosis: Pregnancy Planning (PREP) Study
IRAS ID
255100
Contact name
Ian Jones
Contact email
Sponsor organisation
Cardiff University
Duration of Study in the UK
3 years, 0 months, 0 days
Research summary
Bipolar disorder is characterised by episodes of high mood (mania) and low mood (depression). For women with bipolar disorder (around 3% of the population), childbirth is a period of high risk with on average 40-50% experiencing a significant recurrence, including in 20%, a severe episode of mania or psychotic illness - postpartum psychosis. Postpartum psychosis is a psychiatric emergency and is usually characterised by episodes of mania, severe psychotic depression, or mixed episodes with features of both high and low mood. These episodes have a big impact on women and their families: illness can influence bonding with the new baby; relationships can suffer; and suicide is a leading cause of maternal death.
Women with lived experience of bipolar disorder or postpartum psychosis therefore, have very difficult decisions to make about pregnancy. These include stopping, switching or continuing medications, with all of these options having potential risks and benefits. Recent work has shown that women have great difficulty in getting the information they need and in working with clinical services to develop a plan for pregnancy and the postpartum period.
Researchers from the National Centre for Mental Health (NCMH) will work with Action on Postpartum Psychosis (APP) (www.app-network.org), the leading 3rd sector organisation in this area, and women with lived experience of bipolar disorder and / or postpartum psychosis, to develop and test a ‘collaborative guide’ to aid co-production and joint decision making related to planning a family, pregnancy and the postpartum period. The aim of the guide is to help women address the difficult questions they face through pregnancy and the postpartum, reduce their risk of becoming unwell in the perinatal period, and improve their access to care if they experience an episode of illness. This will enable women with lived experience of bipolar disorder and / or postpartum psychosis, who are therefore at high risk of experiencing mental illness during the perinatal period, to take an enhanced role in planning their pregnancy and the postpartum period.
The methodology can be broken down into two stages:
Stage 1
In stage 1, women, partners and key stakeholders will be asked to share their thoughts and opinions on what should be included in the guide, how it should be delivered and when, as well as any additional factors based on their own experiences. We will also ask participants to consider background information, including up-to-date information on risk factors for postpartum psychosis and self-management strategies used to prevent and manage postpartum psychosis.Stage 2
Stage 2 will include testing the ‘collaborative guide’ through two pilot studies, with separate groups of women with lived experience of bipolar disorder and / or postpartum psychosis taking part in pilot study 1 and pilot study 2. Women taking part will either be pregnant or planning a pregnancy and will use the guide at home and during clinical appointments to make informed decisions relating to pregnancy, childbirth and the postpartum period.REC name
Wales REC 2
REC reference
19/WA/0142
Date of REC Opinion
7 Jun 2019
REC opinion
Further Information Favourable Opinion