The DOI matches its Crossref record; 34 of the 34 references it cites were found in a registry or an index.
Risks and Predictors of Readmission for a Mental Disorder During the Postpartum Period
Abstract
CONTEXT: It has been suggested that the risk of inpatient psychiatric readmissions is elevated during the postpartum period. To our knowledge, no prior study has compared mothers and nonmothers to determine whether the risk of readmission differs between these 2 groups of women. OBJECTIVES: To compare mothers and nonmothers to assess whether childbirth increases the risk for psychiatric readmission and to identify predictors of psychiatric readmission during the postpartum period. DESIGN: A population-based cohort study merging data from the Danish Civil Registration System and the Danish Psychiatric Central Register. SETTING: The population of Denmark. PARTICIPANTS: Two partly overlapping study populations included a total of 28 124 women, 10 218 of whom were mothers, who were followed up from January 1, 1973, through June 30, 2005. Main Outcome Measure Readmission rates to psychiatric hospitals during the 12 months after childbirth (first live-born child). RESULTS: The period of highest risk of psychiatric readmission in new mothers was 10 to 19 days post partum (relative risk [RR], 2.71; 95% confidence interval [CI], 1.68-4.37), and the period of lowest risk was during pregnancy (0.54; 0.43-0.69). Childbirth was associated with an increased risk of readmission during the first postpartum month, after which risk for readmission was higher among nonmothers (RR, 1.53; 95% CI, 1.31-1.80). A previous diagnosis of bipolar affective disorder was the strongest predictor of readmissions 10 to 19 days post partum (RR, 37.22; 95% CI, 13.58-102.04). In all, 26.9% of mothers with this diagnosis were readmitted within the first postpartum year. CONCLUSIONS: Mothers with mental disorders have lower readmission rates compared with women with mental disorders who do not have children. However, the first month after childbirth is associated with increased risk of psychiatric readmission, and women with a history of bipolar affective disorder are at particular risk of postpartum psychiatric readmissions.
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“Women are vulnerable to affective psychoses after birth more than at any other time during their lives [28].”
From Perinatal mental illness: Definition, description and aetiology (2014) · cites this paper as [28]
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“Munk-Olsen et al. (2009) assessed a group of mothers who had all been hospitalized for psychosis prior to delivery and found that women most likely to be hospitalized postpartum were those with a greater number of previous admissions, those with a more recent psychiatric admission (especially…”
BackgroundResultInfluentialRehospitalization of Postpartum Depression and Psychosis After Electroconvulsive Therapy
Rönnqvist, I., Brus, O., Hammar, Å., Landén, M., Lundberg, J., Nordanskog, P., & Nordenskjöld, A. (2019) · Journal of Ect · doi:10.1097/yct.0000000000000578 · Cited by 20
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“Longitudinal studies have identified and characterized periods of heightened risk for mood episodes during reproductive transitions [7, 8].”
BackgroundPsychosocial Assessment and Integrated Perinatal Care
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“population administrative data have yielded similar or slightly lower estimates than our clinical sample [3,35,36].”
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Self-citationFamily planning for women with severe mental illness in rural Ethiopia: a qualitative study
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Postpartum Relapse in Patients with Bipolar Disorder
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“[7] analyzed the risk of perinatal psychiatric readmission in a population of more than 28,000 women with preexisting mental illness, finding a higher relative risk of relapse during the early postpartum period for BD patients (relative risk = 37.”
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“…motherhood, or social support do not seem to predict a first postpartum episode in women with BD (Akdeniz et al. 2003), nor was a history of mental illness in the father of the baby associated with increased risk of admission during the peri-natal period in women with BD (Munk-Olsen et al. 2009).”
BackgroundResultOestradiol and Psychosis: Clinical Findings and Biological Mechanisms
Wieck, A. (2011) · Current topics in behavioral neurosciences · doi:10.1007/7854_2011_127 · Cited by 15
“It has been known for some time that childbirth can trigger psychotic illnesses, but two recent epidemiological studies covering the whole population of Denmark over three decades have quantified this effect for different diagnoses more precisely ( Munk-Olsen et al. 2006, 2009 ).”
BackgroundEmotional anticipation after delivery – a longitudinal neuroimaging study of the postpartum period
Gingnell, M., Toffoletto, S., Wikström, J., Engman, J., Bannbers, E., Comasco, E., & Poromaa, I. S. (2017) · Scientific Reports · doi:10.1038/s41598-017-00146-3 · Cited by 15
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(2022) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9780890425787.x03_bipolar_and_related_disorders · Cited by 17
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Screening for Bipolar Disorder During Pregnancy and the Postpartum Period
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“Current literature shows that pregnancy is a low-risk period for a first-onset manic episode in women with BD [9].”
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“Studies have documented a strong temporal association between childbirth and the occurrence of a range of severe mental disorders in new mothers, e.g. (Munk-Olsen et al. 2006, 2009; Harlow et al. 2007; Viguera et al. 2000; Kendell et al. 1987; Terp and Mortensen 1998).”
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Is parity status associated with bipolar disorder clinical features, severity or evolution?
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“However, women with bipolar disorder are at high risk of symptom relapse during the perinatal period (Munk-Olsen et al., 2009; Viguera et al., 2011; Wesseloo et al., 2016), and those treated with lithium have a significantly lower rate of relapse during this period (Bergink et al.”
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Bipolar Disorder Through Pregnancy and Postpartum
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Postpartum bipolar episodes are not distinct from spontaneous episodes: Implications for DSM-V
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“This should not be used to cast any doubt on the existence of postpartum onset as a clinical phenomena, as its relevance as a risk or triggering factor remains unquestionable and is well supported by the evidence (Tsuchiya et al., 2003; Munk-Olsen et al., 2009).”
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Self-citationLight therapy for mood disorders
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“Furthermore the postpartum period is a time of increased risk for psychotic relapse and parenting difficulties [20,21].”
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“Moreover, women are at higher risk for post-partum mania (i.e. first or recurrent episode) compared to both psychosis and major depressive disorder (Munk-olsen et al., 2009).”
Kang, S., Yang, J. S., Yun, B. H., Gelaye, B., An, S. K., & Jung, S. J. (2025) · The British Journal of Psychiatry · doi:10.1192/bjp.2024.247 · Cited by 9
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“Indeed, bipolar disorder has the highest risk of relapse within the postpartum period (7).”
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“Also, studies have shown an increased incidence of depression during the first 5 months postpartum (Eberhard-Gran, Tambs, Opjordsmoen, Skrondal, & Eskild 2003; Gavin et al., 2005; Munk-Olsen et al., 2009).”
BackgroundPrescrire des antipsychotiquesen postpartum
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“The distinction between onset in the first 3 months after delivery and lateronset illness was made as the first 3 months postpartum is the highest risk time of a postpartum mental disorder.(5)”
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“The observed patterns align with Danish population-based perinatal mental health literature, which reported bipolar affective disorder as the strongest predictor of a mother requiring MBU care [38].”
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“Among major mental disorders, bipolar disorder is the highest risk group with regard to relapse and readmission during the postpartum period (33).”
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Course and Outcome of Bipolar Disorder
Mitchell, P. B., Hadži-Pavlović, D., & Loo, C. K. A. (2010) · Current topics in behavioral neurosciences · doi:10.1007/7854_2010_66 · Cited by 6
“Munk-Olsen et al. (2009) reported that 27% of mothers with prior BPD were admitted within 1-year postpartum, and that a previous diagnosis of BPD was the strongest predictor of a postpartum psychiatric admission.”
BackgroundBrexanolone and related neurosteroid GABA(A) positive allosteric modulators for postnatal depression
Wilson, C. A., Robertson, L., Brown, J. V. E., Ayre, K., & Khalifeh, H. (2021) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd014624 · Cited by 6
Mental Disorders of the Female Reproductive Cycle
Medvedev, V. E. (2022) · Psikhiatriya · doi:10.30629/2618-6667-2022-20-2-85-96 · Cited by 6
Barker, L. C., & Vigod, S. N. (2023) · Current Psychiatry Reports · doi:10.1007/s11920-023-01472-2 · Cited by 6
“Immediately postpartum, risk for admission increases [36]; however, the immediate postpartum risk among individuals with schizophrenia does not appear to be as high as for those with bipolar disorder who are at a particularly high risk of postpartum psychosis and admission [35, 37].”
Yang, J. M. K., Jones, I. R., & Florio, A. D. (2022) · Springer eBooks · doi:10.1007/978-3-030-91832-3_9 · Cited by 6
Uso de antipsicóticos durante el embarazo y la lactancia
Guillén, J. M. B. (2009) · Revista de Psiquiatría y Salud Mental · doi:10.1016/s1888-9891(09)72405-x · Cited by 6
Acute psychiatric illness and drug addiction during pregnancy and the puerperium
Bijma, H. H., Aaldriks, A. A., Knijff, E. M., & Koorengevel, K. M. (2020) · Handbook of clinical neurology · doi:10.1016/b978-0-444-64240-0.00007-6 · Cited by 5
Psychiatric Disorders During Pregnancy and Postpartum Period: A Guide For Perinatal Interview
Yazıcı, E., & Şahin, S. (2023) · Eurasian Journal of Medicine · doi:10.5152/eurasianjmed.2023.23329 · Cited by 7
“26 In a large-scale meta-analysis, the prevalence of bipolar disorder in women without any known psychiatric disease before the perinatal period was found to be 2.6%, and the prevalence of any mood episode in the bipolar spectrum during pregnancy and the postpartum period was 20.1%.”
InfluentialIntegrated theory to unify status among schizophrenia and manic depressive illness.
Fukuda, K. (2015) · Medical Hypotheses · doi:10.1016/j.mehy.2015.06.012 · Cited by 5
“Furthermore, women with premenstrual symptoms may be more likely to experience postpartum depression [50].”
BackgroundMaternal Perinatal Psychopathology: Overview
Cantwell, R. (2015) · Springer eBooks · doi:10.1007/978-3-319-21557-0_2 · Cited by 5
Affective Disorders and Gender Differences
de Arrieta, P. P. M., & Arenaza, J. G. (2019) · Springer eBooks · doi:10.1007/978-3-030-15179-9_26 · Cited by 6
Bergink, V., & Kushner, S. A. (2014) · Springer eBooks · doi:10.1007/978-3-642-54562-7_10 · Cited by 4
Caruso, S., Caruso, G., Bruno, M. T., Minona, P., Guardo, F. D., & Palumbo, M. A. (2023) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2023.06.026 · Cited by 5
Anke, T. M. S., & Skjelstad, D. V. (2025) · International Journal of Bipolar Disorders · doi:10.1186/s40345-025-00374-x · Cited by 6
“Adapting to motherhood and caring for an infant may be a potentially stressful process for women with bipolar disorder (BD), as they are far more likely to suffer from postpartum illness episodes than women with any other mental disorder (Jones et al. 2014; Munk-Olsen et al. 2006, 2009).”
Mental Health and Behavioral Disorders in Pregnancy
Wisner, K. L., Sit, D. K. Y., Bogen, D. L., Altemus, M. M., Pearlstein, T. B., Svikis, D. S., Misra, D. P., & Miller, E. S. (2017) · Elsevier eBooks · doi:10.1016/b978-0-323-32108-2.00055-x · Cited by 4
Gestational Stress and Parenting: A Review of Human and Animal Literature
Cost, K. T., McGowan, P. O., & Pawluski, J. L. (2021) · Springer eBooks · doi:10.1007/978-3-030-60159-1_12 · Cited by 4
The course of bipolar disorder in pregnant versus non-pregnant women
Stevens, A. W. M. M., Draisma, S., Goossens, P. J. J., Broekman, B. F. P., Honig, A., der Klein, E. A. M. K.-V., Nolen, W. A., Post, R. M., & Kupka, R. (2021) · International Journal of Bipolar Disorders · doi:10.1186/s40345-021-00239-z · Cited by 5
Jones, I. R., Chandra, P. S., Dazzan, P., & Howard, L. M. (2014) · Cited by 4
Antidepressant treatment for postnatal depression
Brown, J. V. E., Wilson, C. A., Ayre, K., South, E., Molyneaux, E., Trevillion, K., Howard, L. M., & Khalifeh, H. (2020) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013560 · Cited by 6
The Incidence of Mental Illness in Early Motherhood in a Population-Based Survey
Mota, N. P., Enns, M. W., & Sareen, J. (2011) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e31820c73ff · Cited by 4
“Finally, the postpartum time frame examined in previous research has also varied widely, while the studies by Munk-Olsen et al. (2006, 2009) suggest that the risk of mental disorder in postpartum changes considerably over time.”
BackgroundResultInfluentialCoopérer entre institutions en périnatalité
Nezelof, S. (2016) · Spirale · doi:10.3917/spi.078.0018 · Cited by 4
Use of antipsychotics during pregnancy and breastfeeding
Guillén, J. M. B. (2009) · Revista de Psiquiatría y Salud Mental (English Edition) · doi:10.1016/s2173-5050(09)70045-7 · Cited by 4
Bipolar Disorder in Women: Menstrual Cycle, Perinatal Period, and Menopause Transition
Forrest, L. F., Smith, M., Quevedo, J., & Frey, B. N. (2020) · Springer eBooks · doi:10.1007/978-3-030-29081-8_6 · Cited by 4
Maternal Mortality in Sweden : Classification, Country of Birth, and Quality of Care
Esscher, A. (2014) · KTH Publication Database DiVA (KTH Royal Institute of Technology) · Cited by 4
Metadata
- Authors
- Munk-Olsen, T., Laursen, T. M., Mendelson, T., Pedersen, C. B., Mors, O., & Mortensen, P. B.
- Affiliations
- Aarhus University (DK)
- Johns Hopkins University (US)
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2009-02-01
- Volume
- 66
- Issue
- 2
- Pages
- 189
- ISSN
- 0003-990X (ISSN-L)
- OpenAlex
- W2066961699
- Cited by
- 299
- References
- 34
- Citations by year
- 2026: 7 · 2025: 13 · 2024: 9 · 2023: 20 · 2022: 16 · 2021: 30 · 2020: 19 · 2019: 21 · 2018: 20 · 2017: 16 · 2016: 17 · 2015: 20 · 2014: 17 · 2013: 17 · 2012: 17
- FWCI
- 18.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Keywords
- postpartum period, psychiatric readmission, maternal mental illness, bipolar disorder, childbirth, predictors of readmission, pregnancy, psychiatric hospitalization
- MeSH terms
- Adjustment Disorders, Adult, Feeding and Eating Disorders, Mental Disorders, Bipolar Disorder, Cross-Sectional Studies, Denmark, Female, Hospitals, Psychiatric, Humans, Patient Readmission, Personality Disorders, Pregnancy, Puerperal Disorders, Recurrence, Risk, Schizophrenia, Cohort Studies, Incidence, Depression, Postpartum, Substance-Related Disorders
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