Reproduction among 1975 Sardinian women and men diagnosed with major mood disorders

Disability varies in patients with major affective disorders [type I and II bipolar disorders (BPD) and recurrent unipolar major depressive disorder (UP-MDD)]. It may include reproductive functioning, which has rarely been studied systematically.

We compared information acquired over several years pertaining to marital/reproductive status among 1975 systematically evaluated, treated, and followed women (n = 1351) and men (n = 624) diagnosed with DSM-IV type I (n = 300) or II BPD (n = 223), or MDD (n = 1452). We compared factors between patients with vs. without children and associated with fertility rate (children/fertile years × 100), using standard bivariate methods followed by multivariate modeling.

Childless patients were younger at illness onset, more likely men, diagnosed with type I BPD, more educated, and unmarried, but similar in many aspects of clinical history to those with children. Fertility rate ranked: BP-I < BP-II ≤ MDD, and men < women. Mood-disorder patients had 17% fewer children/person than in the comparable general population of Sardinia. Among mood-disorder patients, fertility appeared to decline in Sardinia in recent decades, more in men than women.

Type I BPD was associated with lower fertility than BP-II or UP-MDD, consistent with their relatively high levels of other disabilities.