Psychiatric episodes in women with young children

An historical cohort study was performed. Subjects were 118 pregnant women or mothers of children of < 3 years who were assessed at presentation to a psychiatric hospital and 5 years later. The relationship of episode onset to childbearing (during pregnancy or within 3 months of birth) was derived from psychiatric records at presentation and retrospectively determined by interview and life-event charting at follow-up. Determining childbearing status from records yielded an error rate of 30% compared with the status derived from direct interview. A change in diagnosis in the ChildBearing-Related Onset Illness (CBROI) category occurred in 50% of subjects. When Research Diagnostic Criteria were applied retrospectively to the presenting episodes, 95% of women with CBROI had affective disorder diagnoses. Clinicians in our intake setting often missed episodes of mania or hypomania in our subjects' histories.