Social and reproductive lives of women with bipolar disorder: a descriptive study from Turkey

Aims: Bipolar disorder (BD) shows some differences across genders. Pregnancy, delivery, and lactation periods of women with BD may sometimes interfere with their treatment. In terms of social and reproductive lives, the characteristics of women with bipolar disorder living in our country have not been thoroughly studied yet. The aims of this study were to investigate the characteristics of marital life, fertility, and social life of the women with BD. Methods: The study was conducted in 5 different centers from 3 parts of the Turkey between January-June 2011. A total of 231 women with the diagnosis of BD have been included in the study. The diagnosis was confirmed by using Structured Clinical Interview for the DSM-IV Axis-I Disorders (SCID-I). Sociodemographical and clinical features of the patients were recorded by using a semistructured form prepared by the authors. Results: The mean age of the patients was 39.19 +/- 11.2 years ranging from 18 to 73. Mean age at onset of BD was 24.22 +/- 7.5 years of age. The type of diagnosis was BD Type-I in 220 (95.2%) patients, whereas, BD Type-II in 11 (4.8%) patients. Mean numbers of depressive, manic, and hypomanic episodes were 3.36 +/- 3.4, 3.75 +/- 3.6, and 1.68 +/- 2.0, respectively. Mean number of hospitalizations was 3.43 +/- 3.8 where 92.3% (n=213) of the participants were hospitalized at least once. History of at least one suicide attempt was proclaimed by 32.5% (n=75) of the patients. Fourty-two (18.2%) patients reported at least one mood episode during their pregnancy. Additionally, a puerperal episode was defined by 20.77% (n=48) of the patients. Almost one fifth of the patients (18.6%) had to suspend their education due to their disorder, whereas 12.1% were not able to pursue it anymore. Frequency of the patients who worked in a regular job was 19.1%. Marital status of the patients were as follows; unmarried 23.3%, married 51.1%, living with a partner 2.2%, divorced 20.3%, and widowed 2.6%. Among the participants 11.3% reported that they could not marry due to stigma of their disorder, whereas, 16% reported a divorce history due to BD. Mean numbers of pregnancy and children were 3.02 +/- 2.0 and 2.18 +/- 1.4, respectively. Menstrual abnormalities were reported by 51.5% of the patients. Amenorrhea and galactorrhea secondary to the medications were identified in 13.9% and 22.5% of the patients at sometime during their disease course, respectively. Only 28.6% of the participants acknowledged that their psychiatrists have provided information about contraception. Conclusions: When its effects on social life and reproductive life were taken into account, BD harbors many specific conditions for female patients that should be investigated further and kept in mind. This study cross-sectionally investigated characteristics of social and reproductive lives of the patients with BD who were living in Turkey. Its results are important given the fact that it is the first large-scale study conducted in our country on this topic.