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Article title: Mood symptoms in pregnant and postpartum women with bipolar disorder: a naturalistic study
Authors: Kara E. Driscoll, Dorothy K. Y. Sit, Eydie L. Moses-Kolko, Emily Pinheiro, Amy Yang, Jody D. Ciolino, Heather F, Eng, James F. Luther, Crystal T. Clark, Stephen R. Wisniewski and Katherine L. Wisner
Year published: 2017
Journal title: Bipolar Disorders
Critique:
The main point in the article is to create advocacy for pharmacotherapy among pregnant women with bipolar disease (BD) in order to enhance their psychiatric outcomes. The hypothesis is that women who received psychotropic treatment would have reduced symptom burden and show fewer functional impairments in comparison to those who did not. To meet their objectives, the authors included 159 pregnant women aged between 18-44 years, with bipolar disease. The women were from Pittsburgh, PA and were all enrolled in Antimanic use at or before 20 weeks of pregnancy. Out of the 159, seven women were lost during follow-up, 88 of the remaining women were put through psychotropic treatment after receiving consultation on bipolar management while 64 women were untreated and thus a control group. Besides, taking medication, the women were assessed three times prepartum and four times postpartum respectively. Participants in the study were not paid.
The findings of the research indicated that the use of psychotropic medication was effective in reducing depressive and manic symptoms among pregnant women with BD.

This agreed with the authors’ prediction, hence proving their hypothesis. In conclusion, the authors postulated that given the presence of mild residual depression symptoms among pregnant BD women, treatment is necessary and should be given urgent clinical consideration to promote psychiatric outcomes.
There were various limitations to the research. The first limitation is that the study may have left out women with more severe BD disorders. This is because participation was based on informed consent, that is why those who did not consent were excluded. The second limitation was in postpartum assessment, where the researchers only managed to achieve a 70% follow-up.
The authors present what they did right in the form of strengths of the investigation. They note that they commendably managed multiple observation of a population that was particularly difficult to study. They also indicate that the diversity of the sample adds to the study’s impact by enhancing the generalizability of results. In my opinion, the authors did right by providing consultation and treatment for the pregnant women, both prepartum and postpartum, which was instrumental in managing their condition. The authors propose that from here, we should consider urgent clinical attention and further research on psychiatric care for PD women in the childbearing age to improve treatment delivery and promote mental health among pregnant women.
The article presents a well-researched study with strong arguments backed by appropriate data. While there were limitations as provided above, the research did not have significant issues, mostly because the participants had made a voluntary commitment to be involved in the study. The article was moderately difficult to understand but also well-articulated, such that the reader could follow how the data informed the results.

Reference
Driscoll, K.E. et al. (2017). Mood symptoms in pregnant and postpartum women with bipolar
disorder: a naturalistic study. Bipolar Disorders. 19(4), 295–304. DOI: 10.1111/bdi.12500