- Promotor
- Promotor
- Co-promotor
- Date
- Wednesday 3 Nov 2021, 13:00 - 14:30
- Type
- PhD defence
- Space
- Professor Andries Querido room
- Building
- Education Center
- Location
- Erasmus MC
Op 3 November 2021, J. Gilden will defend her PhD dissertation, entitled: ‘Severe Mood Disorders During Pregnancy and the Postpartum Period’.
The perinatal period is considered a time of increased risk for the development of both first-onset and recurrent severe psychiatric mood disorders. Both women with postpartum psychosis and bipolar disorder have an increased risk of recurrence during this high-risk period. Unfortunately, the magnitude of this recurrence risk is unknown. This is of profound clinical relevance, because it has important implications for pharmacological treatment and prognosis.
In this thesis I therefore investigated the risk of recurrence in both disease courses during the perinatal period and its possible implications for diagnostic classification within the bipolar spectrum. Studies in this thesis show that almost half of the women with a first-onset postpartum psychosis have no recurrences or only during the postpartum period after a subsequent delivery. For the remaining women, the first-onset postpartum psychosis is the incipient episode of a more disabling disease course, usually within the bipolar spectrum. If women develop a lifelong bipolar disorder, the disease course is characterized by recurrent mood episodes during the whole lifespan. Previous research identified the perinatal period as a high-risk period for recurrence in women with bipolar disorder. This thesis shows that they are especially at increased risk of recurrence after childbirth but not during pregnancy itself. The use of lithium (a mood stabilizer) reduces the risk of recurrence in both periods. However, use of lithium during pregnancy also increases the risk of miscarriage, in addition to the already known risk of birth defects in the fetus. These risks must therefore be carefully weighed against the risk of recurrence in the mother.
The public defence will take place at the Prof. Andries Queridoroom, 3rd floor Education Center, Erasmus MC. The ceremony will begin exactly at 13.00 PM. In light of the solemn nature of the ceremony, we recommend that you do not take children under the age of 6 to the first part of the ceremony.