Two new studies in American Journal of Psychiatry explore risk prediction for postpartum mental health conditions

(Press-News.org) LOS ANGELES, May 19, 2025 — Two new studies examining mental health risks postpartum were published online today in the American Journal of Psychiatry in conjunction with Maternal Mental Health Awareness Month and the 2025 Annual Meeting of the American Psychiatric Association (APA). One study sought to estimate the risk of postpartum depression in people without a history of depression, and the other looked at the familial contribution to the risk of postpartum psychosis. Researchers from both studies were on hand to discuss their findings at a special briefing held at the APA meeting.

 

Risk for Postpartum Depression

Postpartum depression is a treatable mental health condition occurring after childbirth that impacts an estimated one in seven women. It involves feelings of extreme sadness, indifference and/or anxiety and changes in energy, sleep, and appetite and carries risks for the mother and child.

 

As author Mark A. Clapp, M.D., M.P.H., explained, he and a team of researchers, led by Roy H. Perlis, M.D. M.Sc., examined data on more than 29,000 individuals who had delivered at two large medical centers and six community hospitals between 2017 and 2022. About 9% of the individuals had experienced postpartum depression in the six months following delivery. 

 

The researchers tested a machine-learning model to predict the risk of postpartum depression. The model was able to predict the onset of postpartum depression in almost 30% of the people who would have it. It also was able to predict a lack of postpartum depression among 90% of the people who did not develop it.

 

The authors conclude that such a machine learning model could be used to predict the risk of postpartum depression before new parents leave the hospital and note that “This tool could help identify patients within a practice at the highest risk and facilitate individualized postpartum care planning for the prevention of, screening for, and management of postpartum depression at the start of the postpartum period and potentially the onset of symptoms.”

 

Other study authors were Victor M. Castro, M.S., Pilar Verhaak, B.S., Thomas H. McCoy, M.D., Lydia L. Shook, M.D., and Andrea G. Edlow, M.D., M.Sc. This research was supported by grants from National Institute of Mental Health (NIMH), the National Institute of Child Health and Human Development, and the Simons Foundation.

 

Familial Risk of Postpartum Psychosis
A second study looked at the risk for postpartum psychosis, specifically the increased risk among women with a sister who had experienced the condition. Postpartum psychosis is a rare but serious mental illness. The symptoms may include insomnia, excessive energy, agitation, elevated or depressed mood, hearing voices, and paranoia. It is a serious medical emergency but with good treatment outcomes if detected and treated in time.

 

As Veerle Bergink, M.D., Ph.D., one of the study authors, explained, the study looked at records of more than 1.6 million women from the Swedish nationwide registers. Among them, 0.15% (2,514) experienced postpartum psychosis within three months of their first-ever childbirth.

 

The study found that a woman is more than 10 times likely to develop postpartum psychosis if her sister had the condition, compared to a woman with a sister who did not have the condition. Given the overlap between postpartum psychosis and bipolar disorder, the Swedish registry study further showed that the presence of bipolar disorder in a sister doubles the risk of developing postpartum psychosis. Women with a sister with bipolar disorder and postpartum psychosis are at highest risk; their risk for getting postpartum psychosis themselves is 14 times increased. These findings support the view that even though there is overlap between postpartum psychosis and bipolar disorder, these are distinct conditions.

 

While the risk is significantly higher among full siblings, it’s important to note that the absolute risk is still relatively low, estimated at 1.60% within the entire population. The authors note that the results provide guidance for clinicians and that women with a sister who has experienced postpartum psychosis should be counseled that “their own risk is elevated, but that the absolute risk for the disorder remains small.”

 

Other study authors included Adrianna P. Kępińska, Ph.D., Thalia K. Robakis, M.D., Ph.D., Keith Humphreys, Ph.D., Xiaoqin Liu, Ph.D., René S. Kahn, M.D., Ph.D., Trine Munk-Olsen, Ph.D., and Behrang Mahjani, Ph.D.

 

This study was supported by the Beatrice and Samuel A. Seaver Foundation; NIMH grants; an Out to Innovate Career Development Fellowship; and by a NARSAD Young Investigator Grant from the Brain and Behavior Research Foundation. 

 

How the Two Studies Inform the Field

The researchers presenting at the APA meeting were introduced by the American Journal of Psychiatry’s Editor-in-chief, Ned Kalin, M.D., who had this to say about the contributions to the postpartum mental health literature:

 

“Maintaining maternal mental health and well-being is critical for not only mothers’ health but also for their babies’ normal social, emotional, and physical development. Psychiatric illnesses such as anxiety and depression are common during the perinatal period with the most severe problems presenting as postpartum psychoses. Because of the potential negative impacts, sometimes severe, on mother and baby, these illnesses need to be identified and effectively treated.

 

“During this Maternal Mental Health Awareness Month, we are pleased to feature these studies showing significant progress in identifying risk for postpartum mental health conditions and providing valuable information to improve mental health care for new mothers.”

 

Also on hand to provide a clinical perspective drawing from her expertise in perinatal psychiatry was UCLA’s Misty Richards, M.D., M.S., Assistant Clinical Professor, Department of Psychiatry & Biobehavioral Sciences at the David Geffen School of Medicine, and Program Director, UCLA Child & Adolescent Psychiatry Fellowship.

American Psychiatric Association
The American Psychiatric Association, founded in 1844, is the oldest medical association in the country. The APA is also the largest psychiatric association in the world with more than 39,200 physician members specializing in the diagnosis, treatment, prevention and research of mental illnesses. APA’s vision is to ensure access to quality psychiatric diagnosis and treatment. For more information, please visit www.psychiatry.org.

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