History of Premenstrual Mood Change and Postpartum Episodes are Associated with Perimenopausal Episodes in Women with Bipolar Disorder

Background and Aims: Reproductive life events are potential triggers of mood episodes in women with bipolar disorder. We aimed to establish whether a history of premenstrual mood change and postpartum episodes are associated with perimenopausal episodes in women who have bipolar disorder. Methods: Participants were 339 post-menopausal women with DSM-IV bipolar disorder recruited into the Bipolar Disorder Research Network (www.bdrn.org). Women self-reported presence (N = 200) or absence (N = 139) of an illness episode during the perimenopausal period. History of premenstrual mood change was measured using the self-report Premenstrual Symptoms Screening Tool (PSST), and history of postpartum episodes was measured via semi-structured interview (Schedules for Clinical Assessment in Neuropsychiatry, SCAN) and inspection of case-notes. Results: History of a postpartum episode within 6 months of delivery (OR = 2.13, p = 0.03) and history of moderate/severe premenstrual syndrome (OR = 6.33, p < 0.001) were significant predictors of the presence of a perimenopausal episode, even after controlling for demographic factors. When we narrowed the definition of premenstrual mood change to premenstrual dysphoric disorder, it remained significant (OR = 2.68, p = 0.007). Conclusions: Some women who have bipolar disorder may be particularly sensitive to reproductive life events. Previous mood episodes in relation to the female reproductive lifecycle may help clinicians predict individual risk for women with bipolar disorder approaching the menopause. There is a need for prospective longitudinal studies of women with bipolar disorder providing frequent contemporaneous ratings of their mood to overcome the limitations of retrospective self-report data.

The Professionalisation of Non-Denominational Religious Education in England: Politics, Organisation and Knowledge

In response to contemporary concerns, and using neglected primary sources, this article explores the professionalisation of teachers of Religious Education (RI/RE) in non-denominational, state-maintained schools in England. It does so from the launch of Religion in Education (1934) and the Institute for Christian Education at Home and Abroad (1935) to the founding of the Religious Education Council of England and Wales (1973) and the British Journal of Religious Education (1978). Professionalisation is defined as a collective historical process in terms of three inter-related concepts: (1) professional self-organisation and professional politics, (2) professional knowledge, and (3) initial and continuing professional development. The article sketches the history of non-denominational religious education prior to the focus period, to contextualise the emergence of the professionalising processes under scrutiny. Professional self-organisation and professional politics are explored by reconstructing the origins and history of the Institute of Christian Education at Home and Abroad, which became the principal body offering professional development provision for RI/RE teachers for some fifty years. Professional knowledge is discussed in relation to the content of Religion in Education which was oriented around Christian Idealism and interdenominational networking. Changes in journal name in the 1960s and 1970s reflected uncertainties about the orientation of the subject and shifts in understanding over the nature and character of professional knowledge. The article also explores a particular case of resistance, in the late 1960s, to the prevailing consensus surrounding the nature and purpose of RI/RE, and the representativeness and authority of the pre-eminent professional body of the time. In conclusion, the article examines some implications which may be drawn from this history for the prospects and problems of the professionalisation of RE today.