Adverse Childhood Life Events and Postpartum Psychosis in Bipolar Disorder

Background Women with bipolar disorder are at increased risk of postpartum psychosis. Adverse childhood life events have been associated with depression in the postpartum period, but have been little studied in relation to postpartum psychosis. In this study we investigated whether adverse childhood life events are associated with postpartum psychosis in a large sample of women with bipolar I disorder. Methods Participants were 432 parous women with DSM-IV bipolar I disorder recruited into the Bipolar Disorder Research Network (www.BDRN.org). Diagnoses and lifetime psychopathology, including perinatal episodes, were obtained via a semi-structured interview (Schedules for Clinical Assessment in Neuropsychiatry; Wing et al., 1990) and case-notes. Adverse childhood life events were assessed via self-report and case-notes, and compared between women with postpartum psychosis (n=208) and those without a lifetime history of perinatal mood episodes (n=224). Results There was no significant difference in the rate of any adverse childhood life event, including childhood sexual abuse, or in the total number of adverse childhood life events between women who experienced postpartum psychosis and those without a lifetime history of perinatal mood episodes, even after controlling for demographic and clinical differences between the groups. Limitations Adverse childhood life events were assessed in adulthood and therefore may be subject to recall errors. Conclusions We found no evidence for an association between adverse childhood life events and the occurrence of postpartum psychosis. Our data suggest that, unlike postpartum depression, childhood adversity does not play a significant role in the triggering of postpartum psychosis in women with bipolar disorder.

The Welsh Marches: Resilient Farmers? Exploring Farmers' Resilience to Extreme Weather Events in the Recent Past

In the 21st century climate change will cause a significant increase in the frequency and intensity of extreme weather events across Europe. Investigating farmers’ resilience to extreme weather events in the past can be used to establish the inherent level of resilience farmers’ will have to respond to comparable events in the future. The Welsh Marches has experienced a range of extreme weather events including: heatwaves, flooding; prolonged rainfall; and heavy snowfall. To identify the resilience of farmers in the Marches farmers’ apparent vulnerabilities, coping capacity, social capital and adaptive capacity that have been exposed in past events are discussed. Rural isolation is identified as an exacerbating factor of farming vulnerability. Yet, this is also an apparent source of resilience as farmers are found to rely on high social capital to assist each other in emergency and challenging situations during extreme weather events. The paper concludes by indicating that more localised studies are required, situated within unique farming cultures. This will enable a more complete picture of farmers’ resilience across Europe to be established.