Mania Triggered by Sleep Loss: Implications for Postpartum Psychosis

Background and Aims To examine whether a history of mood episodes triggered by sleep loss is associated with (1) postpartum psychosis (PP) and (2) more broadly-defined postpartum mood episodes that included postnatal depression (PND), in women with bipolar disorder (BD). Methods Participants were 622 parous women with a diagnosis of bipolar-I disorder recruited in the UK to the Bipolar Disorder Research Network. Diagnosis and perinatal episodes were assessed via interview and case note data. Women were also asked during the interview whether episodes of mania and/or depression were triggered by sleep loss. We compared the rates of PP and PND within women who did and did not endorse sleep loss as a trigger of mood episodes. Results Women who reported that their episodes of mania were usually triggered by sleep loss were twice as likely to have experienced an episode of PP (OR = 2.00, 95% CI = 1.20–3.36) than women who did not report this. This effect remained significant when controlling for clinical and demographic factors. We found no significant associations between depression triggered by sleep loss and PP. Analyses in which we defined postpartum episodes at a broader level to include both PP and PND were not significant. Conclusions In pregnant women with BD, a history of mania following sleep loss could be a potential marker of vulnerability to severe postpartum episodes. Further study in prospective samples is required in order to confirm these findings, which may have important implications for understanding the aetiology of PP and of mood disorders more generally.

Arabidopsis T-DNA Insertional Lines For CDC25 Are Hypersensitive to Hydroxyurea But Not to Zeocin or Salt Stress.

Background and Aims In yeasts and animals, cyclin-dependent kinases are key regulators of cell cycle progression and are negatively and positively regulated by WEE1 kinase and CDC25 phosphatase, respectively. In higher plants a full-length orthologue of CDC25 has not been isolated but a shorter gene with homology only to the C-terminal catalytic domain is present. The Arabidopis thaliana;CDC25 can act as a phosphatase in vitro. Since in arabidopsis, WEE1 plays an important role in the DNA damage/DNA replication checkpoints, the role of Arath;CDC25 in conditions that induce these checkpoints or induce abiotic stress was tested. Methods arath;cdc25 T-DNA insertion lines, Arath;CDC25 over-expressing lines and wild type were challenged with hydroxyurea (HU) and zeocin, substances that stall DNA replication and damage DNA, respectively, together with an abiotic stressor, NaCl. A molecular and phenotypic assessment was made of all genotypes Key Results There was a null phenotypic response to perturbation of Arath;CDC25 expression under control conditions. However, compared with wild type, the arath;cdc25 T-DNA insertion lines were hypersensitive to HU, whereas the Arath;CDC25 over-expressing lines were relatively insensitive. In particular, the over-expressing lines consistently outgrew the T-DNA insertion lines and wild type when challenged with HU. All genotypes were equally sensitive to zeocin and NaCl. Conclusions Arath;CDC25 plays a role in overcoming stress imposed by HU, an agent know to induce the DNA replication checkpoint in arabidopsis. However, it could not enhance tolerance to either a zeocin treatment, known to induce DNA damage, or salinity stress.