Measuring hypomania in the postpartum: a comparison of the Highs Scale and the Altman Mania Rating Scale

Smith, S. C.; Heron, Jessica; Haque, Sayeed; Clarke, Paula; Oyebode, Femi; Jones, Ian

doi:10.1007/s00737-009-0076-3

Cited by 17 publications

(7 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Last, there are no screening instruments that have been validated in the specific population of perinatal women with MDD. The instruments available include the Highs and the ASRM; the former of which has been suggested to underestimate, and the latter to overestimate the frequency and symptoms of mania in the postpartum period (Smith et al 2009). For this study, we selected the ASRM because unlike the Highs, it has been validated in a population of individuals with MDD, but this remains an important caveat.…”

Section: Limitationsmentioning

confidence: 99%

Mania and depression in the perinatal period among women with a history of major depressive disorders

Inglis

Hippman

Carrion

et al. 2014

Arch Womens Ment Health

View full text Add to dashboard Cite

Women with a history of major depressive disorder (MDD) have increased risks for postpartum depression, but less is known about postpartum mania in this population. The objectives of this study were to prospectively determine the frequency with which mania occurs in the postpartum among women who have a history of MDD and to explore temporal relationships between onset of mania/hypomania and depression. We administered the Structured Clinical Interview for DSM IV disorders (SCID) to pregnant women with a self-reported history of MDD to confirm diagnosis and exclude women with any history of mania/hypomania. Participants completed the Edinburgh Postnatal Depression Scale and Altman Self-Rating Mania Scale (ASRM) once during the pregnancy (∼26 weeks) and 1 week, 1 month, and 3 months postpartum. Among women (n = 107) with a SCID-confirmed diagnosis of MDD, 34.6 % (n = 37) experienced mania/hypomania (defined by an ASRM score of ≥6) at ≥1 time point during the postpartum, and for just over half (20/37, 54 %), onset was during the postpartum. The highest frequency of mania/hypomania (26.4 %, n = 26) was at 1 week postpartum. Women who experienced mania/hypomania at 1 week postpartum had significantly more symptoms of mania/hypomania later in the postpartum. A substantive proportion of women with a history of MDD may experience first onset of mania/hypomania symptoms in the early postpartum, others may experience first onset during pregnancy. Taken with other recent data, these findings suggest a possible rationale for screening women with a history of MDD for mania/hypomania during the early postpartum period, but issues with screening instruments are discussed.

show abstract

Section: Limitationsmentioning

confidence: 99%

Mania and depression in the perinatal period among women with a history of major depressive disorders

Inglis

Hippman

Carrion

et al. 2014

Arch Womens Ment Health

View full text Add to dashboard Cite

show abstract

“…The Highs scale is rated on a three-point Likert Scale: “Yes, a lot” (2 points), “Yes, a little” (1 point), or “No” (0 point). The total score ranges between 0 and 14, with cutoff scores between 5 and 8 ( 20 , 30 , 33 ). The high score indicates hypomania.…”

Section: Methodsmentioning

confidence: 99%

“…Using a scale threshold of ≥ 8, 100% of the women with hypomania as define by the Highs scale also had hypomania as defined by the Altman Self Rating Mania Scale (AMRS) ( 30 ). The Highs scale was poorly correlated with the EPDS and the Kennerley Blues Scale at the postpartum period ( 17 , 20 ), and fairly correlated with the Comprehensive Psychopathological Rating Scale mania subscale and the AMRS at the postpartum period ( 20 , 30 ). The internal reliability of the Highs scale has been reported at 0.63 ( 31 ).…”

Section: Methodsmentioning

confidence: 99%

“…It is a simple screening scale consisting of seven questions that can be quickly answered. Concurrent validity of the Spearman rank correlation of the Highs scale was verified with the Comprehensive Psychopathological Rating Scale ( r = 0.62) ( 20 ) and the Altman Self Rating Mania Scale ( r = 0.63) ( 30 ) in the postpartum period. The internal reliability of the Highs scale has also been also reported at 0.63 ( 31 ).…”

Section: Introductionmentioning

confidence: 93%

See 1 more Smart Citation

Validation and Factor Analysis of the Japanese Version of the Highs Scale in Perinatal Women

et al. 2018

View full text Add to dashboard Cite

Background: The Highs scale has been developed to evaluate hypomanic symptoms in the first postpartum week. However, it has not been elucidated whether this scale is also applicable to pregnant women. To address this issue, we confirmed the factor structure, reliability, and validity of the Japanese version of the Highs scale for pregnant and postpartum women.Methods: 418 women provided effective responses to both the Highs scale and the Edinburgh Postnatal Depression Scale (EPDS) during early pregnancy (before week 25), late pregnancy (around week 36), at 5 days and at 1 month after delivery. Subjects were randomly divided into two groups, and exploratory and confirmatory factor analyses were performed for each group. Cronbach's alpha was calculated and the correlation of the Highs scale with EPDS was analyzed. The correlation between the subscales was analyzed at four time points, and the correlation of subscales between the four time points was confirmed.Results: This scale was found to have the two-factor structure with elation and agitation subscales. The two subscales had reasonable internal consistency at all time points (Cronbach's alpha range: Factor 1, 0.696–0.758; Factor 2, 0.553–0.694). The overall scale had reasonable internal consistency at all time points (Cronbach's alpha range: 0.672–0.738). Based on the correlation analysis of the two subscales and EPDS, discriminative and convergent validity were indicated at all time points, confirming the construct validity of the Highs scale. Subscale scores showed a significant correlation with EPDS at all time points (r = 0.388, 0.384, 0.498, and 0.442, p < 0.01).Conclusions: The Japanese version of the Highs scale is reliable and valid, and can be applied for evaluating the hypomanic symptoms during pregnancy and postpartum period.

show abstract

“…Postpartum hypomanic symptoms are estimated to occur in 10%-18% of women giving birth (Glover, Liddle, Taylor, Adams, & Sandler, 1994;Lane et al, 1997;Smith et al, 2009). By contrast with normal happiness, hypomanic symptoms may include racing thoughts, reduced need for sleep, and excessive, rapid talking.…”

Section: Postpartummentioning

confidence: 99%

Bipolar Disorder in Women

Miller

Ghadiali

LaRusso

et al. 2014

Health Care for Women International

View full text Add to dashboard Cite

This article summarizes research pertinent to the clinical care of women with bipolar disorder. With bipolar disorder, female gender correlates with more depressive symptoms and different comorbidities. There is a high risk of symptom recurrence postpartum and possibly during perimenopause. Women with bipolar disorder have increased risk of sexually transmitted diseases, unplanned pregnancies, excessive weight gain, metabolic syndrome, and cardiovascular disease. Mood stabilizing medications, specific psychotherapies, and lifestyle changes can stabilize mood and improve functioning. Pharmacologic considerations include understanding interactions between mood stabilizing medications and contraceptive agents and risks and benefits of mood stabilizing medication during pregnancy and lactation.

show abstract

Measuring hypomania in the postpartum: a comparison of the Highs Scale and the Altman Mania Rating Scale

Cited by 17 publications

References 26 publications

Mania and depression in the perinatal period among women with a history of major depressive disorders

Mania and depression in the perinatal period among women with a history of major depressive disorders

Validation and Factor Analysis of the Japanese Version of the Highs Scale in Perinatal Women

Bipolar Disorder in Women

Contact Info

Product

Resources

About