UNDERSTANDING MOOD INSTABILITY IN PREGNANT AND

The perinatal period has been recognized as a time of increased vulnerability for women to experience mood related symptoms and disorders. Women’s reproductive years, particularly, pregnancy and postpartum, are often associated with increased moodiness. These seemingly “harmless” mood fluctuations are often regarded as a normal part of a woman’s life. Therefore, there is very limited research on perinatal mood instability (MI). The primary goal of this dissertation was to systematically review the current existing literature of perinatal MI, its relation to perinatal depression, and its effects on children. The second goal was to examine the risk factors for perinatal MI, the association between antenatal MI and postpartum depression (PPD), and the trajectory of perinatal MI. The third goal was to investigate effects of antenatal MI, depression, and anxiety on neonatal outcomes. The fourth goal was to evaluate the construct validity of the Affective Lability Scale-18 (ALS-18) in pregnant and postpartum women with mood symptoms. Manuscript one systematically reviewed existing literature on perinatal MI, its relation to perinatal depression, and its effects on children. A significant gap in perinatal MI research was identified. Manuscript two’s results suggest that depression, history of depression, stress, and labour/birth complications were significant risk factors for perinatal MI in a community sample of 648 women. Mood instability during early pregnancy was strongly associated with PPD. In addition, the trajectory of perinatal MI had an overall decreased trend through perinatal period. Manuscript three’s findings indicate no association between antenatal MI or antenatal depression and neonatal outcomes in a community sample of 648 women. Antenatal anxiety was significantly associated with low 1-minute and 5-minute Apgar scores and LBW. Manuscript four explored the psychometric properties of the ALS-18 in a clinical sample of 113 perinatal women with various mood symptoms. The findings suggest that ALS-18 is an effective instrument for assessing MI in perinatal women Taken together, the findings implicate that more research on perinatal MI is needed. In order to optimize the wellbeing of mothers, their babies, and their families, increasing awareness of perinatal MI among the general public and health care professionals, and screening and assessing women for perinatal MI are essential