Arianna Di Florio

Cardiff University, Cardiff, Wales, United Kingdom

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Publications (7)35.46 Total impact

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    ABSTRACT: To compare rates of bipolar episodes following miscarriage and termination with those occurring in the postpartum period.
    Bipolar Disorders 06/2014; 17(1). DOI:10.1111/bdi.12217 · 4.89 Impact Factor
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    ABSTRACT: Background Episodes of postpartum psychosis have been associated with first pregnancies in women with bipolar I disorder. It is unclear, however, if the effect extends to episodes at other times in relation to childbirth and to women with other mood disorders such as major depression and bipolar II disorder. This primiparity effect, which is also seen in other pregnancy related conditions such as pre-eclampsia, is a potentially important clue to the aetiology of childbirth related mood episodes. Methods Participants were interviewed and case notes reviewed. Best-estimate diagnoses were made according to DSM-IV criteria. Data on the occurrence of episodes in pregnancy and the postpartum were available on 3345 full term deliveries from 1667 participants, 934 with bipolar I disorder (BD-I), 278 with bipolar II disorder (BD-II) and 455 with recurrent major depression (RMD). Results Onsets of psychosis/mania within 6 weeks of childbirth were overrepresented in primiparae (p=0.007) with BD-I. Although primiparity was not associated with perinatal bipolar depression, there was an association with the onset of depression within 6 weeks in women with RMD (p=0.035). Whilst women experiencing a postpartum episode were less likely to go on to have further children, this did not account for the association with primiparity. Limitations Data were collected retrospectively. Information on pharmacological treatment was not available. Conclusions Primiparity is associated not only with postpartum psychosis/mania in BD-I, but also with postpartum depression in RMD. Psychosocial factors and biological differences between first and subsequent pregnancies may play a role and are candidates for examination in further studies.
    Journal of Affective Disorders 01/2014; s 152–154:334–339. DOI:10.1016/j.jad.2013.09.034 · 3.71 Impact Factor
  • Arianna Di Florio, Sue Smith, Ian Jones
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    ABSTRACT: Key contentPostpartum psychosis is a severe mental illness with a dramatic onset shortly after childbirth.All women should be screened antenatally for the known risk factors.Women with bipolar disorder have at least a 1 in 4 risk and need close contact and review during the perinatal period even if they are well.Prompt recognition of the illness and rapid institution of treatment are of vital importance. Learning objectivesTo recognise women at high risk for severe postpartum mental illness.To recognise and appreciate the severity of postpartum psychosis and the need for prompt assessment and treatment. Ethical issuesWho should ultimately make decisions about taking medications in pregnancy – the clinician or the woman and her family?What advice should a woman at high risk of postpartum psychosis be given if she is considering pregnancy?
    The Obstetrician & Gynaecologist 07/2013; 15(3). DOI:10.1111/tog.12041
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    ABSTRACT: CONTEXT Affective disorders are common in women, with many episodes having an onset in pregnancy or during the postpartum period. OBJECTIVE To investigate the occurrence and timing of perinatal mood episodes in women with bipolar I disorder, bipolar II disorder, and recurrent major depression (RMD). SETTING AND PATIENTS Women were recruited in our ongoing research on the genetic and nongenetic determinants of major affective disorders. Participants were interviewed and case notes were reviewed. Best-estimate diagnoses were made according to DSM-IV criteria. The 1785 parous women identified included 1212 women with bipolar disorder (980 with type I and 232 with type II) and 573 with RMD. Data were available on 3017 live births. MAIN OUTCOME MEASURES We report the lifetime occurrence of perinatal mood episodes, the rates of perinatal episodes per pregnancy/postpartum period, and the timing of the onset of episodes in relation to delivery. RESULTS More than two-thirds of all diagnostic groups reported at least 1 lifetime episode of illness during pregnancy or the postpartum period. Women with bipolar I disorder reported an approximately 50% risk of a perinatal major affective episode per pregnancy/postpartum period. Risks were lower in women with RMD or bipolar II disorder, at approximately 40% per pregnancy/postpartum period. Mood episodes were significantly more common in the postpartum period in bipolar I disorder and RMD. Most perinatal episodes occurred within the first postpartum month, with mania or psychosis having an earlier onset than depression. CONCLUSIONS Although episodes of postpartum mood disorder are more common in bipolar I disorder and manic and psychotic presentations occur earlier in the postpartum period, perinatal episodes are highly prevalent across the mood disorder spectrum.
    Archives of general psychiatry 12/2012; 70(2):1-8. DOI:10.1001/jamapsychiatry.2013.279 · 13.75 Impact Factor
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    ABSTRACT:   Psychoeducational approaches are promising interventions for the long-term management of bipolar disorder. In consultation with professionals, patients, and their families we have developed a novel web-based psychoeducational intervention for bipolar disorder called Beating Bipolar. We undertook a preliminary exploratory randomized trial to examine efficacy, feasibility and acceptability.   This was an exploratory randomized controlled trial of Beating Bipolar (current controlled trials registration number: ISRCTN81375447). The control arm was treatment-as-usual and the a priori primary outcome measure was quality of life [measured by the brief World Health Organization Quality of Life (WHOQOL-BREF) scale]. Secondary outcomes included psychosocial functioning, insight, depressive and manic symptoms and relapse, and use of healthcare resources. Fifty participants were randomized to either the Beating Bipolar intervention plus treatment-as-usual or just treatment-as-usual. The intervention was delivered over a four-month period and outcomes were assessed six months later.   There was no significant difference between the intervention and control groups on the primary outcome measure (total WHOQOL-BREF score) but there was a modest improvement within the psychological subsection of the WHOQOL-BREF for the intervention group relative to the control group. There were no significant differences between the groups on any of the secondary outcome measures.   Beating Bipolar is potentially a safe and engaging intervention which can be delivered remotely to large numbers of patients with bipolar disorder at relatively low cost. It may have a modest effect on psychological quality of life. Further work is required to establish the impact of this intervention on insight, knowledge, treatment adherence, self-efficacy and self-management skills.
    Bipolar Disorders 08/2011; 13(5-6):571-7. DOI:10.1111/j.1399-5618.2011.00949.x · 4.89 Impact Factor
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    ABSTRACT: There is currently a great deal of interest in the use of affective temperaments as possible intermediate phenotypes for bipolar disorder. However, much of the literature in this area is conflicting. Our aims were to test the hypothesis of a gradient in affective temperament scores, as measured by the Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-A), from bipolar disorder type I (BP-I), through bipolar disorder type II (BP-II), recurrent major depressive disorder (MDD-R), and a control group (CG) in the largest sample to date of 927 subjects. Non parametric tests were used to compare TEMPS-A scores between diagnostic groups and multinomial logistic regression was used to test the association between TEMPS-A scores and diagnosis while controlling for current mood state, age and gender. Although the BP-II group scored higher than the BP-I and MDD-R groups on several TEMPS-A subscales, these differences were not significant when confounding variables were controlled for. The dysthymic subscale differentiated between affected and controls and the anxious subscale differentiated the MDD-R group from controls. The cross-sectional design did not allow us to evaluate potential longitudinal changes of temperament scores, which were assessed only with a self-report questionnaire. We failed to find evidence of a gradient in affective temperament scores. Both unipolar and bipolar patients reported high dysthymic scores relative to controls, perhaps supporting a unitary view of depression across the bipolar-unipolar spectrum. Taking account of potential confounders will be important in future studies which seek to use affective temperaments as intermediate phenotypes in genetic research.
    Journal of Affective Disorders 10/2009; 123(1-3):42-51. DOI:10.1016/j.jad.2009.09.020 · 3.71 Impact Factor
  • Source
    Arianna Di Florio, Nick Craddock
    Human Genetics 08/2009; 126(2):327-327. DOI:10.1007/s00439-009-0711-0 · 4.52 Impact Factor

Publication Stats

55 Citations
35.46 Total Impact Points


  • 2009–2014
    • Cardiff University
      • • MRC Centre for Neuropsychiatric Genetics & Genomics
      • • School of Medicine
      • • Department of Psychological Medicine and Neurology
      Cardiff, Wales, United Kingdom
    • University of Wales
      Cardiff, Wales, United Kingdom
  • 2012
    • University of South Wales
      Понтиприте, Wales, United Kingdom