Measuring hypomania in the postpartum: a comparison of the Highs Scale and the Altman Mania Rating ScaleSmith et al. (2009) AWMH 12, 323-327

Many women experience mild hypomanic symptoms (highs) in the days following childbirth, and these symptoms are sometimes followed by postpartum depression. It is therefore possible that identifying postnatal hypomanic symptoms could predict women at risk of depression.  Research, however, is hampered by lack of widely used ways of measuring hypomania.

This study compares two methods used for rating hypomanic symptoms: the Highs Scale, which was developed to measure hypomanic symptoms in the postpartum period (a questionnaire including items such as feeling more elated than usual, more active than usual, thoughts racing, problems with concentration), and the Altman Mania Rating Scale (AMRS), which is widely used in bipolar disorder populations.

Women (184) recruited from postnatal wards, completed both questionnaires three days after delivery.  There was good correlation between the two scales, although considerably more women (44%) were classified as having postpartum hypomania using the AMRS, compared with the Highs Scale (11%).

The results confirm that women commonly experience hypomanic symptoms after childbirth. However the AMRS seems to overestimate the level of hypomania in postpartum women, possibly because, unlike the Highs Scale, it is not designed specifically for use in the postpartum period.  It may therefore be necessary to adjust the AMRS if it is used to measure hypomania in women following childbirth.

**Summary awaiting verification from expert**