Physiological Basis of the Couvade Syndrome and Peripartum Onset of Bipolar Disorder in a Man: A Case Report and a Brief Review of the Literature

Rapid hormonal changes during pregnancy as well as psycho-social stressors accompanying parenthood have often been associated with peripartum mood episodes in women with bipolar disorder or with not yet clinically expressed bipolar diathesis. Yet, little is known about the correlation of peripartum onset of bipolar disorder in men. We present the case of a man with bipolar disorder with peripartum onset and subsequent episodes following the peripartum initiation of the disease, as well as the association of the couvade syndrome, as a pathological response to a man due to hormonal shifts observed in males cohabiting with a pregnant female. The patient had his first depressive episode during the peripartum period of his spouse, followed by two mixed episodes with psychotic features that leaded to his compulsory psychiatric evaluation and subsequent hospitalization and the diagnosis of Bipolar Disorder I. There is a well-known correlation between the peripartum period and mood disturbances to the point of inducing full blown episodes, suggesting of a bipolar disorder initiation or mood episodes relapsing in female patients already diagnosed with bipolar disorder. Due to the patient's psychological disturbances and the phenomenology of his symptoms, mainly concerning the psychotic features accompanying his episodes, we discuss the possible underlying biological correlates as a triggering mechanism, that might overlap the manifestation of the Couvade Syndrome as well as the initiation or relapse of Bipolar Disorder in males. It seems that males are not less influenced by hormonal and psycho-social factors posed upon them during the peripartum period of their cohabiting female spouse

Anxiety and depression among Greek undergraduate students in the University of Patras

Background There is an increase in the prevalence of depression and anxiety in university students, reducing their capability of taking care themselves and coping with daily life’s demands. The aim of the present study was to assess the prevalence of and investigate risk factors for anxiety and depression in undergraduate students at the University of Patras, Greece. Methods An analytical cross‐sectional study was conducted on a representative sample of 1.233 (553 male and 680 female) undergraduate university students. The instrument used to assess the anxiety and depression levels was the in Greek translated and validated Hospital Anxiety and Depression Scale (HADS). Statistical analyses were performed using the SPSS v. 17.0. Results Anxiety was present in 423 (34.2%, 20.3% borderline and 13.9% clinical) students and depression in 215 (17.4%, 12.7% borderline and 4.7% clinical) students. Both were found concomitantly in 152 (12.3%) students. Higher age (p=0.014), female gender (p<0.001), higher year of study (p<0.001), school and city being not the first choice (p<0.001), reduction in income (p<0.001) and ignorance of support services available to students were significantly associated with anxiety. Depression was significantly associated with higher age and year of study (p<0.001), school and city being not the first choice (p<0.001), growing up with one parent (p<0.001), having more than three siblings (p<0.001), reduction in income (p<0.001) and ignorance of support services available to students. Conclusions This study indicates that students in the University of Patras experience anxiety and depression which are associated with various sociodemographic and educational factors