A groundbreaking study conducted on over 3.8 million women in California has uncovered that multiracial women are significantly more likely to be diagnosed with bipolar disorder during the perinatal period compared to their single-race counterparts. This research, led by the University of Illinois Urbana-Champaign and published in Frontiers in Psychiatry, highlights critical disparities in mental health diagnoses that could have far-reaching implications for healthcare practices.
The study identified more than 19,260 women with bipolar disorder diagnoses. Although multiracial women comprised only 3.6% of the study population, they accounted for 9.7% of these diagnoses. Dr. Mercy Eigbike, the study’s first author and a psychiatrist at Carle Foundation Hospital, emphasized the higher odds of bipolar disorder among women of biracial Black-white, American Indian/Alaska Native-white, and Black/American Indian/Alaska Native descent.
Understanding the Study’s Framework
The research focused on women who experienced singleton live births between 2011 and 2019, utilizing a comprehensive dataset that combined hospital discharge records and birth certificates. This allowed researchers to extract detailed clinical and demographic information. Women with discharge records indicating bipolar disorder or unspecified episodic mood disorders were classified as cases, while the rest formed the control group.
Key findings revealed that bipolar disorder diagnoses were most prevalent among biracial Black-Asian women, followed by Black-white and Asian-white women. The study further noted that American Indian/Alaska Native women, though only representing 0.3% of the sample, accounted for 1.3% of the bipolar diagnoses. Similarly, Native Hawaiian/Pacific Islanders, making up 0.4% of the sample, represented 0.3% of the diagnoses.
Exploring Potential Causes and Implications
Dr. Eigbike suggested several factors contributing to the higher incidence of bipolar disorder among multiracial women, including limited access to quality healthcare, adverse social determinants like socioeconomic status and education, and systemic racism. She noted the increased prevalence of psychiatric disorders among biracial American Indian/Alaska Native individuals, potentially linked to multigenerational trauma and stress exposure.
Co-author Karen M. Tabb, a social work professor, highlighted the novelty of the study in examining the multiracial category’s subgroups. “Previous studies didn’t contextualize the data,” Tabb said. “Our findings indicate a higher incidence of mental health issues in adults of American Indian/Alaska Native heritage.”
Disparities in Diagnosis and the Need for Improved Screening
The study also revealed disparities in bipolar disorder diagnoses among single-race women. Black women, for instance, represented over 5% of the sample but accounted for 11.8% of the diagnoses. Conversely, Hispanic/Latino women, who made up 48% of the sample, composed only 28% of the diagnosed cases, while Asian women represented nearly 15% of the sample but only 3% of the diagnosed cases.
These findings suggest potential underdiagnosis or misinterpretation of symptoms due to racial bias. Current guidelines from the American College of Obstetricians and Gynecologists recommend screening for anxiety and depression, but not specifically for bipolar disorder, which could lead to misdiagnosis.
Dr. Eigbike emphasized the importance of expanding screening to include bipolar disorder. “Some patients presenting with depression may actually be in the depressive phase of bipolar disorder,” she explained. “It’s crucial to identify these cases to provide appropriate treatment.”
Looking Forward: Recommendations and Future Research
The research team advocates for the expansion of depression screening protocols to encompass bipolar disorder, particularly for perinatal women. They stress the need for culturally responsive approaches that address the unique needs of multiracial women.
Further research is essential to develop best practices for identifying and treating perinatal women with bipolar disorder. As the study’s authors noted, understanding the patterns and characteristics of serious mental conditions in underrepresented groups is crucial for improving healthcare outcomes.
More information: Mercy Eigbike et al, What racial disparities exist in the prevalence of perinatal bipolar disorder in California?, Frontiers in Psychiatry (2025). DOI: 10.3389/fpsyt.2025.1550634
