A groundbreaking study involving over 3.8 million women who gave birth in California has revealed a significant disparity in the diagnosis of bipolar disorder among multiracial women compared to their single-race counterparts. Conducted by researchers at the University of Illinois Urbana-Champaign, the study found that multiracial women, despite comprising only 3.6% of the study population, accounted for 9.7% of bipolar disorder diagnoses. The findings were published in the journal Frontiers in Psychiatry.
The study’s lead author, Dr. Mercy Eigbike, a psychiatrist at Carle Foundation Hospital, highlighted that women who identified as biracial Black white, American Indian/Alaska Native/white, or Black/American Indian/Alaska Native were particularly at risk. “Further examination of the multiracial group revealed higher odds of having a bipolar disorder diagnosis among these women compared with single-race white women,” Dr. Eigbike stated.
Exploring the Study’s Findings
The study analyzed women who had singleton live births between 2011 and 2019, utilizing a linked dataset of hospital discharge records and birth certificates. Women with discharge records indicating bipolar disorder or unspecified episodic mood disorders were classified as cases for the study. Notably, the highest rates of bipolar diagnoses were found among women who were biracial Black Asian, followed by Black white, and Asian white women.
Dr. Eigbike suggested several potential factors contributing to the elevated incidence of mental illness among multiracial women. These include limited access to quality healthcare, adverse social determinants such as socioeconomic status and education, and systemic racism. “It is known that people of biracial American Indian/Alaska Native heritage have increased prevalence of general psychiatric disorders,” she noted. “This may be related to multigenerational trauma and differences in exposure to stress.”
Understanding the Broader Implications
The study underscores a critical need for further research, particularly as these groups have been historically underrepresented. Co-author Karen M. Tabb, a social work professor, emphasized the importance of contextualizing data within the multiracial category. “Several studies have come out over the past year—and I have several under review—that show increased burden of perinatal mental health problems among multiracial people,” Tabb remarked.
The researchers chose California for the study due to its diverse population, which includes a significant number of women from multiple racial backgrounds. The findings revealed that single-race women who were Black, Asian, or Hispanic/Latino had disproportionately lower rates of bipolar diagnoses compared to their representation in the sample population. Conversely, Black women, who made up over 5% of the sample, represented 11.8% of bipolar diagnoses.
Addressing Racial Disparities in Mental Health Care
These disparities suggest potential issues with underdiagnosis or misinterpretation of symptoms due to racial bias, according to Dr. Eigbike. Current guidelines from the American College of Obstetricians and Gynecologists recommend screening all women for anxiety and depression, but not specifically for bipolar disorder before treatment. Eigbike stressed the importance of expanding screening to include bipolar disorder, as some patients may present with depression while actually experiencing the depressive phase of bipolar disorder.
Several states, including Illinois, Massachusetts, New York, and West Virginia, have implemented policies for screening perinatal depression during prenatal, postpartum, or well-child visits. However, these screeners may not detect bipolar disorder symptoms. “The screeners that are used for perinatal depression are not able to pick up bipolar disorder, so it’s very important to screen for it as well,” Dr. Eigbike emphasized.
The research team advocates for the expansion of depression screening to encompass bipolar disorder, aiming to better address the mental health needs of perinatal women. They also call for further studies to develop best practices for identifying and treating bipolar disorder in perinatal women, with a focus on culturally responsive approaches for multiracial women.
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
