did a uk biobank study find a peak in bipolar disorder onset around perimenopause?

“there is a new UK bio-bank study, or not, that new, it's last year or so, showing that for bipolar disorder, it has a bit of a peak”

a guest, a psychiatrist and researcher in women's mental health said on Psychiatry & Psychotherapy Podcast, 2026-10-24, at 33:02. hear it in context → the speaker cited: a UK Biobank study.

the episode: Perimenopause and Mental Health: Depression, Anxiety, Brain Fog, Sleep, and Hormone Therapy (at 33:02). we link the show's own page; we do not re-host audio.

first, the part that holds

the study is real and says what the speaker remembered: in 128,294 UK Biobank women, first onsets of mania/bipolar disorder were about twice as common in the four years around the final period as in the late reproductive years, then fell back after menopause. the only part that doesn't hold up is the date. the paper came out in august 2024, about two years before the episode, not "last year or so", and the speaker flagged that themselves ("or not, that new").

what we found when we went and looked

we read the paper, a 2024 Nature Mental Health analysis of 128,294 female UK Biobank participants. first onsets of "mania/bipolar/manic-depression" rose from 26 in the reference window (6 to 10 years before the final menstrual period) to 55 in perimenopause (the 4 years around it). that is a rate ratio of 2.12 (95% CI 1.30–3.52), and it fell back to 0.98 after menopause, which is a peak by any reading. in absolute terms the rate went from 0.05 to 0.11 per 1,000 person-years, so the doubling sits on very small numbers. the paper was published 15 august 2024, roughly 26 months before the episode, so "last year or so" stretches the recency. that is why the headline is not CONFIRMED, even though the finding itself is.

assertion by assertion

both directions

for the speaker: the direction and shape both match what the speaker said. bipolar/mania first onsets roughly doubled in the four years around the final menstrual period and returned to baseline afterward (postmenopause RR 0.98), which is what a peak means. mania had the largest effect of any disorder studied (major depression RR 1.30; schizophrenia spectrum RR 0.95, no association). the association held across deprivation, BMI, alcohol and smoking subgroups. a comparison using men around an equivalent age proxy showed no sharp peak of the same kind, which argues against simple ageing as the explanation. a 2025 World Psychiatry commentary describes the finding the same way.

against: the study is about two years old, not one. the absolute numbers are small: 55 vs 26 onsets, rates of 0.11 vs 0.05 per 1,000 person-years, and a confidence interval running from a 30% to a 252% increase. "risk" here means a self-reported first diagnosis recalled years later in a nurse interview, not a clinician-verified bipolar diagnosis. the timing depends on each woman's recalled age at menopause, which the authors list as open to recall bias. secondary retellings that call it "bipolar I" go further than the paper's outcome definition.

what this cannot say

this is one observational cohort. UK Biobank volunteers are healthier and better off than the general population, and both diagnoses and menopause age were recalled retrospectively, so neither the exact size of the effect nor causation (hormonal or otherwise) can be pinned down from it. it cannot say whether the rise reflects new illness or a first recognised episode of something already present. our own limit: we read the full text on PMC through an automated fetch. nature.com and the PubMed abstract page were blocked by cookie and login walls, and we did not open the supplementary tables.

sources, each one fetched and read

1. Shitomi-Jones LM et al., Exploration of first onsets of mania, schizophrenia spectrum disorders and major depressive disorder in perimenopause, Nature Mental Health, 2024 (published 15 Aug 2024), doi:10.1038/s44220-024-00292-4, PMC11479941 What we read there: mania (defined as 'mania/bipolar/manic–depression' from nurse-conducted interviews): perimenopause vs premenopause RR 2.12 (95% CI 1.30–3.52), 55 vs 26 onsets, 0.11 vs 0.05 per 1,000 person-years; postmenopause 0.98 (0.51–1.86), 18 onsets. MDD RR 1.30 (1.16–1.45); schizophrenia spectrum RR 0.95 (0.48–1.88). Fetched 2026-10-25 (HTTP 200). https://pmc.ncbi.nlm.nih.gov/articles/PMC11479941/
2. The impact of reproductive events on women with severe mental illness: we need more research and professional awareness, World Psychiatry, 2025, doi:10.1002/wps.21312, PMC12079466 What we read there: 'In a population-based UK Biobank study with 128,294 female participants, the first-onset rates of bipolar disorder and major depression significantly increased in the four years around menopause. Bipolar I disorder showed the largest effect (an 112% increase), while the increase was 30% for major depression.' Fetched 2026-10-25 (HTTP 200). https://pmc.ncbi.nlm.nih.gov/articles/PMC12079466/

speakers are described by role, not named. one sentence is quoted under fair use, with attribution and a link to the original at the timestamp; we do not re-host audio or video. nothing on this page is a reason to start, stop or change a medication. if you have the file behind anything marked unverifiable, the research board is where people can answer. adam