Which specifier indicates episodes that occur during pregnancy or shortly after birth?

• A. With peripartum onset
• B. With melancholic features
• C. With mixed features
• D. With seasonal pattern

Answer: (A)

Timing of mood episodes relative to pregnancy is what this specifier captures. Peripartum onset denotes an episode that begins during pregnancy or within a short period after delivery. Recognizing this timing helps clinicians anticipate postpartum risks, coordinate care with obstetric teams, and choose appropriate treatment options that consider breastfeeding and safety. The other descriptors focus on how the symptoms present (melancholic features), the presence of both depressive and manic symptoms (mixed features), or their relation to a season (seasonal pattern), none of which specify when the episode started in relation to pregnancy. Thus, peripartum onset is the correct specifier for episodes that occur during pregnancy or shortly after birth.