Reviewer ’s report  
 
Title: ""Is it menopause or bipolar?": A qualitative study of the experience of menopause for 
women with bipolar dis order  
 
Version: 1 Date: 27 Aug 2017  
 
Reviewer: Simone Vigod  
 
Reviewer's report:  
 
This is a qualitative study of the experience of women with bipolar disorder and their experience 
of menopause/peri -menopause.  While there is quantitative research that highlights the high risk 
time period of peri -menopause for women with bipolar dis order, there is little qualitative data 
that adds to the understanding of their experience.  I have some questions/clarifications:  
1. The authors should specify some additional characteristics about their participants - basic 
sociodemographics, age of ons et of bipolar disorder (including whether primary onset was in 
perimenopause), number of hospitalizations, medications, that would help contextualize the 
themes that emerged.  This is important because bipolar disorder is such a heterogenous 
disorder.  
2. Given that the authors report in the introduction that other mental disorders are frequently 
comorbid, especially anxiety, it is of interest that women with comorbid disorders were 
excluded from participating in the study.  It would be helpful for the aut hors to expand on the 
rationale for this exclusion, and the implications for the generalizability of the findings.  
3. It was unclear whether the women participating in the study were euthymic, depressed or 
hypomanic/manic at the time of the interview.  T his should be specified, as it may have 
implications that are relevant to the findings. It may also be relevant whether women had a 
relapse of their bipolar disorder at the perimenopause or not (i.e. did they stratify 
participation by women who suffered a severe psychiatric episode related to menopause or 
not?  that might have resulted in very different experiences)?  
4. I think that the discussion could be strengthened with more emphasis on how the experience 
of women with bipolar disorder differs from or is similar to that of women with other 
psychiatric disorders around the perimenopause (i.e. are there special considerations here?)  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in t he manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of  written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
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