One things for sure, women with bipolar disorder will be even less likely to get maternity insurance and will have no standing in custody battles.

For many wonen, forced medication IS forced sterilization, at least temporarily. Risperdal for instance commonly stops women's menstrual cycles and Depakote can cause Polycystic Ovary Disease, particularly in young women, which leads to permanent infertility. Weight gain in itself makes getting pregnant more difficult.

I also hope folks like those at certain advocacy groups won't use this prevalence estimate to insist that women with bipolar disorder undergo forced medication and forced sterilization.

Hmmm. Certain advocacy groups? The ones that think all those with mental illness should be locked up before it becomes severe and before they become criminals and then families have no say in whether they get locked up or not?

No, Dawdy, those don't exist. You're completely delusional. We should hospitalize you before you become a severe threat to society. [sarcasm]

Re: the big back yard fresh air and open spaces theory of wellness vs. Big cities. I live in the "country" compared to the city, and my daughter has been more psychotic since moving into a wooded and peaceful place. She always told me she loved the big city, and couldn't get enough of city lights and noise. I need to address part of Mind Hacks post that I believe is key for wellness, with schizophrenia and severe psychosis: a support system, of people, whether in a therapy group, church, school, etc. It was when my daughter's support system within her family [namely her sisters and their friends]all left for college. This is a key factor in her decline, and it happens to be a large part of the decline she is in now. She has said "I have given up." Very profound.

Re:Women, divorce, kids, insurance: Anyone w a mental illness can be discriminated against, man or woman. Personally, I have not turned in any insurance claims for seeing my pdoc, to keep bipolar out of my medical records. That's extreme, but that's me. I also was dx later in life, and never had any post partum depression or psychosis, nothing. Interesting how hormones can cause psychosis and psychiatry needs to step out of that picture sometimes.

Re: Neighborhood effects

I only have access to one of the articles, but I am pretty sure both are using the same data. One big limitation with this research is that it looks at current residence and not the priors. If neighborhood characteristics have an important causal effect, it would need to be measured at onset and should include some variable indicating where they are from, not just where they currently live. But for this research, we basically only know that first-incidence schizophrenia clusters in urban areas and the areas themselves are clustered. We don't know if the people who develop schizophrenia came from these same areas. I have to think that the reason for this is because there is more benefit to living in urban areas for schizophreniacs than in rural areas, for the following reasons:
1. More services available: Same with U.S.; the biggest healthcare shortages in rural areas are mental health related.
2. More hetergenous population: you don't stand out as much when the population is not all similar. If you see someone talking to themselves walking down the street in a big city, you just walk by and probably don't think too much about it afterwards; it's not a rare sight. If they're in a small town, they're going to be noticed and the stigma may increase.
3. More economic opportunities, more subsidized housing....really more of everything. It's easier to get by.

Basically, I would bet that in the maps shown, the lighter colored wards had near equivalent (probably less though just because of heritableness in new births in the darker wards) rates of schizophrenia onset but they decreased as that population moved to the other wards.

In my opinion, the stopping of a women's menstrual cycle due to a drug like Resperdal is indeed forced sterilization. I know this happened to me and I'm trying to find a lawyer because it wasn't my choice. I've also been placed on Depakote before and I didn't know it could cause permanent infertility. What right do they have? Especially if you didn't do anything and were a victim.