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Harvard Medical School

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Prenatal Valproate Exposure and Risk of Autism Spectrum Disorders

Autism spectrum disorders (ASDs), which include childhood autism, autistic disorder, Asperger syndrome, atypical autism, and other pervasive developmental disorders, are characterized by social and communication difficulties and by stereotyped or repetitive behaviors and interests. It is estimated that autism spectrum disorders affect about 1% of children. While genes play a significant role in the risk […]

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Pregnancy Outcomes in Women with Schizophrenia

With the advent of the newer, atypical antipsychotic medications, patients with psychotic disorders have been able to achieve greater symptom control with less disabling side effects. For women with schizophrenia, there has also been an increase in fertility rates over the last decade.  Previous studies have suggested that women with schizophrenia, as compared to women with no psychiatric illness, are at increased risk for pregnancy and delivery complications, including low birthweight, intrauterine growth restriction, and preterm birth.  However, most of these studies occurred at a time when the women were treated with older antipsychotic medications, and we cannot assume that these findings are relevant now, when women with schizophrenia are more commonly treated with the newer atypical antipsychotics and have much better control of their symptoms.

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Stimulants Improve Cognitive Functioning in Menopausal Women

Many women report cognitive difficulties — forgetfulness, distractibility, feeling foggy —during the transition to menopause.  While much attention has been devoted to the treatment of vasomotor symptoms, such as hot flashes or night sweats, less attention has focused on the management of the memory difficulties and other cognitive problems many menopausal women may suffer. In […]

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Impaired Maternal Infant Bonding More Common in Women with Severe Postpartum Depression

Maternal psychiatric illness can profoundly affect how a mother interacts with her child and is a risk factor for impaired mother-infant bonding, which may include a spectrum of difficulties: decreased maternal affective involvement, increased irritability, aggressive impulses, or, at worst, outright rejection of the infant (Brockington et al, 2006).  It is important to note, however, […]

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CBT is Effective for Menopausal Vasomotor Symptoms

Cognitive Behavioral Therapy or CBT is a type of psychotherapy that has been shown to be effective for the treatment of depression, anxiety, and sleep problems.  Recently, several randomized controlled trials have demonstrated that CBT is effective for managing vasomotor symptoms in menopausal women. The first study to test the effectiveness of CBT for vasomotor […]

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Poor Sleep Quality Predicts Severity of Postpartum Depression

All women are at risk for postpartum depression (PPD), and there is growing evidence to suggest that poor sleep during pregnancy and the postpartum period may be a risk factor for the development of depression. A recent longitudinal study supports the hypothesis that disrupted sleep may contribute to the emergence and extent of postpartum depression […]

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EPDS Modified to Screen for Lifetime Perinatal Depression

The Edinburgh Postnatal Depression Scale (EPDS) was modified by adding lifetime PND screening questions, assessing worst episode, and symptom timing of onset, in order to assess the lifetime prevalence of perinatal depression. Subjects from the Netherlands Study of Depression and Anxiety (NESDA) were screened using the EPDS-Lifetime. Of 682 women with lifetime major depressive disorder […]

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Women Who Stop SSRIs Prior to Pregnancy Have Same Risk of Miscarriage as Women who elect to Remain on SSRI Antidepressants

Some, but not all, studies have demonstrated an increased risk of miscarriage among women who take antidepressants. However, it has been difficult to determine whether this increased risk was related to exposure to the medication or to exposure to other risk factors, including maternal depression. Several recent studies have been reassuring and indicate that antidepressants […]

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Better Peripartum Pain Management: An Intervention to Reduce Risk of Postpartum Depression

A recent report suggests that epidural labor analgesia is associated with a decreased risk of postpartum depression (PPD). This prospective study included 214 pregnant women from Beijing, China who were preparing for a vaginal delivery. Epidural labor analgesia was performed in 107 of 214 patients based on their request. Depressive symptoms were assessed with the Edinburgh Postnatal […]

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