Anxiety Symptoms and Risk for Perimenopausal Depression
A growing body of research indicates that the menopausal transition is a period of increased vulnerability to depressive illness.  Some women have experienced episodes of major depressive disorder (MDD) earlier in life and experience recurrent illness during the menopausal transition.  Other women, however, experience first lifetime-onset of MDD during this transition.  The identification of  specific risk factors for depression could improve depression screening and facilitate earlier intervention in this population of [...]
Postpartum Depression is a Heterogeneous Illness
About 15% of women suffer from postpartum depression (PPD). It appears, however, that women with PPD constitute a heterogeneous population. Â One difference that we observe clinically is that a subgroup of women with PPD experience depression only during the postpartum period, whereas other women with PPD report a pattern of recurrent depressive illness consisting of both puerperal and non-puerperal episodes. Â We suspect that these two subtypes differ from one another, but [...]
November 2015 Roundup: Recent Publications in Reproductive Psychiatry
It has been another busy month! Ruta Nonacs, MD PhD Antidepressants, pregnancy, and stigma: how we are failing mothers and babies. Osborne LM, Payne J. J Nerv Ment Dis. 2015 Mar;203(3):164-6. Do anxiety symptoms predict major depressive disorder in midlife women? The Study of Women's Health Across the Nation (SWAN) Mental Health Study (MHS). Kravitz HM, Schott LL, Joffe H, Cyranowski JM, Bromberger JT. Psychol Med. 2014 Sep;44(12):2593-602. Free PMC Article Salisbury AL, O’Grady KE, Battle [...]
SSRIs and Poor Neonatal Adaptation: How Long Do the Symptoms Last?
Multiple studies have demonstrated an increased risk of poor neonatal adaptation associated with exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants in late pregnancy. Â Results in the literature consistently indicate that about 25%-30% of infants exposed to SSRIs late in pregnancy manifest symptoms of poor neonatal adaptation. Â The most commonly observed symptoms include jitteriness, restlessness, increased muscle tone, and rapid breathing. Â These symptoms are transient, resolving spontaneously with no specific medical [...]
Fear of Childbirth: How Common is It? And What Should We Do?
Childbirth fear has been studied in Scandinavian countries for more than three decades; however, it has received less attention in other countries. In Australia, Toohill and colleagues reported high levels of childbirth fear, as measured using the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ score >Â 66) in approximately 20% of Australian women of childbearing age. Â This estimate is similar to rates reported by Swedish, Canadian and United Kingdom (UK) researchers. In the United [...]
Venlafaxine and Duloxetine: Pooled Analysis Shows No Increase in Risk of Malformations
Women face difficult choices when deciding whether or not to continue psychiatric medications during pregnancy. Â This choice can be especially difficult for women taking newer medications which lack adequate reproductive safety data. Â While we have adequate data regarding the reproductive safety of most of the selective serotonin reuptake inhibitors (SSRIs), there has been less information available on the serotonin norepinephrine reuptake inhibitors (SNRIs): Â venlafaxine (Effexor) and duloxetine (Cymbalta). Â A recent article, [...]