Monthly Archives: July 2012

Using the Edinburgh Postnatal Depression Scale to Screen for Antenatal Depression: Once is Not Enough

Over the past few years, there has been a push to screen women for depression both during pregnancy and the postpartum period.   While there have been various initiatives mandating screening, there remain questions regarding the optimal timing of screening and the best screening tools to use.

Folic Acid and Risk of Perinatal Depression: Is There an Association?

Recent reports suggest that people with lower folate levels are at higher risk of major depression or may experience more severe depressive symptoms.  Other studies indicate that in folate deficient patients, antidepressants may be less effective or may take longer to take effect.  In addition, some clinical trials have shown that folate may have a therapeutic effect on depression, either when taken alone or in combination with an antidepressant.

New Research from the CWMH: History of Depression and Anxiety Predict Lower Quality of Life in Midlife Women

The National Comorbidity Survey estimates that by the time women reach midlife, approximately 23% have experienced at least one episode of major depression and 30% have been diagnosed with an anxiety disorder.  Depression and anxiety disorders are each associated with impaired functioning and lower quality of life (QOL).  There is also some data to suggest that, even after a depressive episode resolves, those with a history of a affective illness have a lower quality of life than those without histories of depression, with impairment in social and interpersonal functioning.

Soy Supplements: No Effect on Cognition in Postmenopausal Women

Soy-based products have long been touted as a treatment for menopausal symptoms.  However, many of the clinical studies measuring the effectiveness of dietary sources of soy isoflavones (e.g., soy beverages, soy powder) for the treatment of menopausal vasomotor symptoms (i.e., hot flushes, night sweats) have been negative.  Less is known about the effects of soy on cognition.  A large clinical trial suggests that soy may not have any positive effects on cognition in postmenopausal women.

Use of Antipsychotic Medications in Pregnancy Increases Risk of Gestational Diabetes

Atypical antipsychotic medications are commonly used for the treatment of schizophrenia and bipolar disorder.  Despite the increasing use of these medications in women of child-bearing age, there is still relatively little data regarding the reproductive safety of these medications. 

Infertility Increases Risk of Serious Psychiatric Illness

Multiple small studies have demonstrated a link between infertility and psychological distress, reporting high rates of anxiety and depressive symptoms among women with infertility.  These studies have evaluated psychiatric symptoms or psychological distress; however, less is known about the prevalence of more significant psychiatric disorders in this population.  

Measuring the Effects of Antidepressants versus Untreated Depression on Pregnancy Outcomes

Multiple studies have demonstrated an increased risk of poor neonatal adaptation associated with exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants in late pregnancy.  Results in the literature consistently indicate that about 25%-30% of infants exposed to SSRIs late in pregnancy manifest symptoms of poor neonatal adaption, including jitteriness, restlessness, increased muscle tone, rapid breathing.  These symptoms are transient, resolving spontaneously with no specific medical intervention.

Acupuncture Helpful for Reducing Anxiety in Women Undergoing IVF

Most women undergoing infertility treatment experience increased anxiety.  In a randomized clinical trial, researchers explored the effectiveness of acupuncture in diminishing anxiety in a group of women undergoing IVF.  43 patients undergoing IVF received either active acupuncture (n=22) or sham treatment (n=21).  Women with a history of psychiatric illness and those using antidepressants and/or anxiolytic drugs were excluded from the study.  Anxiety levels were assessed before and after treatment using the Hamilton Anxiety Rating Scale (HAS). 

A Simple Educational Intervention Reduces the Risk of Postpartum Intervention

While postpartum depression can affect all women, there are certain populations which appear to be at particularly high risk, including women of lower socioeconomic status.  These women have limited access to resources and have multiple stressors including housing problems, financial strain, and being a single parent.  Researchers recently piloted an intervention randomized controlled trial involving 540 participants at an inner-city hospital in East Harlem, New York.  The primary goal of this psychoeducational intervention was to reduce the risk of postpartum depression among black and Latina mothers.