About 10-30% of children have functional somatic symptoms (FSS). These are physical complaints, such as headaches, pain, fatigue, and dizziness, that cannot be explained medically. A new study suggests that when a child is exposed to depression or anxiety in the mother during the first year of life, he or she is more likely to report these somatic symptoms later on.
This is a small case report but is an important one, demonstrating the effectiveness of ultra-brief electroconvulsive therapy (ECT) for the treatment of severe postpartum depression. While most women with postpartum illness have mild to moderate illness, there are some women with severe depression that significantly impairs their ability to function and to care for their child. Women with severe PPD are also at higher risk for suicide.Â
In a recent retrospective cohort study, data collected from linked records from the Women's and Children's Health Network in South Australia were used to investigate neonatal outcomes in children exposed prenatally to selective serotonin reuptake inhibitors (SSRIs). Women were included in this study if they gave birth to a singleton, live-born infant between September 2000 and December 2008 (n = 33,965).
Over the past few years, there have been a large number of studies which have relied on large administrative databases to generate information on the reproductive safety of various medications. One of the strengths of this type of approach is that it provides an opportunity to observe outcomes in a large number of subjects; however, there are certain, very important limitations. A recent study published in the American Journal of Obstetrics and Gynecology helps to understand some of the challenges in interpreting the data generated from these studies.
Over the past decade, the clinical literature has published many studies documenting the psychosocial and health benefits of various mind-body interventions. Mindfulness-based interventions have been shown to reduce stress, to improve coping skills, and to promote feelings of well-being. Mindfulness-Based Cognitive Therapy (MBCT) is a new psychotherapeutic treatment which has been shown to reduce depressive symptoms and to reduce the risk of depressive relapse.Â
Some, but not all, studies have indicated that depression during pregnancy increases the risk of preterm birth. A recent study published in the American Journal of Obstetrics and Gynecology is one of the largest to address this question.
Most studies have shown that women experience an improvement or remission in eating disorders during pregnancy; however, studies assessing how eating disorders may affect pregnancy outcomes have yielded conflicting results. While some studies have demonstrated no negative effects, others have demonstrated higher miscarriage rates among women with bulimia nervosa. In addition, women with histories of eating disorders have been shown to be significantly more likely to experience preterm delivery and to give birth to babies small for gestational age.
While we have data on the use of lithium use during pregnancy with regard to risk for congenital malformations, there is much less information on the long-term effects of lithium on neurodevelopment. A recent study from the Perinatal Center of the Leiden University Medical Center provides some reassuring data on the long-term effects of lithium exposure.
We have recently written about the link between vitamin D and depression. While several studies have indicated that low vitamin D levels may be associated with depression, we lack randomized, controlled trials assessing the benefits of vitamin D supplements for the treatment (or prevention) of depression. A recent report from the Women's Health Initiative Calcium and Vitamin D Trial included 36,282 women (50 to 80 years of age) who were randomized to receive 400 IU vitamin D (with 1000 mg calcium) or to placebo.Â
Selective serotonin and serotonin-norepinephrine inhibitors (SSRIs and SNRIs) have been shown to be effective for the treatment of hot flashes. However, these agents may carry certain side effects, including sexual side effects and sleep disturbance. These two side effects may be particularly concerning to peri- and postmenopausal women who, in addition to having vasomotor symptoms, are more likely to experience sexual dysfunction and sleep disruption than premenopausal women.
