Postpartum depression (PPD) is a relatively common problem, affecting between 10% and 15% of women after delivery. Although it is difficult to reliably predict which women in the general population will experience postpartum mood disturbance, it is possible to identify certain subgroups of women who are more vulnerable.  One such group is teen mothers, where the risk of PPD is about 25%.
In an excellent and thoughtful review article, Kristina Deligiannidis and Marlene Freeman (from the MGH Center for Women’s Mental Health) summarize data on the efficacy of complementary and alternative medicine therapies for the treatment of perinatal depression. This is one of the most thorough reviews on CAM and provides thoughtful, evidence-based recommendations regarding the use of these treatments for women with perinatal depression. It is definitely worth tracking down a copy of this review, but if you can’t find it, here is a summary.
Pregnancy loss may cause great psychological stress for women. How such a loss, whether or not the woman identifies it as a stressor, affects her emotional well-being after the birth of a future child is unknown. In order to better understand the relationship between pregnancy loss and risk for postpartum psychiatric illness, researchers assessed 192 women at their first-year pediatric well-child care visits in an urban pediatric clinic. In this group of low income mothers, 49% of the women reported a previous pregnancy loss (miscarriage, stillbirth, or induced abortion).
Eating disorders are relatively common among women of reproductive age, yet the literature on the effects of maternal eating disorders (ED) on pregnancy outcomes is relatively sparse. There has been concern that eating disorders may negatively affect gestational weight gain. Previous studies have demonstrated an association between maternal anorexia nervosa (AN) (both active and past) and lower infant birthweight (as compared to women with no history of ED); however, calculations of the magnitude of this effect have been inconsistent.Â
Various screening tools have been used to identify women with postpartum depression (PPD. The most widely used self-report tools for detection of PPD are the Edinburgh Postnatal Depression Scale (EPDS) and the Beck Depression Inventory (BDI) having ten and 21 items, respectively. However, the EPDS and the BDI may be too lengthy to use for quickly screening patients in obstetric, primary care, or pediatric settings.
Women with premenstrual symptoms (PMS) and premenstrual dysphoric disorder experience symptoms during the premenstrual phase of their cycles.  Because levels of estrogen and progesterone do not differ significantly between women with PMS and those without, it has long been hypothesized that PMS/PMDD represents an abnormal response to normal hormonal fluctuations (Schmidt et al, 1998).
Many studies have assessed the risk of depression in the mothers of infants, but fewer studies have focused on the risk of depression in the mothers with older children.Â
Having a newborn child to the neonatal intensive care unit (NICU) is stressful to parents. It would be easy to imagine that in this environment, women may be more vulnerable to postpartum depression (PPD). A recent study assessed the incidence of PPD in a total of 131 mothers with infant admitted to the NICU.
We write often here about the negative effects of postpartum depression on the child. Â Most of the studies thus far have focused on behavior and cognitive development; a recent study from researchers at JohnsHopkinsUniversity suggests that being exposed to maternal depression during the first year of life may negatively affect the physical development of the child as well.
Postpartum psychosis is a rare but serious psychiatric illness, occurring in about 1 to 2 per 1000 women after delivery. Because postpartum psychosis carries significant risks for both the mother and her child, most women with this illness are psychiatrically hospitalized. Electroconvulsive therapy (ECT) is an effective treatment for postpartum psychosis and may reduce the risks associated with medication exposure in the nursing infant; however, very few research studies have focused on the use of ECT in this setting and it is less commonly used in the United States than in other countries. A recent study explores the safety and advantages of ECT for the treatment of women hospitalized for postpartum psychosis.
