• depressive disorders

    Research from the CWMH: Duloxetine for Menopausal Symptoms

    A substantial proportion of women transitioning into menopause experience a new onset or recurrence of depressive symptoms.  A new study from the Center for Women’s Mental Health indicates that duloxetine (Cymbalta) is effective for the treatment of depression and may also have a beneficial effect on vasomotor symptoms (hot flashes and night sweats).

    L-Methylfolate for the Treatment of Depression: Can We Use it During Pregnancy?

    Last summer, we posted a blog about using folate to treat (and perhaps prevent) depression in women of childbearing age.  Supporting that recommendation are the several reports indicating that people with lower folate levels are at higher risk of major depression or may experience more severe depressive symptoms.  Other studies have indicated that in folate-deficient patients, antidepressants may be less effective or may take longer to take effect.

    Using the EPDS to Screen for Anxiety Disorders: Conceptual and Methodological Considerations

    The Edinburgh Postnatal Depression Scale (EPDS) was designed to screen women for postnatal depression.  Cox and Holden (2003) state that the EPDS was not designed to measure anxiety.  However, recent emphasis on the importance of recognizing symptoms of perinatal anxiety disorders, coupled with findings in research, have led to the suggestion that the EPDS may be used as a multidimensional tool to screen for anxiety disorders in addition to depression during the perinatal period (Matthey et al, 2012).

    Screening for Peripartum Anxiety Disorders: What Are the Best Screening Tools?

    A significant number of women experience anxiety symptoms during pregnancy, with about 8.5% of women meeting criteria for generalized anxiety disorder.  Other anxiety disorders are less common.   The estimated prevalence of panic disorder during pregnancy is 1-2%.   The estimated prevalence of obsessive-compulsive disorder is 0.2-1.2%.  While we use certain tools, including the Edinburgh Postnatal Depression Scale (EPDS) to screen for depression during pregnancy, what are the best tools for indentifying women with clinically significant anxiety symptoms?

    No Increase in Risk of Infant Mortality in Women Taking SSRIs During Pregnancy

    While there has been a great deal of attention paid to the risks of exposure to antidepressants, particularly the selective serotonin reuptake inhibitors (SSRIs), during pregnancy, there has been comparatively little information on the risk of stillbirth and infant mortality in this population.  In a recent population-based cohort study utilizing data from all Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden), researchers assessed the risk of stillbirth and infant mortality associated with the use of SSRIs during pregnancy.

    Duloxetine and Pregnancy: Preliminary Data

    Duloxetine (sold in the United Sates under the brand name of Cymbalta) is a serotonin-norepinephrine reuptake inhibitor (SNRI) effective for major depressive disorder and generalized anxiety disorder (GAD).  Although used fairly commonly in women of child-bearing age, information regarding its reproductive safety has been lacking.

    Screening for Perinatal Depression: What Can We Learn From Australia?

    In 2009, the Australian government launched the National Perinatal Depression Initiative (NPDI) in order “to improve the prevention and early detection of antenatal and postnatal depression and to provide better support and treatment for expectant and new mothers experiencing depression.” Its scope is very much like the MOTHERS Act, which became law in the United States in 2010. Both initiatives seek to increase public awareness of perinatal depression, to provide support and treatment for pregnant and postpartum women with depression, to fund research in this area, and to implement training of health care professionals. 

    CBT for Depression During Pregnancy Improves Mothers’ Attentiveness to Her Infant

    During pregnancy, a woman develops increasing sensitivity and responsiveness to infants’ distress.  If depression during pregnancy occurs, this process may be disrupted.  Various studies are shown that women with depression are less responsive to an infant’s distress.  The major concern is that this diminished responsiveness may persist as long as one year after the child is born, and when it persists, it may negatively affect the child.  Decreased responsiveness of the mother to the infant’s cues may lead to emotional, cognitive and developmental problems in the child later on.

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