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Harvard Medical School

Weekly Roundup for AUGUST 18, 2017: Recent Publications in Women’s Mental Health

Brandlistuen and colleagues look at the long-term effects of prenatal exposure to benzodiazepines and sedative-hypnotics, attempting to control for genetic and environmental confounds by using sibling-controlled comparisons.  Using data from Danish registers, Liu and colleagues find that first-onset nonpsychotic postpartum affective disorder can be a marker of underlying bipolarity.


Association of prenatal exposure to benzodiazepines and child internalizing problems: A sibling-controlled cohort study.

Brandlistuen RE, Ystrom E, Hernandez-Diaz S, Skurtveit S, Selmer R, Handal M, Nordeng H.  PLoS One. 2017 Jul 26.   Free Article

Analyses on specific drug groups showed that prenatal exposure to benzodiazepines was associated with increased internalizing problems at both 1.5 years and 3 years while exposure to z-hypnotics was not associated with any adverse outcomes after adjustment.


Depression and Anxiety in the Postpartum Period and Risk of Bipolar Disorder: A Danish Nationwide Register-Based Cohort Study.

Liu X, Agerbo E, Li J, Meltzer-Brody S, Bergink V, Munk-Olsen T.  J Clin Psychiatry. 2017 May;78(5):e469-e476.   Free Article

First-onset nonpsychotic postpartum affective disorder can be a marker of underlying bipolarity. Women who fill an antidepressant prescription following childbirth should be asked about hypomanic or manic symptoms and monitored long term. Clinically, when antidepressant monotherapy is ineffective or the individual woman experiences persistent and concerning symptoms, health professionals should consider a possible bipolar spectrum disorder.


Pharmacological Management of Bipolar Disorder in Pregnancy.

Jones SC, Jones I.  CNS Drugs. 2017 Aug 7. Review.


Associations Between Postpartum Depression, Breastfeeding, and Oxytocin Levels in Latina Mothers.

Lara-Cinisomo S, McKenney K, Di Florio A, Meltzer-Brody S.  Breastfeed Med. 2017 Jul 27.

Depression during pregnancy, PPD, and anxiety were associated with early breastfeeding cessation (before 2 months). Lower levels of oxytocin were observed in women who had PPD at 8 weeks and who had stopped breastfeeding their infant by 8 weeks postpartum.


Can exercise or physical activity help improve postnatal depression and weight loss? A systematic review.

Saligheh M, Hackett D, Boyce P, Cobley S.Arch Womens Ment Health. 2017 Jul 12.

There was inconsistency as to whether exercise or physical activity simultaneously reduced postpartum depression symptoms and assisted weight loss (or related body composition indices).


Appraisal of the Psychiatric Diagnostic Screening Questionnaire in a perinatal cohort: The APrON study.

Leung B, Letourneau N, Bright K, Giesbrecht GF, Ntanda H, Gagnon L; APrONTeam.  Scand J Public Health. 2017 Aug;45(6):658-665.

The Psychiatric Diagnostic Screening Questionnaire (PDSQ) is a potentially useful tool to screen for psychiatric conditions; however, in this study of  pregnant and postpartum women in a community sample, it was found that subscales may not be appropriate for screening in the pregnant population.


Family Context Moderates the Association of Maternal Postpartum Depression and Stability of Infant Temperament.

Parade SH, Armstrong LM, Dickstein S, Seifer R.  Child Dev. 2017 Jul 14.

Maternal depression was associated with change in infant temperament when maternal sensitivity was low but not when maternal sensitivity was high.


Social adversity in pregnancy and trajectories of women’s depressive symptoms: A longitudinal study.

Kingsbury AM, Plotnikova M, Clavarino A, Mamun A, Najman JM.  Women Birth. 2017 Jul 12.

Experiencing adversity during pregnancy predicts subsequent patterns of maternal depression over an extended period of women’s reproductive life course. Experiencing financial problems, housing problems, serious disagreements with partners and with others, and experiencing serious health problems in pregnancy were associated with high and middle depression trajectories over the 27 years. Having someone close die or have a serious illness was associated with the high depression trajectory only.


Trajectories of mood and stress and relationships with protective factors during the transition to menopause: results using latent class growth modeling in a Canadian cohort.

Guérin E, Goldfield G, Prud’homme D.  Arch Womens Ment Health. 2017 Jul 13.

Neither time spent in perimenopause nor BMI had a significant influence on levels of mood symptoms. However, higher scores on body image, self-esteem, and general health perceptions were predictive of more positive psychological outcomes over the transition to menopause.


The presence of anxiety, depression and stress in women and their partners during pregnancies following perinatal loss: A meta-analysis.

Hunter A, Tussis L, MacBeth A.  J Affect Disord. 2017 Jul 11;223:153-164.


The global prevalence of postpartum psychosis: a systematic review.

VanderKruik R, Barreix M, Chou D, Allen T, Say L, Cohen LS; Maternal Morbidity Working Group.  BMC Psychiatry. 2017 Jul 28;17(1):272.   Free Article

Five studies reported incidence of puerperal psychosis (ranging from 0.89 to 2.6 in 1000 women) and one reported prevalence of psychosis (5 in 1000).


Maternal posttraumatic stress disorder during the perinatal period and child outcomes: A systematic review.

Cook N, Ayers S, Horsch A.  J Affect Disord. 2017 Jul 27;225:18-31

Maternal postpartum PTSD is associated with low birth weight and lower rates of breastfeeding.


Lifelong estradiol exposure and risk of depressive symptoms during thetransition to menopause and postmenopause.

Marsh WK, Bromberger JT, Crawford SL, Leung K, Kravitz HM, Randolph JF, Joffe H, Soares CN.  Menopause. 2017 Jul 17.

Longer duration of estrogen exposure from menarche to the onset of menopausal transition was associated with a reduced risk of depression during the menopausal transition and 10 years of follow-up (odds ratio 0.85).  Longer duration of birth control use was associated with a decreased risk of depression (odds ratio 0.90), but number of pregnancies or breastfeeding was not.


Influence of adjuvant detached mindfulness and stress management training compared to pharmacologic treatment in primiparae with postpartum depression.

Ahmadpanah M, Nazaribadie M, Aghaei E, Ghaleiha A, Bakhtiari A, Haghighi M, Bahmani DS, Akhondi A, Bajoghli H, Jahangard L, Holsboer-Trachsler E, Brand S.  Arch Womens Ment Health. 2017 Jul 18.

45 primiparae with PPD were treated with an SSRI (citalopram; CIT) and randomly assigned to one of the following: detached mindfulness (CIT+DM); stress management training (CIT+SMT); control condition (CIT). Symptoms of depression decreased significantly over time, but more so in the CIT+DM and CIT+SMT groups, compared to the control condition.


Omega-3 supplementation from pregnancy to postpartum to prevent depressive symptoms: a randomized placebo-controlled trial.

Vaz JDS, Farias DR, Adegboye ARA, Nardi AE, Kac G.  BMC Pregnancy Childbirth. 2017 Jun 9;17(1):180. PMID:  Free Article

Daily supplementation of 1.8 g of n-3 PUFAs during 16 weeks did not prevent maternal depressive symptoms in a sample of Brazilian women.


HPA axis reactivity to pharmacologic and psychological stressors in euthymic women with histories of postpartum versus major depression.

Ferguson EH, Di Florio A, Pearson B, Putnam KT, Girdler S, Rubinow DR, Meltzer-Brody S.  Arch Womens Ment Health. 2017 Jun;20(3):411-420.

Currently euthymic women with histories of MDD or PPD did not demonstrate residual abnormal stress responsivity following administration of either a pharmacologic or psychological stressor.

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