Every week we review the most recent publications in women’s mental health, covering topics related to premenstrual symptoms, perinatal mood and anxiety disorders, use of medications in pregnant and breastfeeding women, perinatal substance use, and menopausal mental health. 

For more detailed descriptions of many of these topics, you can sign up to receive our weekly CWMH NEWSLETTER which comes out every Thursday.  

And don’t forget to visit ESSENTIAL READS – a curated selection of up-to-date and clinically relevant articles in women’s mental health.

Ruta Nonacs, MD PhD


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Does One Treatment Fit All? Effectiveness of a Multicomponent Cognitive Behavioral Therapy Program in Data-Driven Subtypes of Perinatal Depression.

Waqas A, Rahman A. Front Psychiatry. 2021 Nov 17;12:736790. Free article.

Four different clusters of perinatal depression were identified: mixed anxiety-depression, somatic depression, mild depression, and atypical depression. All clinical phenotypes responded well to the low-intensity cognitive behavioral Thinking Healthy Programme (THP).

Perinatal Mental Health Care In The United States: An Overview Of Policies And Programs.

Griffen A, McIntyre L, Belsito JZ, Burkhard J, Davis W, Kimmel M, Stuebe A, Clark C, Meltzer-Brody S. Health Aff (Millwood). 2021 Oct;40(10):1543-1550. Review.

Women’s experiences and perceptions of anxiety and stress during the perinatal period: a systematic review and qualitative evidence synthesis.

McCarthy M, Houghton C, Matvienko-Sikar K. BMC Pregnancy Childbirth. 2021 Dec 6;21(1):811. Free article.

Findings indicate that increased support for perinatal mental health in antenatal and postpartum care is needed. Addressing unrealistic expectations and conceptualisations of motherhood is also important to better support women. Enhancing women’s social support networks and provision of clear and consistent information are also essential to support women and minimise stress and anxiety in the perinatal period.

The role of inflammation in the pathogenesis of perinatal depression and offspring outcomes.

Sawyer KM. Brain Behav Immun Health. 2021 Nov 19;18:100390.

Sharma V. Treatment of Depression in a Patient With Intractable Hyperemesis Gravidarum. Prim Care Companion CNS Disord. 2021 Dec 16;23(6):20cr02905.

What medications would you use?


Andrade C. Major Congenital Malformations Associated With Exposure to Second-Generation Antipsychotic Drugs During Pregnancy. J Clin Psychiatry. 2021 Oct 5;82(5):21f14252. doi: 10.4088/JCP.21f14252. PMID: 34610230.

This article examines the findings of the meta-analysis as well as the findings of 2 recent observational studies that were not included in the meta-analysis; an outcome of specific interest was the risk of MCMs after first-trimester gestational exposure to second-generation antipsychotic (SGA) drugs.

Bipolar women’s antepartum psychotropic exposure and offspring risk of attention-deficit/hyperactivity disorder and autism spectrum disorder.

Yeh TC, Bai YM, Hsu JW, Huang KL, Tsai SJ, Chu HT, Liang CS, Chen MH. J Affect Disord. 2021 Dec 1;295:1407-1414. doi: 10.1016/j.jad.2021.09.016. Epub 2021 Sep 16. Free article.

We will cover this study in greater detail. While this study demonstrated an increased risk for ADHD and ASD, the study made no attempt to control for confounding factors.

Andrade C. Gestational and Neurodevelopmental Outcomes Associated With Antipsychotic Drug Exposure During Pregnancy. J Clin Psychiatry. 2021 Oct 12;82(5):21f14265. doi: 10.4088/JCP.21f14265. PMID: 34644464.

This article reviews the study from Wang et al (2021) which looked at gestational outcomes and risk for ADHD and autism spectrum disorder in children with prenatal exposure to antipsychotic medications. No increase in risk of ADHD or ASD.

In utero exposure to antipsychotic medication and psychiatric outcomes in the offspring.

Momen NC, Robakis T, Liu X, Reichenberg A, Bergink V, Munk-Olsen T. Neuropsychopharmacology. 2021 Nov 8.

Antipsychotic use in pregnancy and risk of attention/deficit-hyperactivity disorder and autism spectrum disorder: a Nordic cohort study.

Hálfdánarson Ó, Cohen JM, Karlstad Ø, Cesta CE, Bjørk MH, Håberg SE, Einarsdóttir K, Furu K, Gissler M, Hjellvik V, Kieler H, Leinonen MK, Nørgaard M, Öztürk Essen B, Ulrichsen SP, Reutfors J, Zoega H. Evid Based Ment Health. 2021 Nov 22.

Using data from Scandinavian medical databases, this study observed no association between maternal use of antipsychotic medications and risk for ADHD and ASD and the offspring.


A systematic review of the association between postpartum depression and neuraxial labor analgesia.

Orbach-Zinger S, Heesen M, Grigoriadis S, Heesen P, Halpern S. Int J Obstet Anesth. 2021 Feb;45:142-149.

This systematic review did not find compelling evidence for an association between PPD and labor analgesia.

Postpartum anhedonia: Emergent patterns in bipolar and unipolar depression.

Gollan JK, Yang A, Ciolino JD, Sit D, Wisner KL. Psychiatry Res. 2021 Dec;306:114274.

Among those women who reported postpartum anhedonia, twice as many women had a diagnosis of bipolar depression relative to unipolar depression (65.03% versus 39.47%, respectively). Anhedonia was also correlated with depression severit

Measures of anxiety, depression and stress in the antenatal and perinatal period following a stillbirth or neonatal death: a multicentre cohort study.

Thomas S, Stephens L, Mills TA, Hughes C, Kerby A, Smith DM, Heazell AEP. BMC Pregnancy Childbirth. 2021 Dec 10;21(1):818.

This study demonstrated heightened anxiety and depressive symptoms and elevated cortisol levels in women during pregnancies after having had a stillbirth or neonatal death; these symptoms decrease as the pregnancy progresses.

Internet and Face-to-face Cognitive Behavioral Therapy for Postnatal Depression Compared With Treatment as Usual: Randomized Controlled Trial of MumMoodBooster.

Milgrom J, Danaher BG, Seeley JR, Holt CJ, Holt C, Ericksen J, Tyler MS, Gau JM, Gemmill AW. J Med Internet Res. 2021 Dec 8;23(12):e17185. Free article.

This randomized controlled trial compares a web-based cognitive behavioral therapy (CBT) intervention (internet CBT+coach calls) for postpartum depression (MumMoodBooster [MMB]) with face-to-face (FTF) CBT. MMB was at least as effective as FTF-CBT in achieving remission from postpartum depression. MMB was superior to treatment as usual and FTF-CBT in encouraging and maintaining reduction of symptom severity over the 21-week follow-up for depressed postpartum women.

Evaluation of Repeated Web-Based Screening for Predicting Postpartum Depression: Prospective Cohort Study.

Haßdenteufel K, Lingenfelder K, Schwarze CE, Feisst M, Brusniak K, Matthies LM, Goetz M, Wallwiener M, Wallwiener S. JMIR Ment Health. 2021 Dec 10;8(12):e26665. doi: 10.2196/26665. Free article.

The best predictive accuracy for PPD has been shown for screening between the 24th and the 28th gestational week (GW) and seems to be beneficial for identifying women at risk.


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