Weekly Roundup for JANUARY 31, 2020: Recent Publications in Women’s Mental Health

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.

There are quite a few articles this week looking at the effects of CBT for the treatment of depression and anxiety during pregnancy. The results are mixed. While some of the studies show that CBT is effective for reducing anxiety, CBT appeared to have less of an impact on depressive symptoms. In addition, the single study which looked at infant outcomes in women receiving CBT did not show any positive impact of CBT. On the other hand, a small MRI study suggested that CBT had an impact on infant brain microstructure, and another small study demonstrated epigenetic changes in the infants of CBT-treated mothers.

Don’t forget that our online course on women’s mental health will begin on FEBRUARY 10TH. You can find out more about the course and register HERE.

For more detailed descriptions of many of these topics, you can sign up for the CWMH NEWSLETTER which comes out every Thursday. You can sign up for our newsletter HERE.

Ruta Nonacs, MD PhD

PMS AND PMDD

No articles this week

INFERTILITY AND MENTAL HEALTH

No articles this week

PSYCHIATRIC ILLNESS DURING PREGNANCY

Effects of psychological treatment of mental health problems in pregnant women to protect their offspring: randomised controlled trial.

Burger H, Verbeek T, Aris-Meijer JL, Beijers C, Mol BW, Hollon SD, Ormel J, van Pampus MG, Bockting CLH. Br J Psychiatry. 2019 Dec 6:1-7.

Prenatally initiated CBT did not improve maternal symptoms or child outcomes among non-help-seeking women with antenatal depression or anxiety.

Brain Magnetic Resonance Imaging Findings in Children after Antenatal Maternal Depression Treatment, a Longitudinal Study Built on a Pilot Randomized Controlled Trial.

Bleker LS, Milgrom J, Parker D, Gemmill AW, Holt CJ, Connelly A, Burger H, Roseboom TJ, de Rooij SR. Int J Environ Res Public Health. 2019 May 22;16(10).

Antenatal CBT for depression may ameliorate offspring’s brain (micro)structural outcomes, but the sample size was extremely small.

Exploring the effect of antenatal depression treatment on children’s epigenetic profiles: findings from a pilot randomized controlled trial.

Bleker LS, Milgrom J, Sexton-Oates A, Roseboom TJ, Gemmill AW, Holt CJ, Saffery R, Burger H, de Rooij SR.

Clin Epigenetics. 2019 Feb 4;11(1):18. Free Article

This study found preliminary evidence of a possible effect of CBT during pregnancy on widespread methylation in children’s genomes and a trend toward lower methylation of a CpG site previously shown by others to be linked to depression and child maltreatment.

Efficacy of brief guided self-help cognitive behavioral treatment for perfectionism in reducing perinatal depression and anxiety: a randomized controlled trial.

Lowndes TA, Egan SJ, McEvoy PM. Cogn Behav Ther. 2019 Mar;48(2):106-120.

There were significant reductions in perfectionism and symptoms for participants who received CBT for perfectionism from pre- to post-treatment, which were maintained at 3-month follow-up, while the waitlist control group demonstrated no significant changes. The data suggested that changes in perfectionism were associated with decreases in depressive symptoms.

Prevalence and clinical characterisation of pregnant women with eating disorders.

Bye A, Nath S, Ryan EG, Bick D, Easter A, Howard LM, Micali N. Eur Eat Disord Rev. 2020 Jan 27.

Weighted prevalence of lifetime eating disorders was 15.35% (95% CI [11.80, 19.71]), and current eating disorders was 1.47% (95% CI [0.64, 3.35]) in a UK inner-city antenatal sample; however, eating disorders were poorly recognised in antenatal care. Depression, anxiety, and a history of deliberate self-harm or attempted suicide are common amongst pregnant women with eating disorders.

Cognitive behavioral therapy for perinatal anxiety: A randomized controlled trial.

Green SM, Donegan E, McCabe RE, Streiner DL, Agako A, Frey BN. Aust N Z J Psychiatry 2020 Jan 20.

Cognitive behavioral group therapy was effective in improving anxiety and related symptoms among women with anxiety disorders in the perinatal period.

A randomized controlled trial of ‘MUMentum Pregnancy’: Internet-delivered cognitive behavioral therapy program for antenatal anxiety and depression.

Loughnan SA, Sie A, Hobbs MJ, Joubert AE, Smith J, Haskelberg H, Mahoney AEJ, Kladnitski N, Holt CJ, Milgrom J, Austin MP, Andrews G, Newby JM. J Affect Disord. 2019 Jan 15;243:381-390.

Of the 36 women who started internet-guided CBT, 26 completed all three lessons of treatment (76% adherence rate). iCBT produced moderate to large effect size reductions for anxiety on the GAD-7 and psychological distress on the Kessler-10 that were superior to treatment as usual. Only small nonsignificant differences were found for depression outcomes.

Development of a Psychological Intervention to Address Anxiety During Pregnancy in a Low-Income Country.

Atif N, Nazir H, Zafar S, Chaudhri R, Atiq M, Mullany LC, Rowther AA, Malik A, Surkan PJ, Rahman A. Front Psychiatry. 2020 Jan 10;10:927. Free Article

The “Happy Mother, Healthy Baby” intervention, which was based on principles of cognitive behavior therapy. Its evidence-based elements included: developing an empathetic relationship, challenging thoughts, behavior activation, problem solving, and involving family.

MEDICATIONS AND PREGNANCY

No articles this week

POSTPARTUM PSYCHIATRIC ILLNESS

Symptom profile of postpartum and non-postpartum manic episodes in bipolar I disorder: a within-subjects study.

Gordon-Smith K, Perry A, Di Florio A, Forty L, Fraser C, Casanova Dias M, Warne N, MacDonald T, Craddock N, Jones L, Jones I. Psychiatry Res. 2020 Jan 2;284:112748

Postpartum manic episodes had a significantly higher incidence of perplexity and excessive self-reproach. Classic manic symptoms, specifically pressured speech and increased sociability, were significantly less frequent in postpartum manic episodes. Overall there were significantly fewer manic symptoms and significantly more depressive symptoms in the postpartum episodes than in the non-postpartum episodes.

MEDICATIONS AND BREASTFEEDING

No articles this week

PERINATAL SUBSTANCE USE

Engagement in Early Intervention Services Among Mothers in Recovery From Opioid Use Disorders.

Peacock-Chambers E, Feinberg E, Senn-McNally M, Clark MC, Jurkowski B, Suchman NE, Byatt N, Friedmann PD. Pediatrics. 2020 Jan 28. pii

Barriers to engagement in EI among mothers in recovery from OUDs include a range of emotions, perceived stigma, and ambivalence.

MATERNAL MENTAL HEALTH AND CHILD OUTCOMES

Association of Prenatal Maternal Psychological Distress With Fetal Brain Growth, Metabolism, and Cortical Maturation.

Wu Y, Lu YC, Jacobs M, Pradhan S, Kapse K, Zhao L, Niforatos-Andescavage N, Vezina G, du Plessis AJ, Limperopoulos C. JAMA Netw Open. 2020 Jan 3;3(1):e1919940.

This study found that the prevalence of maternal psychological distress in healthy, well-educated, and employed pregnant women was high, underappreciated, and associated with impaired fetal brain biochemistry and hippocampal growth as well as accelerated cortical folding.

MENOPAUSE AND MENTAL HEALTH

Lights on MsFLASH: a review of contributions.

Reed SD, LaCroix AZ, Anderson GL, Ensrud KE, Caan B, Carpenter JS, Cohen L, Diem SJ, Freeman EW, Joffe H, Larson JC, McCurry SM, Mitchell CM, Newton KM, Sternfeld B, Guthrie KA. Menopause. 2020 Jan 20.