In a large study published in the American Journal of Psychiatry, researchers observed higher rates of depressive symptoms in adolescents treated with oral contraceptives.  However, this study did not show any increase in risk for depression in older women taking oral contraceptives. These findings are similar to those reported in an earlier study from Denmark.  

In that study, the risk of depressive symptoms generally decreased with increasing age. Adolescents (15-19 years) using oral contraceptives had a relative risk of new onset of depression (first use of an antidepressant) of 1.8.

For more detailed descriptions of many of these topics, you can read 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

Collective impact of chronic medical conditions and poverty on perinatal mental illness: population-based cohort study.

Faulkner MR, Barker LC, Vigod SN, Dennis CL, Brown HK.  J Epidemiol Community Health. 2019 Nov 2.

Chronic medical conditions (CMC) and poverty were each independently associated with increased risk of perinatal mental illness (CMC vs no CMC exposure: 19.8% vs 15.6%, adjusted relative risk (aRR) 1.21), poverty vs no poverty exposure: 16.7% vs 15.5%, aRR 1.06).


Cohort study of the relationship between individual psychotherapy and pregnancy outcomes.

Snapper LA, Hart KL, Venkatesh KK, Kaimal AJ, Perlis RH.  J Affect Disord. 2018 Oct 15;239:253-257. 

Women who received one or more psychotherapy sessions during pregnancy had increased odds of preterm delivery and decreased odds of high maternal weight gain (more than 40 pounds). Individuals who received four or more psychotherapy sessions during pregnancy had increased odds of preterm birth and low infant birth weight and decreased odds of high maternal weight gain.  While treatment of depression in pregnant women has been shown to benefit the mother, the absence of benefit in terms of pregnancy outcomes merits further investigation.


Pregnant and Postpartum Women With Bipolar Disorder: Taking the Care to Where They Are.

Bhat A, Cerimele JM, Byatt N.  Psychiatr Serv. 2018 Dec 1;69(12):1207-1209. 

This article describes clinical programs that support identification and management of depression and bipolar disorder among women in non-mental health settings. The programs use diverse management strategies, including referral to specialty mental health, collaborative care, and consultation and care coordination.

 

MEDICATIONS AND PREGNANCY

Lithium Use and Non-use for Pregnant and Postpartum Women with Bipolar Disorder.

Hermann A, Gorun A, Benudis A.  Curr Psychiatry Rep. 2019 Nov 7;21(11):114.

In contrast to prior data, recent studies indicate that lithium use in pregnancy is associated with either no increased malformations risk or a small increase in risk for cardiac malformations including Ebstein’s anomaly.


Trend of antidepressants before, during, and after pregnancy across two decades-A population-based study.

Sun Y, Dreier JW, Liu X, Glejsted Ingstrup K, Maegbaek ML, Munk-Olsen T, Christensen J.  Brain Behav. 2019 Oct 15. Free Article

In a study from Denmark, prescription of antidepressants during pregnancy increased steadily from 0.4% in 1997 to 4.6% in 2011, but decreased thereafter to 3.1% in 2016.

 

POSTPARTUM PSYCHIATRIC ILLNESS

Weight Loss, Gain, or Stability from 6 Weeks to 6 Months Postpartum: Associations with Depressive Symptoms and Behavioral Habits.

Walker LO, Sterling BS.  J Womens Health (Larchmt). 2019 Nov 8. 

Gaining weight after delivery (compared with stable weight) was associated with prepregnant overweight/obesity (adjusted odds ratio [aOR]?=?3.22).  Losing weight increased with excessive gestational weight gain (aOR?=?2.40) and depression risk at 6 months (aOR?=?2.57). Weight loss, although welcomed, may be secondary to depression risk.


Postpartum depression screening: are we doing a competent job?

Sudhanthar S, Sheikh ZE, Thakur K.  BMJ Open Qual. 2019 Oct 13. Free Article

Three Plan-Do-Study-Act (PDSA) cycles were implemented involving educational strategies, system-based practice improvement and stakeholder participation. Improvement seen after PDSA cycle 1 was minimal. At the end of cycle 2, 16/50 (33%) charts had documentation of screening using EPDS. At the end of cycle 3, 33/40 (82%) charts had EPDS documentation.

 

MEDICATIONS AND BREASTFEEDING

No articles this week

PERINATAL SUBSTANCE USE DISORDERS

Identification of substance use disorders among pregnant women: A comparison of screeners.

Chang G, Ondersma SJ, Blake-Lamb T, Gilstad-Hayden K, Orav EJ, Yonkers KA.  Drug Alcohol Depend. 2019 Oct 21.

The CRAFFT and SURP-P showed modest ability to identify substance use disorders among pregnant women.


Prenatal drug exposure and neurodevelopmental programming of glucocorticoid signalling.

Franks AL, Berry KJ, DeFranco DB.  J Neuroendocrinol. 2019 Aug 30:e12786. 

Prenatal exposure to drugs of abuse, including opioids, alcohol, cocaine and cannabis, has been shown to not only impact GC signalling, but also alter functioning of the hypothalamic-pituitary-adrenal (HPA) axis. Such exposures can have long-lasting neurobehavioural consequences, including alterations in the stress response in the offspring.

 

MATERNAL MENTAL HEALTH AND CHILD OUTCOMES

No articles this week

MENOPAUSE AND MENTAL HEALTH

Impact of estradiol variability and progesterone on mood in perimenopausal women with depressive symptoms.

Joffe H, de Wit A, Coborn J, Crawford S, Freeman M, Wiley A, Athappilly G, Kim S, Sullivan KA, Cohen LS, Hall JE.  J Clin Endocrinol Metab. 2019 Nov 6. 

Increasing dysregulation of ovarian hormones, and greater variability of estradiol levels, but not VMS, is associated with more depressive symptom burden during perimenopause.


Does mid-life aging impact women’s sleep duration, continuity, and timing?: A longitudinal analysis from the Study of Women’s Health Across the Nation.

Matthews KA, Kravitz HM, Lee L, Harlow SD, Bromberger JT, Joffe H, Hall MH.  Sleep. 2019 Oct 21. 

This study suggests that sleep may not worsen in general in midlife women. Perhaps the expected negative effect of aging in midlife into early old age on sleep is overstated.


Association of dietary n-3 polyunsaturated fatty acids intake with depressive symptoms in midlife women.

Li D, Liang H, Tong Y, Li Y.  J Affect Disord. 2019 Oct 11;261:164-171.

Dietary n-3 polyunsaturated fatty acids may be inversely associated with depressive symptoms in early perimenopausal women, but not in premenopausal women.

 

OTHER TOPICS IN WOMEN’S MENTAL HEALTH

Association of Use of Oral Contraceptives With Depressive Symptoms Among Adolescents and Young Women.

de Wit AE, Booij SH, Giltay EJ, Joffe H, Schoevers RA, Oldehinkel AJ.  JAMA Psychiatry. 2019 Oct 2.

Although oral contraceptive use showed no association with depressive symptoms when all age groups were combined, 16-year-old girls reported higher depressive symptom scores when using oral contraceptives.


Transition to parenthood and mental health at 30 years: a prospective comparison of mothers and fathers in a large Brazilian birth cohort.

Pearson RM, Culpin I, Loret de Mola C, Quevedo L, Murray J, Matijasevich A, Tilling K, Barros FC, Stein A, Horta BL.  Arch Womens Ment Health. 2019 Oct;22(5):621-629. Free Article

Mothers, but not fathers, with higher number of children by age 30 years, were at a substantially increased risk of a wide range of mental health disorders compared to women with no children. There was evidence that motherhood was associated with an increase in symptoms over time rather than higher symptoms at baseline.