While the use of lithium has been in decline over the last 20 years, lithium continues to be a useful and highly effective mood stabilizer for women with bipolar disorder.  We have long been aware of its teratogenic effects, with some, but not all, studies documenting an increased risk of cardiovascular malformations.  A new study published in the American Journal of Psychiatry conducts a systematic review and meta-analysis to look at outcomes in children with prenatal exposure to lithium.  No big surprises. Lithium was associated with a small but statistically significant increase in overall risk of congenital malformations and in risk for cardiovascular malformations.

We plan to review this paper in greater detail in the upcoming weeks. 

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



Clinical and psychometric features of psychiatric patients after a suicide attempt in relation with menstrual cycle phases.

Papadopoulou A, Efstathiou V, Christodoulou C, Gournellis R, Papageorgiou C, Douzenis A, Markianos M.  Arch Womens Ment Health. 2019 Oct;22(5):605-611.

Suicide attempts were more frequent during the last 4 days of luteal phase and during the 4 days of menses, with 59% of attempts to occur during these 8 days.


Stress and Anxiety in Couples Who Conceive via In Vitro Fertilization Compared With Those Who Conceive Spontaneously.

Stevenson EL, Cebert M, Silva S.  J Obstet Gynecol Neonatal Nurs. 2019 Oct 12.

Among the participants, IVF did not increase risk for stress, state anxiety, or pregnancy-related anxiety.

Infertility-related stress and the risk of antidepressants prescription in women: a 10-year register study.

Pedro J, Vassard D, Malling GMH, Hougaard CØ, Schmidt L, Martins MV.  Hum Reprod. 2019 Aug 1;34(8):1505-1513.

Women presenting high infertility-related stress in the personal and marital domains were at higher risk of redeemed first-time prescription of antidepressants after ART, independently of having delivered a child or not after initiation of ART treatment. Women would benefit from an initial screening specifically for high infertility-related stress. The COMPI Fertility Problem Stress Scales can be used by clinical staff in order to identify women in need of psychological support before starting ART treatments.


The longitudinal course of pregnancy-related anxiety in parous and nulliparous women and its association with symptoms of social and generalized anxiety.

Mudra S, Göbel A, Barkmann C, Goletzke J, Hecher K, Schulte-Markwort M, Diemert A, Arck P.  J Affect Disord. 2019 Aug 19;260:111-118.

Symptoms of social phobia significantly predicted higher levels of fear of childbirth, child-related worries and concerns about mother´s appearance. Symptoms of GAD predicted higher child-related worries.

Emotional Stress During Pregnancy – Associations With Maternal Anxiety Disorders, Infant Cortisol Reactivity, and Mother-Child Interaction at Pre-school Age.

Zietlow AL, Nonnenmacher N, Reck C, Ditzen B, Müller M. Front Psychol. 2019 Sep 25.  Free Article

Socioeconomic status and treatment of depression during pregnancy: a retrospective population-based cohort study in British Columbia, Canada.

Hanley GE, Park M, Oberlander TF.  Arch Womens Ment Health. 2018 Dec;21(6):765-775.

Women in the highest income quintile were significantly more likely to see a psychiatrist for depression during pregnancy and to fill prescriptions for serotonin reuptake inhibitor (SRI) antidepressants than women in the lowest income quintile. Women at the lower end of the income distribution were more likely to have a GP visit for depression. Women at the low end of the income distribution were more likely to end up in hospital for depression or a mental health condition during pregnancy and more likely to receive a benzodiazepine and/or an antipsychotic medication.


Lithium Exposure During Pregnancy and the Postpartum Period: A Systematic Review and Meta-Analysis of Safety and Efficacy Outcomes.

Fornaro M, Maritan E, Ferranti R, Zaninotto L, Miola A, Anastasia A, Murru A, Solé E, Stubbs B, Carvalho AF, Serretti A, Vieta E, Fusar-Poli P, McGuire P, Young AH, Dazzan P, Vigod SN, Correll CU, Solmi M.  Am J Psychiatry. 2019 Oct 18.

Lithium prescribed during pregnancy was associated with higher odds of any congenital anomaly (N=23,300; prevalence=4.1%; odds ratio=1.81, 95% CI=1.35-2.41) and of cardiac anomalies (N=1,348,475; prevalence=1.2%; odds ratio=1.86, 95% CI=1.16-2.96). 


No articles this week


No articles this week


No articles this week


Perinatal maternal mental health and infant socio-emotional development: A growth curve analysis using the MPEWS cohort.

Porter E, Lewis AJ, Watson SJ, Galbally M.  Infant Behav Dev. 2019 Aug 9;57:101336.

Both baseline maternal depression and anxiety symptom levels, and the increase in these symptoms over time, predicted more problems with children’s social and emotional development.

Maternal postnatal mental health and offspring symptoms of ADHD at 8-9 years: pathways via parenting behavior.

Mulraney M, Giallo R, Efron D, Brown S, Nicholson JM, Sciberras E.  Eur Child Adolesc Psychiatry. 2019 Jul;28(7):923-932. 

There was evidence of an indirect pathway from maternal postnatal distress to child ADHD at age 8-9 years via parenting hostility, but not through parenting warmth or consistency.

Out-of-home placement to age 18 years in children exposed to a postpartum mental disorder.

Vigod SN, Laursen TM, Ranning A, Nordentoft M, Munk-Olsen T.  Acta Psychiatr Scand. 2018 Jul;138(1):35-43.

Compared to children unexposed to maternal mental illness, risk was higher for children exposed to a maternal mental disorder whose mothers had a first contact for a mental disorder in the 0-12 months of pre-delivery (8.17/1000 person-years; aIRR 4.56, 95% CI 4.08-5.09), the first 3 months postpartum (4.60/1000 person-years; aIRR 3.55) and 4-12 months postpartum (6.49/1000 person-years; aIRR 3.93).


No articles this week


Gender differences in trajectories of depressive symptoms across childhood and adolescence: A multi-group growth mixture model.

Lewis AJ, Sae-Koew JH, Toumbourou JW, Rowland B.  J Affect Disord. 2019 Sep 4;260:463-472.

Four trajectories were found to be the best fitting model characterising low-stable (75%); decreasing (11%); increasing (9%); high and rising (6%) groups. Females were more likely to be in a trajectory of increasing depressive symptoms between 4 and 14 years of age than males. Reactive temperament and maternal depression at four and six years of age were consistent predictors of increasing and high trajectories while persistent temperament acts as a protective factor for females.

Prenatal and childhood adverse life events, inflammation and depressive symptoms across adolescence.

Flouri E, Francesconi M, Midouhas E, Lewis G.  J Affect Disord. 2019 Sep 3;260:577-582. 

In the general adolescent population, increasing exposure to psychosocial stressors over time during childhood is associated with the early onset of depressive symptoms, partly via increasing levels of plasma IL-6.

The brain as a target of hormonal contraceptives: evidence from animal studies.

Porcu P, Serra M, Concas A. Front Neuroendocrinol. 2019 Oct 12.

Animal studies suggest that hormonal contraceptives influence neurohormones, neurotransmitters, neuropeptides, and emotional, cognitive, social and sexual behaviors.



Related Posts