Archives of Women's Mental Health最新文献

Purpose: Pregnant women are particularly vulnerable to experiencing mental health difficulties, especially anxiety. Anxiety in pregnancy can be characterized as having two components: general symptomology experienced in the general population, and pregnancy-related anxiety more focused on pregnancy, delivery, and the future child. In addition, women also commonly report experiencing attentional control and self-regulation difficulties across the peripartum period. However, links between anxiety and neural and cognitive functioning in pregnancy remain unclear. The present study investigated whether anxiety is associated with neural markers of attention and self-regulation measured using electroencephalography (EEG). Specifically, we examined associations between general and pregnancy-related anxiety and (1) beta oscillations, a neural marker of attentional processing; and (2) the coupling of beta and delta oscillations, a neural marker of self-regulation, in frontal and prefrontal regions.

Methods: A sample of 135 women in the third trimester of their pregnancy completed a resting-state EEG session.

Results: General anxiety was associated with increased beta oscillations, in line with research in the general population, interpreted as reflecting hyperarousal. Pregnancy-related anxiety was associated with decreased beta oscillations, interpreted as reflecting inattention and mind-wandering. Moreover, pregnancy-related anxiety, but not general anxiety, was linked to stronger delta-beta coupling, suggesting anxiety specifically related to the pregnancy is associated with investing greater effort in self-regulation.

Conclusion: Our results suggest that general and pregnancy-related anxiety may differentially relate to neural patterns underlying attention and self-regulation in pregnancy.

Purpose: Using social media can have negative consequences. The present study aimed to examine how the partner's problematic social media use (SMU) was related to the pregnant woman's time perspective and prenatal depression.

Methods: The study included 30 pregnant women and their 30 male partners. Research was conducted twice: in the first and third trimesters of pregnancy. Women completed online measures: the Zimbardo Time Perspective Inventory Fatalism scale (ZTPI-Fat), the Dark Future Scale (DFS), and the Edinburgh Postpartum Depression Scale (EPDS). Men completed the online Social Media Addiction Questionnaire (SMAQ).

Results: The woman's depressive symptoms were positively associated with fatalism (r = .35, p < .01 in the first trimester; r = .49, p < .01 in the third trimester) and future negative perspective (r = .33, p < .05 in the first trimester; r = .77, p < .001 in the third trimester). Moreover, in the third trimester, women's depressive symptoms correlated positively with their partners' problematic SMU (r = .36, p < .05) and negatively with their financial situation (r = - .37, p < .05). The results of the mediation analyses showed that the more intensive the partner's problematic SMU, the stronger the pregnant woman's fatalism and, consequently, the stronger her future negative perspective, resulting in more severe prenatal depressive symptoms in the third trimester (indirect effect: β = .16, SE = .09, 95% CI [.021, .393]).

Conclusions: Our findings show how important the behavior of the partner is for the mental health of the pregnant woman. The results suggest a possible mechanism explaining the relationship between the partner's problematic SMU and the woman's prenatal depressive symptoms. This mechanism probably consists in increasing the woman's sense of helplessness and loss of control over life, which leads to intensified future anxiety and, consequently, to depressive symptoms. Moreover, we interpreted the results to mean that the partner's time-consuming preoccupation with SMU may make the woman feel emotionally neglected. The lack of support from the partner may give rise to feelings of powerlessness, and may cause depressive symptoms.

Purpose: Our study examines the socio-demographic, forensic psychiatric, and childhood trauma exposure (CTE) data of Turkish intimate partner violence (IPV) perpetrators and draws comparisons with the violence data.

Methods: Data of male perpetrators referred to the domestic violence outpatient clinic by judicial authorities between November 2019 and June 2022 were retrospectively examined, with a focus on CTE data.

Results: The mean age of the male perpetrators examined in the study was 37.1 years. Among the overall sample, 16.2% (n = 17) had experienced violence at school in childhood, and 22.9% (n = 24) had experienced CTE. Regarding the frequency of domestic violence in their households, of the perpetrators admitted to the clinic for IPV, 40% (n = 42) reported rarely, 43.8% (n = 46) sometimes, and 16.2% (n = 17) often engaged in violent acts. There is a significant relationship between the frequency of IPV and the level of CTE (χ2: 13.052, SD: 2, p = 0.001, Cramer's V: 0.353). Similarly, individuals who witnessed domestic violence during childhood were found to commit partner violence more frequently (χ2: 8.157, SD: 2, p = 0.017, Cramer's V: 0.279).

Conclusions: In this study, we found a strong relationship between CTE and IPV. To the best of our knowledge, our study is only example that investigates the relationship between CTE and IPV in a Turkish sample.

Purpose: Research on cognitive and emotional functions during pregnancy challenges the prevalent perception of cognitive decline in pregnant women. This study investigates the behavioral and neural dynamics of cognitive-affective processing in third-trimester pregnant women, comparing them with non-pregnant controls.

Methods: Using a 64-channel EEG-ERP system, we recorded brain activity as participants engaged in an emotional word recognition task. This task involved initially viewing a sequence of emotional and neutral words, followed by a recognition test where participants identified each word as 'new' or 'previously seen'.

Results: Contrary to widespread beliefs about diminished recognition ability during late pregnancy, our results revealed no significant differences in error rates between groups. However, pregnant participants demonstrated slower reaction times. In terms of neural responses, pregnant women exhibited increased amplitudes in the N1, P2, and N400 ERP components, suggesting that they may require additional brain resources compared with non-pregnant individuals to process perceptual information. A significant interaction was observed between pregnancy status and the emotional valence of stimuli. Pregnant women showed heightened N1 and N400 responses to negative words, indicating increased sensitivity to stimuli potentially representing threat. This enhanced response was not observed for positive or neutral words. Furthermore, there was an amplified N1 response to 'new' words, but not to 'old' words.

Conclusion: These findings suggest that late pregnancy is characterized by heightened responsiveness to new and particularly negative stimuli, potentially leading to a more cautious behavioral approach. Heightened vigilance and sensitivity could offer evolutionary advantages, optimizing fetal development and enhancing maternal well-being.

Purpose: Alcohol is posited to affect sex steroid hormone concentrations, and a growing body of research has demonstrated menstrual cycle effects on women's use of alcohol. The present targeted review synthesizes the literature examining the relationship between alcohol use and estradiol in women and suggests directions for future research.

Methods: Articles were identified using the PubMed database using the following criteria: published in English, presented original findings for women, were peerreviewed, and included measures of estradiol levels in the analyses. Twenty-nine articles were identified for inclusion.

Results: Results from this review indicate acute alcohol use temporarily increases estradiol levels in women, and this may be strongest when gonadotropins are high. Regular alcohol use (≥1 drink per day) increases estradiol levels, but estradiol appears to be suppressed in women with alcohol use disorders and physiologic dependence. Alcohol use tends to be highest in women during ovulation, when estradiol is high, and progesterone is low.

Conclusion: Alcohol use increases estradiol levels in women, particularly in the presence of gonadotropins. More research is needed to assess the effect of estradiol on alcohol use in women. Research on the relationship of estrogen and alcohol use in women is needed to elucidate health outcomes through the lifespan.

Purpose: While neuropsychological deficits are commonly observed in affective and psychotic disorders, this remains unexplored in these disorders when they occur during pregnancy and the postpartum period.

Methods: A neuropsychological test battery was administered to women defined at risk of postpartum depression (PD, N = 53) because having either a current or past diagnosis of major depressive disorder, women at risk of postpartum psychosis (PP, N = 43) because of a diagnosis of bipolar disorder or schizoaffective disorder and/or a previous episode of PP and women not at risk (NR, N = 48) in the third trimester of pregnancy. Generalized and specific cognitive abilities were compared between groups.

Results: Women at risk of PP presented worse executive functions and processing speed compared to NR and worse performance compared to women at risk of PD across all cognitive domains. In addition, women at risk of PP who developed a psychiatric relapse in the first four weeks post-partum showed worse verbal learning and memory, visual memory, executive functions and processing speed in pregnancy compared to NR, whereas women at risk of PP who remained well presented neuropsychological performance that was intermediate between that of the women NR and those at risk of PP who developed symptoms. There were no differences in performance between women at risk of PD and the NR women, even if 31 women at risk of PD presented depressive symptoms at the time of cognitive assessment.

Conclusions: Our findings in women at risk of PP align with neuropsychological findings in individuals with, or at risk of psychosis unrelated to pregnancy. In addition, initial evidence that women at risk of PP who develop a psychiatric relapse in the postpartum show a particularly poor neuropsychological performance in pregnancy suggests that this could be considered part of a phenotype for the disease and help guiding future preventive strategies in this clinical population. In women at risk of PD, the presence of depressive symptoms did not influence cognitive performance.

Purpose: Postpartum mood disorders affect many women following childbirth. Prescribing medication for depression and anxiety is one strategy for the effective treatment of postpartum mood disorders. Left untreated, mothers experiencing these disorders and their infants face increased risks of adverse health outcomes. Little is known about how diagnosis and treatment of postpartum mood disorders changed during COVID-19.

Methods: We used a retrospective pooled cross-sectional design in a sample of privately-insured postpartum women in U.S. claims data from January 1, 2016 to December 31, 2020. We measured changes in diagnoses of anxiety and depression and changes in prescription fills and days supplied of classes of medications used to treat these conditions (antidepressants, benzodiazepines, and z-drugs). We used ordinary least squares (OLS) regression for each outcome variable during the pre-pandemic period and forecast expected outcomes the observation period. Forecasted and actual values of the outcomes were then compared.

Results: Following the onset of the COVID-19 pandemic in March 2020, diagnoses of depression and anxiety were not significantly higher among privately insured postpartum women in the United States. The proportion of privately-insured postpartum women filling a benzodiazepine prescription increased by 15.2%.

Conclusions: We find diagnosis of postpartum mood disorders did not increase after the onset of the COVID-19 pandemic, however, fills of benzodiazepines increased among privately-insured postpartum women. Given prior evidence of increased depressive and anxiety symptoms among postpartum women during COVID-19, this suggests increased barriers to appropriate diagnoses and treatment for depression during this period.

Purpose: This study tests the hypotheses that lifetime history of depression, and prenatal depression, are associated with a reduced likelihood of breastfeeding initiation (giving the baby any breastmilk during the first week of life) and breastfeeding maintenance (giving the baby breastmilk for at least 6 months), and a greater likelihood of reporting breastfeeding problems.

Methods: We analyzed data from the Norwegian Mother, Father, and Child cohort study (MoBa), N = 78,307. Mothers reported a lifetime history of depression during the second trimester of pregnancy, and current symptoms of depression during the third trimester using the Hopkins Symptoms Checklist short version (SCL-8). At six months postpartum, mothers self-reported breastfeeding initiation, maintenance, and difficulties.

Results: Using binary logistic regression analyses, we report that a lifetime history of depression is associated with a lower likelihood of breastfeeding initiation (OR = 0.751, 95%CI = 0.650-0.938), breastfeeding maintenance (OR = 0.712, 95%CI = 0.669-0.785), and a greater likelihood of breastfeeding difficulties (OR = 1.86, 95%CI = 1.72-2.06). Similarly, prenatal depression was associated with a lower likelihood of breastfeeding initiation (OR = 0.904, 95%CI = 0.878-0.929), breastfeeding maintenance (OR = 0.929, 95%CI = 0.920-0.938), and a greater likelihood of breastfeeding difficulties (OR = 1.10, 95%CI = 1.09-1.12). Results remained largely unchanged when covaried for several confounding variables, including medication use.

Conclusion: We provide novel evidence that pre-conception and prenatal symptoms of depression are associated with breastfeeding outcomes. This information could be used to identify women very early in pregnancy who may need additional support with breastfeeding. There is also a need to fully understand the biopsychosocial mechanisms that mediate the relationship between depression prior to birth and breastfeeding outcomes.

Whilst the field of maternal cognition is gaining interest, with a recent increase in publications, there are still only a handful of existing studies. This presents a unique opportunity for reflection and growth, advancing scientific rigor to ensure that future interpretations of maternal cognitive functioning are based on robust, generalizable data. With this in mind, we offer ten recommendations for future cognitive research in motherhood, with a focus on intentional study design. A study's design dictates the questions that can be asked, and the answers that can be gleaned from collected data, making study design a cornerstone of robust and reproducible science. These recommendations are intended as a resource for study conceptualization and design, participant recruitment, result interpretation, and peer review.

Purpose: Perinatal Intensive Outpatient Programs (IOPs) address severe perinatal mood and anxiety disorders (PMADs) and mother-infant relationship concerns. Given the impact of PMADs on mothers and infants, rapid transitions to virtual services (telehealth) amid COVID-19, and service expansions to populations in need, it is critical to evaluate how effectively virtual and in-person perinatal IOP services treat PMADs and mother-infant bonding.

Methods: This quality-improvement record review examined patient records (n = 361) for a perinatal IOP from May 2016 to July 2023, amid multiple transitions between in-person and virtual services related to COVID-19, influenza, and respiratory syncytial virus. Patients in the completed measures sample (n = 115) completed depression (EPDS), anxiety (GAD-7, PASS), and mother-infant bonding (PBQ) measures over the first 3 weeks of treatment. Patients also anonymously provided program satisfaction ratings and qualitative feedback.

Results: While anxiety and depression symptoms improved similarly across service settings, mother-baby bonding only significantly improved with in-person treatment. Patient symptom outcomes also differed by public/private insurance, race, and number of children. Patients reported high service ratings and overall satisfaction, and available feedback indicates some preference for in-person services.

Conclusion: As perinatal mental health services and IOPs continue to expand, virtual services can similarly address anxiety and depression symptoms and help to reach in-need populations. However, for perinatal IOPs, the core treatment target of mother-infant bonding may be uniquely addressed via in-person services.