Archives of Women's Mental Health最新文献

Purpose: Neurocognitive impairments are a core feature of psychosis and impact long-term outcomes. While sex differences in neurocognition have been observed in first-episode psychosis (FEP), findings remain mixed, and little is known about differential responses to metacognitive interventions. This study examined sex differences in the effectiveness of Metacognitive Training (MCT) on neurocognitive outcomes in FEP.

Methods: A total of 122 individuals with FEP were randomized to receive either MCT or psychoeducational intervention. Neurocognitive performance was assessed at baseline and at 6-month follow-up using a comprehensive battery (CPT-II, TMT, WCST, Stroop test, TAVEC, WAIS-III Digit Span). General Linear Models tested the effects of intervention, sex, and their interaction, both unadjusted and adjusted for covariates.

Results: MCT led to greater improvements than psychoeducation in immediate recall, processing speed, cognitive flexibility, inhibitory control, and attention. Improvements in immediate recall and Stroop Interference remained significant after adjustment, with Stroop performance also influenced by diagnosis. Across groups, men performed better in verbal memory, while women showed increased serial clustering in short-term recall, an effect that remained significant after adjustment. Notably, a group-by-sex interaction indicated that women receiving MCT experienced greater gains in short-term recall after controlling for covariates.

Conclusions: MCT enhances specific neurocognitive functions in FEP and shows promising effects for women in verbal memory processes. These findings underscore the importance of incorporating sex and diagnostic factors when tailoring early interventions for psychosis and highlight the potential of MCT as a personalized cognitive strategy.

Purpose: Perinatal depression (PND), occurring during pregnancy or within the first year after childbirth, is a common medical complication with serious consequences when left untreated, including hospitalizations, increased morbidity, and suicide. This study examined the intersection among racial, ethnic, and sociodemographic disparities in PND screening and diagnosis within a Midwestern health system.

Methods: We performed a multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) using electronic health record data for 79,992 deliveries. The study included women aged 15-50 who delivered live-born infants between 22 and 44 weeks of gestation. PND screening was identified by the presence of a PHQ-9 or EPDS score, and ICD9/10 codes were used to define depression diagnosis within one year before or after delivery.

Results: Across groups older women (≥ 36 years) were less likely to be screened for PND (OR = 0.65; 95%CI = 0.56-0.75) but not less likely to be diagnosed. Non-Hispanic Black, Hispanic, and Asian women were more likely to receive PND screening (ORs = 1.23-1.31) but less likely to be diagnosed (ORs = 0.16-0.60) compared to Non-Hispanic White women. Enrollment in public insurance was not associated with PND screening but was linked to a higher likelihood of diagnosis (OR = 1.41, CI = 1.24-1.61). Women in rural areas were less likely to be screened for PND (OR = 0.66, CI = 0.58-0.75), with no significant association with diagnosis.

Conclusions: Significant disparities exist in PND screening and diagnosis. Groups facing historic structural inequities are more likely to be screened but less likely to receive a diagnosis, highlighting the need for targeted interventions to address these inequities.

Purpose: The goal of this systematic review is to establish the prevalence of sexual dysfunction among women with migraines. Secondarily, this review explores factors contributing to the relationship between sexual dysfunction and migraine in women.

Methods: A thorough search of PubMed from inception to June 17, 2024 was completed. Search terms included migraine related terms and sexual dysfunction outcome related terms. Two independent reviewers assessed articles for relevance and extracted information from selected articles.

Results: In this review, a thorough search of the MEDLINE and CINAHL databases yielded 16 studies with 1,715 participants. The results demonstrated prevalence rates of sexual dysfunction in female migraine patients between 22.6% and 90%. There was a pooled prevalence of 69% (95% CI 61-77%) with substantial between-study heterogeneity (I² = 78.73%). Prevalence rates of sexual dysfunction were higher in women with migraine than in healthy controls. Migraine characteristics, such as duration, frequency, and pain are associated with sexual dysfunction. A bi-directional correlation exists between psychological factors, such as anxiety and depression, and sexual dysfunction in patients with migraine.

Conclusion: Migraines are associated with profound impacts on health-related quality of life. Sexual dysfunction is commonly associated with migraine in female patients, indicating that clinicians should routinely screen for sexual dysfunction in this population. Anxiety and depression may play a significant role in female sexual dysfunction in migraine.

Purpose: Postpartum depression (PPD) is a serious mental health concern with a high prevalence in India. For working women from economically disadvantaged backgrounds, awareness of PPD symptoms and available support is essential for early detection and management. However, due to the social stigma associated with mental disorder, general health literacy may not automatically translate into postpartum depression literacy (PPDL). This study investigates the key determinants of PPDL among economically disadvantaged working women in urban India.

Methods: A cross-sectional study was conducted in Hyderabad and Lucknow between March and August 2024. Using a two-stage sampling method based on socioeconomic indicators, 998 women employed in physically demanding jobs were recruited. The data were collected using the PoDLiS and HLS-EU-Q16 instruments. Descriptive statistics and a two-stage least squares (2SLS) regression model were used to examine the associations and explain the possible endogeneity between health literacy and PPDL.

Results: The mean PPDL score was 95.11 (SD = 13.58). Higher monthly household expenditure was positively associated with PPDL, whereas the general health literacy showed a marginally significant inverse relationship. Religion, caste, nuclear family structure, abortion history, and lower personal income were also significantly associated with PPDL. The model explained 17% of the variance.

Conclusion: The findings highlighted that there is a need for PPD - focused mental health education. To support women from economically marginalised backgrounds, policies and programmes must be designed to overcome social stigma and the everyday barriers they face when accessing mental care.

Purpose: This study investigates how different forms and intensities of intimate partner violence (IPV)-particularly emotional abuse and coercive control control-are associated with symptoms of depression and anxiety among women in Nepal.

Methods: We analyzed the 2022 Nepal Demographic and Health Survey, focusing on 4377 ever-partnered women aged 15-49 years. IPV was categorised into four domains: physical, sexual, emotional, and coercive control. Depression and anxiety were assessed using Nepali versions of the PHQ-9 and GAD-7. Multivariable logistic regression and marginal effects models were applied to estimate associations and explore dose-response patterns.

Results: Emotional IPV (aOR = 3.8) and coercive control (aOR = 1.8) were independently associated with moderate-to-severe depressive symptoms. Similar associations were observed for anxiety (emotional IPV aOR = 2.9; coercive control aOR = 1.6). Male partner alcohol use independently increased the risk of both IPV and common mental disorders (CMDs). Predicted probabilities of CMD symptoms were 5.45% with neither IPV nor alcohol use, 7.82% with alcohol use only, 11.64% with IPV only, and 17.95% with both exposures. Marginal effects analysis showed a clear dose-response pattern: each additional act of emotional, physical, or sexual IPV significantly increased CMD risk.

Conclusion: Psychological IPV-including emotional abuse and coercive control-has a strong, cumulative effect on women's mental health and remains underrecognized in clinical protocol and public health policies. Male partner alcohol use further amplifies this risk. Integrated IPV-mental health-alcohol interventions, grounded in syndemic and trauma-informed frameworks, are urgently needed in Nepal's primary health care systems.