Archives of Women's Mental Health最新文献

Purpose

Using an intersectional lens, this study examined the association between maternal reports of emotional distress due to racism (EDR) and postpartum depression (PPD) symptoms among persons with and without disabilities in minoritized racial and ethnic populations.

Methods

An analysis of Phase 8 (2018–2020) data from the Pregnancy Risk Assessment Monitoring System (PRAMS) included 2,452 respondents with a recent live birth from three states (MO, GA, VA). We examined the association between EDR and PPD symptoms among respondents with and without disabilities using Pearson’s chi-square test. Multivariate regression models were used to further estimate the odds of PPD symptoms associated with EDR and to examine differences in this relationship by disability status.

Results

EDR was significantly associated with PPD symptoms, with a higher prevalence of PPD symptoms among those with at least one disability (52.3%) compared to those without disabilities (19.9%). After adjusting for maternal demographics, EDR was significantly associated with PPD symptoms across disability groups. No significant interaction between disability group and EDR was observed, suggesting the association’s strength did not differ significantly by disability group in this study. In the fully adjusted model, history of depression attenuated the EDR-PPD association across disability groups, highlighting the effect of prior depressive episodes on PPD outcomes.

Conclusion

EDR is significantly associated with PPD symptoms, and persons with disabilities in minoritized racial and ethnic populations may be particularly susceptible to EDR and PPD. Additional research using an intersectional perspective is needed to elucidate PPD disparities as related to multiple, intersecting social identities and experiences of discrimination.

Purpose

Being a parent, in addition to its rewarding aspects, also involves significant psychological and physical challenges. When the balance between caregiving burden and support resources is disrupted, it becomes almost inevitable for mothers to experience burnout. We designed our study to investigate the factors related to burnout complaints in mothers of preschool children.

Methods

The sample of our study consisted of 80 mothers who presented to psychiatry clinics with burnout complaints and 80 healthy controls. Data collection tools included the Maslach Burnout Inventory, the Parenting Stress Index, and the Spousal Support Scale. Scale scores were compared between the groups. The mediating role of the Spousal Support Scale (SSS) in the relationship between the Parenting Stress Index (PSI) and the Maslach Burnout Inventory (MBI) was tested using path analysis.

Results

No statistically significant age difference was found between the two groups (p > 0.05). The number of children among participants in the burnout group was higher (p = 0.018).In the burnout group, a positive and statistically significant relationship was found between the total scores of the Maslach Burnout Inventory (MBI) and the Parenting Stress Index (PSI) (r: 0.664; p: 0.000), and a negative and statistically significant relationship with the total score of the Spousal Support Scale (SSS) (r: -0.409; p: 0.000).The indirect effect of the Parenting Stress Index (PSI) on the Maslach Burnout Inventory (MBI) through the Spousal Support Scale (SSS) was found to be statistically significant ( (:beta:) = -0.3294, p < 0.001).

Conclusion

Parental stress is associated with the level of burnout in mothers. However, spousal support may weaken the relationship between parental stress and burnout. Further research on the relationship between spousal support and burnout, as well as awareness projects related to spousal support, is needed.

Purpose

The current study investigated the mental health of Yazidi women exposed to kidnapping and sexual violence among Yazidi women survivors of the Islamic State of Iraq and Syria (ISIS) attacks during captivity in the 2014 genocide period in Iraq.

Methods

This cross-sectional population-based study was conducted at the Internal Displaced People (IDP) camps located in the Duhok Governorate, Kurdistan Regional Government of Iraq (KRG). The data were collected from September 2023 to May 2024. The KRG granted the principal researcher and 2 assistants access to 7 of the 18 IDP camps in Duhok. The number of households for inclusion in each camp was selected proportional to the total number of households in each selected camp by division of each camp’s census into the total census of all camps combined, and all adult women > 18 years of age in these households were deemed eligible for participation in the study. The study sample included 215 Yazidi women aged 18 to 41 years. Face-to-face interviewing was conducted by the first author and trained clinical psychologists, following structured questionnaires: a 6-item demographic questionnaire, The Event Scale (ES), Suicidality (3 questions included suicidality ideation, suicide attempt, and suicidal behavior), Posttraumatic Check List for DSM-5 (PCL-5), and General Health Questionnaire-28 (GHQ-28).

Results

Women’s current mental health following rape during captivity revealed risk for posttraumatic stress disorder (PTSD), general psychopathology, and suicidality in association with kidnapping and sexual violence, with odds ratios between 3.11 and 4.89 for the three main variables (PTSD risk, General psychopathology and suicidality) in multivariate models.

Conclusion

It can be concluded that ISIS captivity and wartime rapes had extensive long-term consequences on the mental health of women survivors. The high prevalence of PTSD emphasizes the need for culturally sensitive diagnostic and therapeutic services to address the intermediate and long-term consequences of wartime rape.

Purpose

Female sex hormones as well as the synthetic hormones contained within combined oral contraceptives (COCs) may influence emotional and cognitive functioning including learning and memory; however, findings are inconsistent. We here present the largest study to date investigating the effect of COC use on verbal memory in healthy women.

Methods

COC use and verbal memory scores were available from the CIMBI database for 205 healthy women in the reproductive age. We assessed if verbal memory and affective bias differed between COC users and non-users. In a subgroup of natural cycling women in the follicular phase, we assessed if verbal memory was associated with plasma estradiol levels.

Results

We found no statistically significant group differences in either overall memory performance (p = 0.16) or affective memory bias (p = 0.18) between COC users and non-users, although there was a trend suggesting COC users may exhibit slightly better recall for short-term (p = 0.09) and long-term task (p = 0.08) conditions. Similarly, COC users tended to have slightly better overall memory compared with women in the follicular phase (p = 0.05). Follicular phase plasma estradiol levels were not associated with verbal memory.

Conclusions

We found no support for COC use to negatively impact verbal memory, if anything COC users tended to perform better than natural cycling women in follicular phase; however, this could be influenced by a healthy user bias. In conclusion, these findings highlight that women who tolerate COCs well should not be concerned about potential adverse effects on memory.   

Purpose

Screening is necessary to identify patients with postpartum depression or anxiety and facilitate access to mental healthcare. This study evaluated a quality improvement initiative for inpatient postpartum depression screening, which was implemented to better identify patients in need of mental healthcare. This initiative replaced the Patient Health Questionnaire (PHQ-9) administered verbally by nurses with the Edinburgh Postnatal Depression Scale (EPDS-10) self-administered by patients via iPads.

Methods

Electronic medical records for patients who delivered June 2020-October 2023 at Cedars-Sinai were analyzed (N = 17,403). Differences in completed screenings, positive depression screenings, suicidal ideation, and social work referrals before and after the initiative were examined with chi-square tests and multiple logistic regression models. Factors associated with positive anxiety screenings on the EPDS-10 were also identified.

Results

Overall, 98.6% of patients completed depression screenings. Among those who completed screenings, positive depression screenings increased from 4.0 to 11.4%, identified suicidal ideation increased from 0.2 to 1.1%, and social work referrals increased from 64.1 to 84.0%, before and after the initiative. Post-initiative, patients had higher odds of positive depression screenings, indicating suicidal ideation, and receiving social work referrals compared to pre-initiative. Among those who completed EPDS-10 screenings, 31% were positive for anxiety.

Conclusions

Compared to the PHQ-9 administered verbally by nurses, the EPDS-10 self-administered by patients via iPads resulted in higher rates of positive depression screenings, identified suicidal ideation, and social work referrals. It is imperative to accurately screen patients for postpartum depression and anxiety to facilitate access to mental healthcare and address morbidity and mortality.

Clinical trial number

Not applicable.

This is a follow up on a 2016 article discussing the rise in punitive perinatal substance use laws. From 2016–2023, there has been a 39% increase in laws equating perinatal substance use with child abuse, and a 73% increase in mandated reporting laws, despite limited evidence that these laws are helpful. We write this update to raise awareness for providers, so they may better counsel patients on this topic and help advocate for treatment focused policies in their state.

Introduction

Polycystic ovarian syndrome (PCOS) is a common endocrine condition in women. Studies have shown that PCOS is associated with poor quality of life, anxiety, sadness, dissatisfaction with one's appearance, and sexual dysfunction.

Objective

This study was conducted to determine whether a strong psycho-pathological personality is related to PCOS and whether this personality is related to the hyperandrogenic state.

Methods

Anthropometric, metabolic, hormonal, clinical, and psychological characteristics were examined in 90 Bahraini women with PCOS. After confirming the diagnosis of PCOS via Rotterdam criteria, including ovarian ultrasound, each patient was evaluated via the following questionnaires: 1) the GAD-7 (General Anxiety Disorder-7) to measure the severity of anxiety; 2) the Patient Health Questionnaire-9 (PHQ-9) to confirm and measure the severity of depression; 3) the Barratt Impulsiveness Scale (BIS‐11) to measure aggression; and 4) the McLean Screening Instrument to identify borderline personality disorders (MSI-BPDs). The study was approved by the Institutional Review Board.

Results

Compared to controls, PCOS patients exhibited significantly higher rates of severe depression (8% vs. 0%, p < 0.001), severe anxiety (7% vs. 0%, p < 0.001), impulsivity (BIS-11: 39.43 ± 9.69 vs. 26.64 ± 2.92, p < 0.001), and borderline personality traits (McLean: 2.41 ± 2.44 vs. 1.2 ± 0.94, p < 0.001). Metabolic comorbidities, including obesity (BMI 28.88 vs. 20.27, p < 0.001) and hypothyroidism (48% vs. 0%, p < 0.001), were prevalent in PCOS. Hyperandrogenism correlated weakly with psychiatric outcomes (all p > 0.05).

Conclusion

Women with PCOS demonstrate markedly elevated psychiatric and medical burdens compared to healthy controls. While hyperandrogenism showed limited direct associations, metabolic dysfunction (e.g., obesity) may mediate psychiatric risk. These findings underscore the need for multidisciplinary care integrating psychological and endocrine management, particularly in populations where cultural norms exacerbate PCOS-related distress.

Purpose

Postpartum depression (PPD), the most common childbirth complication in the United States, can be treated using brexanolone, an intravenous form of allopregnanolone.

Methods

This retrospective chart review study evaluated clinical outcomes of 64 postpartum women who received brexanolone infusion for PPD in a real-world setting.

Results

Treatment was associated with improved depression and anxiety symptoms, and 71% of patients reported significant improvement in their PPD.

Conclusions

While further research is needed, this study supports brexanolone as an efficacious treatment for PPD.