Archives of Women's Mental Health最新文献_第3页

Health care across the first year postpartum and experiences of women with anxiety/depressive symptoms: A longitudinal cohort of first-time mothers in Ireland (MAMMI) 产后第一年的医疗保健和有焦虑/抑郁症状的妇女的经历：爱尔兰首次母亲的纵向队列（MAMMI）。

IF 2.7 3区医学 Q2 PSYCHIATRY

Archives of Women's Mental Health

Pub Date : 2026-02-05 DOI: 10.1007/s00737-025-01670-2

Susan Hannon, Deirdre Gartland, Agnes Higgins, Stephanie J. Brown, Deirdre Daly

Background

Women’s increased contact with healthcare professionals during pregnancy and the early postpartum make it an opportune time to identify any physical or mental health problems that emerge during this period, yet mental health problems are under-identified in clinical settings. This study uses quantitative and qualitative survey data from a large prospective study of first-time mothers in Ireland to investigate contacts with healthcare professionals, enquiry about mental health, and women’s satisfaction with the support they received.

Methods

Quantitative and qualitative data were collected during pregnancy and at 3, 6, 9 and 12 months postpartum. The sample comprised 2572 mothers reporting on postpartum anxiety/depressive symptoms using the Depression, Anxiety and Stress Scale.

Results

Approximately 50–70% of women reported that a healthcare professional asked about their mental health at three months postpartum. Contact with healthcare professionals and enquiries about maternal health decreased significantly over the course of the first 12 months. Women felt that postpartum care was concluded too soon, and that appointments were often hurried and infant-focused. Women reporting anxiety/depressive symptoms had more frequent appointments for their own and their baby’s health than women who did not report symptoms. Women with symptoms were more likely to indicate they felt uncomfortable addressing sensitive topics and worried about the consequences of disclosure. Many women described positive and supportive interactions with professionals; others reported that their disclosures were dismissed, while some feared that disclosures may lead to judgment, labelling or being recommended psychotropic medication as a solution.

Conclusions

The findings support the need for an expansion of the postpartum care currently provided in Ireland. Greater support for health professionals regarding asking and responding to women’s needs across the postpartum period is required to address mothers’ hesitancy to share concerns and to broaden access and pathways of care.

背景：妇女在怀孕期间和产后早期与保健专业人员接触的增加，使其成为确定在此期间出现的任何身体或精神健康问题的时机，但在临床环境中，精神健康问题尚未得到充分确认。本研究使用了爱尔兰一项大型前瞻性研究的定量和定性调查数据，调查了与医疗保健专业人员的接触情况、心理健康问题以及妇女对所得到的支持的满意度。方法在妊娠期间及产后3、6、9、12个月收集定量和定性资料。样本包括2572名使用抑郁、焦虑和压力量表报告产后焦虑/抑郁症状的母亲。结果约50-70%的妇女报告说，保健专业人员在产后三个月询问她们的心理健康状况。在头12个月期间，与保健专业人员的接触和对孕产妇保健的询问显著减少。妇女们觉得产后护理结束得太早，而且预约往往很匆忙，而且以婴儿为中心。报告焦虑/抑郁症状的妇女比没有报告症状的妇女更频繁地为自己和婴儿的健康进行预约。有症状的妇女更有可能表示，她们在谈论敏感话题时感到不舒服，并担心披露的后果。许多女性描述了与专业人士的积极和支持性互动；其他人报告说，他们的披露被驳回，而一些人担心披露可能导致评判、贴上标签或被建议使用精神药物作为解决方案。结论：研究结果支持爱尔兰目前扩大产后护理的必要性。在询问和回应妇女在产后期间的需求方面，需要向保健专业人员提供更多支持，以解决母亲在分享关切和扩大护理机会和途径方面的犹豫。

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引用次数: 0

Female genital self-image and psychological distress: the serial mediating effects of existential shame and limited access to emotion regulation strategies 女性生殖器自我形象与心理困扰：存在羞耻和情绪调节策略有限通路的系列中介作用。

IF 2.7 3区医学 Q2 PSYCHIATRY

Archives of Women's Mental Health

Pub Date : 2026-02-04 DOI: 10.1007/s00737-025-01662-2

Isabella Magdala, Magdalena Sánchez-Fernández, Jose M. Mestre

Purpose

Concern about female genital self-image (FGSI) is increasing due to its implications for women's well-being. Previous research has linked negative FGSI to psychological distress. However, the underlying mechanisms of this association remain unclear, with shame and emotional dysregulation being potential mediators. This study aimed to test a serial mediation model in which FGSI is associated with psychological distress through shame and emotional dysregulation.

Methods

A cross-sectional design was employed, with a total of 445 women (Age: M = 40.22, SD = 10.69, range = 17–70) completing an online survey.

Results

Linear regression analysis revealed a significant association between psychological distress and both existential shame and limited access to emotion regulation strategies. FGSI and the remaining dimensions of shame and emotional dysregulation did not show a direct significant association with psychological distress. Mediation analysis confirmed that the relationship between FGSI and psychological distress was fully mediated by existential shame, limited access to emotion regulation strategies, and the serial mediation of these two variables.

Conclusion

These findings have important practical implications for the development of preventive and intervention strategies aimed at women with low FGSI, focusing on addressing feelings of maladaptive shame and enhancing effective emotion regulation strategies.

由于女性生殖器自我形象（FGSI）对女性福祉的影响，人们对其的关注日益增加。先前的研究已经将负面的FGSI与心理困扰联系起来。然而，这种关联的潜在机制尚不清楚，羞耻和情绪失调是潜在的中介。本研究旨在验证FGSI通过羞耻和情绪失调与心理困扰相关的一系列中介模型。方法采用横断面设计，对445名女性（年龄：M = 40.22, SD = 10.69，范围= 17-70）进行在线调查。结果线性回归分析显示，心理困扰与存在性羞耻感和情绪调节策略获取受限均有显著相关。FGSI和羞耻感和情绪失调的其他维度没有显示出与心理困扰的直接显著关联。中介分析证实，存在性羞耻感、情绪调节策略的有限获取以及这两个变量的串联中介完全介导了FGSI与心理困扰的关系。结论这些研究结果对于制定针对低FGSI女性的预防和干预策略具有重要的现实意义，重点是解决适应不良羞耻感和增强有效的情绪调节策略。

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引用次数: 0

Sexual dysfunction in women with migraines: a systematic review 女性偏头痛患者的性功能障碍：一项系统综述。

IF 2.7 3区医学 Q2 PSYCHIATRY

Archives of Women's Mental Health

Pub Date : 2026-02-03 DOI: 10.1007/s00737-025-01650-6

Karina Stech, Anupama Jayachandran, Huaqing Zhao, Behnum Habibi

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.

目的：本系统综述的目的是确定偏头痛女性性功能障碍的患病率。其次，本综述探讨了影响女性性功能障碍和偏头痛之间关系的因素。方法：对PubMed自成立至2024年6月17日的数据库进行全面检索。搜索术语包括偏头痛相关术语和性功能障碍结果相关术语。两名独立审稿人评估文章的相关性，并从选定的文章中提取信息。结果：在本综述中，对MEDLINE和CINAHL数据库进行了彻底的搜索，得到了16项研究，1715名参与者。结果显示，女性偏头痛患者的性功能障碍患病率在22.6%至90%之间。合并患病率为69% (95% CI 61-77%)，研究间存在显著异质性（I2 = 78.73%）。偏头痛女性的性功能障碍患病率高于健康对照组。偏头痛的特征，如持续时间、频率和疼痛都与性功能障碍有关。焦虑、抑郁等心理因素与偏头痛患者性功能障碍之间存在双向相关性。结论：偏头痛对健康相关的生活质量有深远的影响。性功能障碍通常与女性偏头痛患者有关，这表明临床医生应该对这一人群的性功能障碍进行常规筛查。焦虑和抑郁可能在女性偏头痛性功能障碍中起重要作用。

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引用次数: 0

Postpartum depression literacy among economically disadvantaged Indian working women: roles of health literacy and social determinants 经济上处于不利地位的印度职业妇女的产后抑郁症知识：健康知识和社会决定因素的作用。

IF 2.7 3区医学 Q2 PSYCHIATRY

Archives of Women's Mental Health

Pub Date : 2026-02-03 DOI: 10.1007/s00737-026-01674-6

Bidisha Banerjee, Archana Srivastava, Anandita Mitro

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.

目的：产后抑郁症（PPD）是一种严重的心理健康问题，在印度的患病率很高。对于经济背景不利的职业妇女来说，了解产后抑郁症的症状并获得支持对于早期发现和治疗至关重要。然而，由于与精神障碍相关的社会耻辱，一般健康素养可能不会自动转化为产后抑郁症素养（PPDL）。本研究调查了印度城市经济弱势职业妇女PPDL的关键决定因素。方法：于2024年3月至8月在海德拉巴和勒克瑙进行横断面研究。采用基于社会经济指标的两阶段抽样方法，招募了998名从事体力劳动的妇女。使用podi和HLS-EU-Q16仪器收集数据。使用描述性统计和两阶段最小二乘（2SLS）回归模型来检验健康素养与PPDL之间的关联并解释可能的内生性。结果：PPDL平均评分为95.11 （SD = 13.58）。较高的每月家庭支出与PPDL呈正相关，而一般健康素养则呈显著的负相关。宗教、种姓、核心家庭结构、流产史和较低的个人收入也与PPDL显著相关。该模型解释了17%的方差。结论：研究结果表明，有必要开展以产后抑郁症为重点的心理健康教育。为了支持来自经济边缘化背景的妇女，必须制定政策和规划，以克服社会耻辱感和她们在获得精神护理时面临的日常障碍。

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引用次数: 0

Depression and anxiety symptoms among Nepali women: a dose–response analysis of emotional abuse and coercive control 尼泊尔妇女的抑郁和焦虑症状：情绪虐待和强制控制的剂量反应分析。

IF 2.7 3区医学 Q2 PSYCHIATRY

Archives of Women's Mental Health

Pub Date : 2026-02-02 DOI: 10.1007/s00737-025-01666-y

Suman Kanougiya

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.

目的：本研究调查了尼泊尔妇女中不同形式和强度的亲密伴侣暴力（IPV）——特别是情感虐待和强制控制——与抑郁和焦虑症状的关系。方法：我们分析了2022年尼泊尔人口与健康调查，重点是4377名15-49岁的有过伴侣的女性。IPV被分为四个领域：身体、性、情感和强制控制。使用尼泊尔版本的PHQ-9和GAD-7来评估抑郁和焦虑。应用多变量逻辑回归和边际效应模型来估计相关性并探索剂量-反应模式。结果：情绪IPV （aOR = 3.8）和强迫控制（aOR = 1.8）与中重度抑郁症状独立相关。在焦虑方面也观察到类似的关联（情绪IPV aOR = 2.9，强迫控制aOR = 1.6）。男性伴侣单独饮酒会增加IPV和常见精神障碍（cmd）的风险。不使用IPV或酒精时CMD症状的预测概率为5.45%，仅使用酒精时为7.82%，仅使用IPV时为11.64%，同时使用IPV时为17.95%。边际效应分析显示了明确的剂量-反应模式：情绪、身体或性IPV的每一次额外行为都显著增加了CMD的风险。结论：心理上的ipvv——包括情绪虐待和强制控制——对妇女的心理健康有强烈的累积影响，但在临床协议和公共卫生政策中仍未得到充分认识。男性伴侣饮酒会进一步增加这种风险。尼泊尔初级卫生保健系统迫切需要以疾病和创伤知情框架为基础的综合心理健康-酒精干预措施。

{"title":"Depression and anxiety symptoms among Nepali women: a dose–response analysis of emotional abuse and coercive control","authors":"Suman Kanougiya","doi":"10.1007/s00737-025-01666-y","DOIUrl":"10.1007/s00737-025-01666-y","url":null,"abstract":"<div><h3>Purpose</h3><p>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.</p><h3>Methods</h3><p>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.</p><h3>Results</h3><p>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.</p><h3>Conclusion</h3><p>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.</p></div>","PeriodicalId":8369,"journal":{"name":"Archives of Women's Mental Health","volume":"29 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146099740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A systematic safety assessment of zuranolone: real-world adverse event analysis from the FAERS database 舒诺酮的系统安全性评估：来自FAERS数据库的真实世界不良事件分析

IF 2.7 3区医学 Q2 PSYCHIATRY

Archives of Women's Mental Health

Pub Date : 2026-01-31 DOI: 10.1007/s00737-026-01679-1

Kun Yao, Hua Liu

Objective

This 2023study aims to evaluate the adverse reaction profile of Zuranolone through large-scale analysis of real-world data and to explore its underlying mechanisms, thereby providing complementary evidence for the safe clinical use of Zuranolone.

Methods

Reports associated with Zuranolone were extracted from the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) database, covering the period from the third quarter (Q3) of 2023 to the first quarter (Q1) of 2025. Signal detection was performed using four distinct methods: the reporting odds ratio (ROR), the proportional reporting ratio (PRR), the Bayesian Confidence Propagation Neural Network (BCPNN), and the Empirical Bayesian Geometric Mean (EBGM).

Results

A total of 464 reports of adverse events (AEs) related to Zuranolone were included in this study. Signal detection analysis revealed that Zuranolone was most significantly associated with AEs in the System Organ Classes (SOCs) of nervous system disorders and psychiatric disorders. Among the frequently reported AEs, those related to central nervous system (CNS) depression were particularly prominent, including somnolence (135 cases), dizziness (101 cases), sedation (35 cases), and tremor (32 cases). The study also identified common psychiatric AEs, including known events such as anxiety, suicidal ideation, depression, insomnia, depressed mood, and perinatal depression, as well as new potential AEs including panic attack, anger, bradyphrenia, intrusive thoughts, tachyphrenia, and decreased interest.

Conclusion

Enhanced monitoring for AEs related to nervous system disorders and psychiatric disorders is required during the clinical use of Zuranolone.

目的本研究旨在通过对真实数据的大规模分析，评价Zuranolone的不良反应概况，并探讨其潜在机制，为Zuranolone的临床安全使用提供补充证据。方法从美国食品和药物管理局不良事件报告系统（FAERS）数据库中提取与祖拉诺酮相关的报告，涵盖2023年第三季度（Q3）至2025年第一季度（Q1）。使用四种不同的方法进行信号检测：报告优势比（ROR）、比例报告比（PRR）、贝叶斯置信传播神经网络（BCPNN）和经验贝叶斯几何平均（EBGM）。结果本研究共纳入464例与舒诺酮相关的不良事件报告。信号检测分析显示，在神经系统疾病和精神疾病的系统器官分类（soc）中，祖拉诺酮与ae的相关性最为显著。在频繁报道的ae中，与中枢神经系统（CNS）抑制相关的ae尤为突出，包括嗜睡（135例）、头晕（101例）、镇静（35例）和震颤（32例）。该研究还确定了常见的精神不良事件，包括已知的事件，如焦虑、自杀意念、抑郁、失眠、抑郁情绪和围产期抑郁症，以及新的潜在不良事件，包括恐慌发作、愤怒、精神分裂症减退、侵入性思维、精神分裂症急促和兴趣减退。结论在临床使用祖拉诺酮时，应加强对神经系统疾病和精神疾病相关不良事件的监测。

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引用次数: 0

Dealing with the impact of pregnancy on the pharmacokinetics of aripiprazole once-monthly 探讨妊娠对阿立哌唑药代动力学的影响

IF 2.7 3区医学 Q2 PSYCHIATRY

Archives of Women's Mental Health

Pub Date : 2026-01-30 DOI: 10.1007/s00737-026-01678-2

Georgios Schoretsanitis, Caitriona Obermann, Michael Paulzen

引用次数: 0

A systematic review of resting-state EEG across the menstrual cycle and its mental health relevance 静息状态脑电图在月经周期中的系统回顾及其与心理健康的相关性

IF 2.7 3区医学 Q2 PSYCHIATRY

Archives of Women's Mental Health

Pub Date : 2026-01-30 DOI: 10.1007/s00737-025-01654-2

Mónica Dafne García-Granados, Manuel Alejandro Cruz-Aguilar, Leonor Estela Hernández-López, Ricardo Mondragón-Ceballos, Lucía Martínez-Mota, Ana Paula Rivera-García, Ignacio Ramírez-Salado

Purpose

This systematic review aims to synthesize current evidence on resting-state EEG activity across the menstrual cycle. Specifically, it explores whether cyclical hormonal fluctuations of estradiol and progesterone are associated with electrophysiological changes and evaluates the potential of resting-state EEG as a possible biomarker for neurophysiological changes related to mood, cognition, and emotional well-being across the healthy menstrual cycle.

Methods

A systematic search of PubMed, Web of Science, Scopus, SpringerLink, and PsycINFO was conducted to January 2025, identifying 23 relevant studies. PRISMA guidelines were followed to extract relevant articles, and we assessed the quality of the evidence using the GRADE approach.

Results

A total of 23 studies met the inclusion criteria. The most convergent findings show that the alpha EEG activity in frontal, parietal, and temporal brain areas tends to decrease, and the theta activity tends to increase during the late follicular phase (characterized by high estradiol and low progesterone) compared to the luteal phase (when estradiol level is lower and progesterone is higher). This resting-state electrophysiological activity could reflect greater attentional efficiency, emotional well-being, and a reduction in self-referential processing in the days surrounding ovulation. Findings for delta, beta, and gamma bands remain inconclusive.

Conclusions

This review suggests that resting-state EEG may serve as a potential biomarker of hormone-related changes in brain activity, offering preliminary insights for further research and early detection of hormone-sensitive mood disorders.

目的本系统综述旨在综合目前关于月经周期静息状态脑电图活动的证据。具体来说，它探讨了雌二醇和黄体酮的周期性激素波动是否与电生理变化有关，并评估了静息状态脑电图作为健康月经周期中与情绪、认知和情绪健康相关的神经生理变化的可能生物标志物的潜力。方法系统检索PubMed、Web of Science、Scopus、SpringerLink、PsycINFO等数据库，截至2025年1月，共检索到23篇相关研究。遵循PRISMA指南提取相关文章，并使用GRADE方法评估证据质量。结果23项研究符合纳入标准。结果显示，与黄体期（雌二醇水平较低，黄体酮水平较高）相比，卵泡期晚期（雌二醇水平较高，黄体酮水平较高），额叶、顶叶和颞叶区α脑电图活动有降低的趋势，θ脑电图活动有增加的趋势。这种静息状态的电生理活动可以反映出更高的注意力效率、情绪健康以及排卵前后自我参照处理的减少。delta， beta和gamma波段的发现仍然没有定论。结论静息状态脑电图可作为激素相关脑活动变化的潜在生物标志物，为激素敏感性情绪障碍的进一步研究和早期发现提供初步见解。

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引用次数: 0

A randomized controlled trial of an electronic patient decision aid (PDA) for decision-making around antidepressant use in pregnancy 电子患者决策辅助（PDA）在孕期抗抑郁药使用决策中的随机对照试验

IF 2.7 3区医学 Q2 PSYCHIATRY

Archives of Women's Mental Health

Pub Date : 2026-01-29 DOI: 10.1007/s00737-025-01671-1

Simone N. Vigod, Cindy-Lee Dennis, Sophie Grigoriadis, Kelly Metcalfe, Tim F. Oberlander, Maria Michalowska, Aysha Butt, Antara Chatterjee, Claire DeOliveira, Wanrudee Isaranuwatchai, Yutong Lu, Janet Parsons, Donna E. Stewart, Kevin E. Thorpe

Purpose

Decisions about whether to use antidepressant medication in pregnancy can be complex for patients. When decisional conflict is high, this can negatively impact on decision-making and resultant clinical outcomes. We evaluated an electronic patient decision aid (PDA) around antidepressant use in pregnancy for its ability to improve patients’ decision-making experience and the clinical outcomes associated with their decisions.

Methods

This parallel-group trial (2018–2025) randomized preconception and pregnant Canadian participants with depression in a 1:1 ratio to an electronic PDA plus standard resources or standard resource control. Groups were compared on decisional conflict (measured using the Decisional Conflict Scale, DCS) at 4 weeks post-randomization. Those who were pregnant/became pregnant were evaluated for postpartum depression (PPD) at 3 months postpartum using the Structured Clinical Interview for DSM-5.

Results

Of n = 462 participants, n = 231 (mean age 32.4 +/- 4.0 years. 48.3% pregnant at baseline) were randomized to the PDA and n = 231 (mean age 32.5 +/- 4.2 years. 48.1% pregnant at baseline) to control. Between baseline and 4-weeks post-randomization, mean (SD) DCS score decreased from 48.3 (13.1) to 33.9 (14.9) in the PDA condition and 47.9 (14.5) to 40.1 (17.0) in controls, an adjusted mean difference of -6.34 (95%CI -8.92 to -3.79). PPD at 3 months postpartum was present in 7 (6.0%) PDA and 15 (12.9%) control participants, an absolute risk difference of -6.9% (95% CI -14.4% to 0.5%).

Conclusions

Compared to standard resources alone, our PDA plus standard resources significantly reduced decisional conflict about the decision of whether or not to use antidepressant medication in pregnancy. PPD rates at 3 months postpartum were non-significantly lower in the PDA group as well. These results support dissemination of the PDA, and the evaluation of its utility with a wider audience.

目的决定是否在怀孕期间使用抗抑郁药物对患者来说可能很复杂。当决策冲突高时，这可能对决策和最终的临床结果产生负面影响。我们评估了电子患者决策辅助（PDA）在妊娠期抗抑郁药使用方面的能力，以改善患者的决策经验和与其决策相关的临床结果。方法本平行组试验（2018-2025）将加拿大孕前和孕妇抑郁症患者按1:1的比例随机分配到电子PDA加标准资源或标准资源对照中。各组在随机化后4周比较决策冲突（使用决策冲突量表，DCS测量）。使用DSM-5的结构化临床访谈，在产后3个月对怀孕/即将怀孕的妇女进行产后抑郁（PPD）评估。结果462例受试者中，231例（平均年龄32.4±4.0岁）。基线时怀孕的48.3%)随机分配到PDA， n = 231（平均年龄32.5±4.2岁）。48.1%在基线时怀孕)到对照组。在基线和随机化后4周之间，PDA组的平均（SD） DCS评分从48.3（13.1）下降到33.9(14.9)，对照组的平均（SD） DCS评分从47.9（14.5）下降到40.1(17.0)，调整后的平均差异为-6.34 （95%CI -8.92 -3.79）。7名（6.0%）PDA参与者和15名（12.9%）对照参与者在产后3个月出现PPD，绝对风险差异为-6.9% （95% CI -14.4%至0.5%）。结论与单独使用标准资源相比，PDA联合标准资源显著降低了妊娠期是否使用抗抑郁药物的决策冲突。PDA组产后3个月的PPD发生率也没有显著降低。这些结果支持传播PDA，并向更广泛的受众评价其效用。

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引用次数: 0

The price of care: alcohol misuse as a moderator of financial hardship and mental health outcomes of U.S. women caregivers 护理的价格：酒精滥用对美国女性护理人员的经济困难和心理健康结果的调节作用。

IF 2.7 3区医学 Q2 PSYCHIATRY

Archives of Women's Mental Health

Pub Date : 2026-01-28 DOI: 10.1007/s00737-025-01672-0

Heather DeGrande, Luis Enrique Espinoza

Purpose

Financial hardship and alcohol misuse are well-established predictors of caregiver mental health. The purpose of this study was to examine if alcohol misuse influenced the associations between financial hardship and mental health outcomes (depression diagnosis and poor mental health days).

Methods

A retrospective data analysis was conducted from 4,212 U.S. women caregivers utilizing 2023 Behavioral Risk Factor Surveillance System dataset.

Results

Alcohol misuse when measured dichotomously was not independently associated with depression diagnosis or poor mental health days. However, more frequent alcohol misuse substantially strengthened the food insecurity–psychological distress relationship among women caregivers. Financial hardship—particularly food insecurity—was strongly associated with depression and more days in the past month with worse mental health, especially among women with lower income, lower educational attainment, and heavier caregiving responsibilities.

Conclusions

This study contributes to international research by demonstrating the value of using frequency-based rather than binary substance use measures, thereby enhancing data comparability across health systems. Findings align with evidence from countries that economic vulnerability and maladaptive coping, such as alcohol misuse, can have negative impacts on caregiver well-being. Trauma-informed, harm-reduction, and culturally sensitive public health strategies could reduce both financial and behavioral risks for substance misuse and mental health symptoms among women caregivers globally.

经济困难和酒精滥用是公认的看护者心理健康的预测因素。本研究的目的是检查酒精滥用是否影响经济困难和心理健康结果（抑郁症诊断和不良心理健康天数）之间的关联。方法利用2023年行为风险因素监测系统数据集对4212名美国女性护理人员进行回顾性数据分析。结果酒精滥用与抑郁症诊断或心理健康状况不佳没有独立的关系。然而，更频繁的酒精滥用大大加强了女性照顾者之间的食物不安全-心理困扰关系。经济困难——尤其是食物不安全——与抑郁密切相关，而且在过去一个月里，心理健康状况较差的天数更多，尤其是在收入较低、受教育程度较低、照顾责任较重的女性中。本研究通过证明使用基于频率而非二元物质使用措施的价值，从而增强了卫生系统间数据的可比性，从而促进了国际研究。调查结果与各国的证据一致，即经济脆弱性和应对不当，如酒精滥用，可能对照顾者的福祉产生负面影响。了解创伤、减少伤害和文化敏感的公共卫生战略可以在全球范围内减少女性护理人员滥用药物和精神健康症状的财务和行为风险。

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