Archives of Women's Mental Health最新文献

Background and purpose: Premenstrual dysphoric disorder (PMDD) is a debilitating illness that affects 3-8% of women worldwide. There are multiple factors underlying the aetiology of PMDD, ranging from neuroendocrine changes to psychosocial factors such as exposure to trauma. This systematic review aims to assess the prevalence of traumatic exposure in women with PMDD.

Methods: A literature search of MEDLINE, EMBASE and PsycInfo was conducted following PRISMA guidelines. Of the 369 studies identified for abstract and full-text screening, 27 were included for review and 16 studies for the quantitative calculation of average prevalence and 95% confidence intervals. Data extracted included study details, sampling details, demographic details, type of traumatic exposure reported, diagnostic tools used, the prevalence of PMDD (total) and the prevalence of self-reported traumatic exposure in PMDD patients.

Results: The reported prevalence of traumatic exposure in PMDD ranged from 18.03 to 90.5%. Using a random effects model, the pooled prevalence was 61% (95%CI, 46-74%). The level of heterogeneity (I²) was 95%, showing considerable variability in the data. Amongst only those studies with a control group, it was shown that those with PMDD are 1.99 times more likely to have a history of traumatic exposure than those without PMDD.

Conclusion: Our findings suggest that a history of traumatic exposure is highly represented in women living with PMDD. Trauma exposure may be a risk factor for PMDD and could inform this condition's aetiology. A trauma-informed approach should be considered when assessing and managing women presenting with PMDD.

Purpose: The premenstrual phase of the menstrual cycle, childbirth and perimenopause often coincide with a worsening of mood symptoms in women with bipolar disorder (BD). To date, findings from the limited number of studies investigating associations between these events among women with BD have been inconsistent. This study aimed to investigate associations between episodes in relation to the perimenopause and (i) premenstrual symptoms and (ii) postpartum mood episodes in a large sample of postmenopausal women with BD.

Methods: Among 567 postmenopausal women with BD, recruited as part of the UK Bipolar Disorder Research Network, relationships between reproductive event-associated mood symptoms/episodes were examined. Multivariate binary analyses were carried out to identify if history of premenstrual symptoms and/or postpartum episodes predicted the occurrence of mood episodes in relation to the perimenopause, controlling for potential confounders including number of mood episodes per illness year.

Results: History of premenstrual symptoms was associated with experiencing any type of mood episode, and depression specifically, during the perimenopause (OR 6.189, p < 0.001 and OR 2.709, p = 0.019 respectively). History of postpartum depression within 6 weeks of delivery was associated with depressive episodes during the perimenopause (OR 2.635, p = 0.027). Postpartum mania was not a significant predictor.

Conclusions: Our findings suggest that women with BD with a history of premenstrual symptoms and postpartum depression are potentially at increased risk of experiencing episodes of depression in relation to the perimenopause. There are clinical and self-management implications in identifying a subgroup of women with BD who may be particularly vulnerable to episodes of mood disturbance during reproductive events.

Purpose: Given research inconsistency, this study aimed to assess whether attention control changes from pregnancy to postpartum, focusing on the moderating role of maternal objective and subjective sleep. Our second objective was to evaluate attention control's role in predicting psychological outcomes in peripartum women.

Method: A cohort of 224 pregnant women completed the Antisaccade task, a measure of attention control, during the third trimester and again four months post-delivery. Objective and subjective sleep were measured using actigraphy and sleep diaries. Participants also completed questionnaires assessing depression, anxiety, emotion regulation, and maternal perceptions of the mother-infant relationship.

Results: Attention control improved significantly from late pregnancy to postpartum (β = 0.91, p < .001). While objective sleep was not linked to attention control, poorer between-person subjective sleep was associated with better postpartum attention control (β = - 0.84, p < .001). Better within-person subjective sleep was associated with higher attention control during pregnancy (β = 0.87, p < .001), but a negative interaction with time (β = -1.5, p = .001) suggests a reverse trend postpartum. Attention control did not predict postpartum psychological outcomes.

Conclusion: Cognitive recovery may occur by four months postpartum, although the observed improvement could reflect practice effect. The novel finding of a negative association between subjective sleep and postpartum attention control may indicate better adaptation to perceived poor sleep or heightened attunement to sleep fluctuations in women with higher attention control. Attention control did not predict psychological outcomes, suggesting other factors may be more critical for maternal coping postpartum.

Objective: Alcohol withdrawal syndrome (AWS) during pregnancy is under-researched despite growing concerns about increased alcohol use among pregnant women. This study aims to explore the severity of AWS and its impact on maternal and fetal outcomes.

Methods: This retrospective study reviewed the medical records of patients admitted to the Mayo Clinic who underwent the CIWA-Ar protocol for AWS from June 2019 through June 2022. Pregnant women identified in this cohort had their pregnancy, labor, and neonatal data analyzed for alcohol-related complications and outcomes.

Results: Out of the medical records reviewed, 8 cases involved pregnant women experiencing AWS. These cases showed a high severity of withdrawal symptoms, with a median peak CIWA-Ar score of 17 (IQR = 14). Maternal complications included a high rate of ICU admissions (37.5%; n = 3) and significant rates of miscarriage and stillbirth (37.5%; n = 3). Fetal outcomes were concerning, with 1 out of 5 (20%) neonates requiring NICU admission and experiencing conditions such as respiratory failure and neonatal abstinence syndrome. Developmental problems were noted in 2 out of 5 (40%) newborns.

Conclusions: The findings highlight the severe implications of AWS during pregnancy, impacting both maternal and fetal health. The severity of AWS requires attentive clinical management and preventative interventions. Future research should focus on larger, prospective studies to better understand and address the risks associated with AWS in pregnant women and to improve health outcomes for mothers and their children.

Article highlights: • Severe AWS during pregnancy leads to high ICU admissions and adverse neonatal outcomes. • 37.5% of pregnant women with AWS experienced miscarriage or stillbirth. • 20% of newborns from mothers with AWS required NICU admission for serious conditions; 40% of newborns had developmental problems. • Findings underscore the need for specialized treatment protocols to improve outcomes for pregnant women and their newborns.

Purpose: Young mothers, defined as those age 25 and under, are at an increased risk of experiencing mental health problems. Despite this increased risk, very few mental health and parenting interventions that target the unique needs of this group are available. This scoping review summarized extant research on mental health and parenting eHealth interventions aimed at young mothers.

Methods: CINAHL, MEDLINE, PsycINFO, PsycARTICLES, and PubMed databases were used for searches, and articles were screened using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and Arksey and O'Malley's five-stage method for scoping reviews. The eligibility criteria included being peer-reviewed, written in English, published between January 1, 2000, and May 9, 2024, and being an eHealth program targeting mental health and/or parenting skills for women-identifying mothers under the age of 26.

Results: After duplicate removal, 3,431 titles and abstracts were screened, and 112 articles moved to full-text review. Four studies were included, each assessing intervention components, targeting mental health and parenting, and outlining participant feedback on the treatment. Each study evaluated a different type of intervention, with depression being the most studied mental health outcome and coping skills being the most studied parenting outcome.

Conclusion: Preliminary findings suggest that eHealth features such as flexibility, text messaging, and peer support are appreciated among young mothers. Further research on mental health and parenting eHealth interventions aimed at addressing the needs of young mothers is needed.

Purpose: The perinatal period, spanning from pregnancy through the first year after childbirth, is characterized by significant physiological, psychological, and socio-contextual changes. Women face complex stressors including psychosocial pressures, financial constraints, interpersonal dynamics, anticipatory stress related to parenthood, hormonal fluctuations, and societal expectations. These factors collectively influence the perinatal experience, increasing vulnerabilities and stress levels.

Methods: A systematic review was conducted in October 2023 using PubMed, SPORTDiscus, PsycInfo, and Scopus databases. Only English-language publications were included. For the meta-analysis, only randomized controlled trials (RCTs) using the Edinburgh Postnatal Depression Scale (EPDS) were considered. Data extraction was performed independently by two reviewers using Covidence, focusing on study characteristics, population demographics, interventions, and outcomes.

Results: The initial search identified 2,373 articles, with 1,196 duplicates removed, leaving 1,177 articles. After screening titles and abstracts, 1,247 were excluded for not meeting the inclusion criteria, resulting in 30 full-text articles reviewed for eligibility by two researchers. Nineteen studies were included in the systematic review, with four in the meta-analysis. Results indicated that higher levels of physical activity during pregnancy were consistently associated with improved postpartum mental health outcomes, including reduced depressive symptoms, lower anxiety, and enhanced overall well-being. Low-intensity exercises, such as yoga, were particularly effective in reducing postpartum depressive symptoms. The impact of moderate-intensity exercise varied, with some studies showing no significant effects. The meta-analysis of four RCTs using the EPDS demonstrated a significant reduction in depression and anxiety symptoms among postpartum women who participated in physical activity interventions, with a substantial overall effect size.

Conclusion: Developing physical activity and exercise regimens encompassing a range of intensities can address the unique physiological and psychological demands of the perinatal period, maximizing the therapeutic benefits of physical activity interventions.

Purpose: To evaluate the prevalence and predictors of cannabis use and reasons for use during and/or after pregnancy among Colorado birthing individuals. To determine the independent association of self-reported depression during pregnancy and cannabis used.

Methods: Data from Health eMoms, a statewide perinatal longitudinal electronic surveillance system were analyzed. Perinatal cannabis use was defined as any use during and/or after pregnancy. Bivariate associations of birthing individual and infant characteristics with use were estimated using chi-square tests. Multivariable logistic regression was used to assess the independent relationship between depression and reported cannabis use versus no reported cannabis use.

Results: A weighted sample of 117,812 birthing individuals was analyzed from survey responses between 2018-2021. Among the 15,585 (13.3%) who reported perinatal cannabis use, 35.5% reported use during pregnancy and 87.3% reported post-partum use. Individuals with depression during pregnancy had 2.2 times higher adjusted odds (95% CI: 1.5. 3.3) of any perinatal cannabis use compared to those without depression. Among those who had any perinatal cannabis use, reported use for medical reasons was 92% during pregnancy, while 43% cited this as the reason for use 12-14 months post-partum.

Conclusion: Self-reported cannabis use during the perinatal period in a state with legalized recreational use was over 1 in 10. Use varied significantly by demographics and social factors with inconsistent perinatal guidance provided by healthcare professionals. Depression during pregnancy was significantly associated with use, illustrating the need for comprehensive mental health screening and therapeutic evidence-based interventions to support these individuals.

Purpose: To summarize the pooled prevalence rates of anxiety and depression in women with polycystic ovary syndrome.

Methods: An overview of systematic reviews with meta-analysis was conducted. The CINAHL, Embase, PsycINFO, and PubMed databases were searched up to April 22, 2024. The methodological quality of systematic reviews was assessed using AMSTAR 2. The degree of overlap between reviews was analyzed by calculating the corrected covered area.

Results: Ten systematic reviews were selected. Regarding anxiety disorders, the pooled prevalence of panic disorder, social phobia, and anxiety disorders without specifying the type of disorder were 4%, 5%, and 16.9%, respectively. This prevalence was higher in depressive disorders, reaching 34.8%. Anxiety symptoms were very prevalent in women with PCOS, although the prevalence varied depending on the self-reported questionnaire used: the Hamilton Anxiety Scale 69.4%, the Hospital Anxiety and Depression Scale 41.5%, and the Self-rating Anxiety Scale 32.4%. Additionally, the highest prevalence of depression symptoms was associated with the Beck Depression Inventory 46.0%, followed by the Self-rating Depression Scale 39.2%, and the Hospital Anxiety and Depression Scale, which ranged from 31% to 33.8%.

Conclusions: Meta-analyses found mainly anxiety and depression symptoms and disorders are prevalent in women with PCOS. Meta-analyses also showed women with PCOS had a higher risk of having anxiety disorders, and depression symptoms than women without PCOS.

Highlights: • Anxiety symptoms were prevalent, although the prevalence varied depending on the self-reported questionnaire. • The highest prevalence of depression symptoms was associated with the Beck Depression Inventory (46.0%). • The pooled prevalence of anxiety disorders without specifying the type of disorder was 16.9%.

Purpose: The peripartum is a time of increased risk for the development or worsening of obsessive-compulsive (OC) symptoms. Existing evidence suggests that OC symptoms commonly surge immediately postpartum followed by a gradual recovery. Yet how societal conditions, such as a widespread public health crisis, may affect this pattern remains unknown. Increased OC symptom prevalence in the general population during the COVID-19 pandemic coupled with the pre-existing vulnerability of peripartum women suggests they may have been at particularly high risk for sustained symptoms. Thus, the aim of the current study was to examine trajectories in OC symptoms, particularly contamination concerns, in women who gave birth during the COVID-19 pandemic, and to look at risk and resiliency factors that may influence symptom course METHODS: A sample of 164 US pregnant women were recruited during the COVID-19 pandemic. They reported OC symptoms at 3 timepoints: April/May, 2020, July, 2020, and February, 2022. We used a growth mixture modeling approach to examine OC symptom trajectories from pregnancy through the postpartum across these timepoints, comparing the goodness of fit of models with 1-5 trajectory classes for overall OC symptoms and for contamination-related OC symptoms.

Results: For total OC symptoms, two classes of trajectories were identified: recovering (29.27%) versus stable low (70.73%) symptoms; for contamination symptoms alone, a subset of total symptoms, three trajectories were identified: recovering (8.54%), stable low symptoms (68.29%), and stable high symptoms (23.17%). Peripartum stress, but not sociodemographic or obstetric factors, predicted class membership.

Conclusions: These findings suggest that peripartum OC symptoms, particularly related to contamination, may persist beyond the postpartum period in some women, particularly for women exposed to elevated stress in pregnancy and the postpartum.

Purpose: A previous diagnosis of depression is a strong predictor for perinatal depression, apart from other mental disorders, stress, and atopies. It is less clear which factors interfere if perinatal depression occurs as a first depression episode (fePND).

Methods: We examined the associations with atopies and related blood parameters using data of CoLaus|PsyCoLaus.

Results: Newly occurring depression during the perinatal period but not recurrent depression was associated with a lifetime diagnosis of allergies and asthma together with persistently increased levels of basophils and eosinophils.

Conclusion: The results imply that immune function may play a relevant role in the risk of a fePND. If confirmed and detailed, these findings could serve as the basis for designing preliminary prevention strategies by observing eosinophil and basophil levels as well as symptoms of atopic diseases before/during pregnancy.