Oral contraceptives (OCs) are commonly used for the treatment of polycystic ovarian syndrome (PCOS). However, the therapeutic effects of OCs on cognitive function have not been explored extensively. This study aimed to determine the changes in cognitive function in PCOS patients treated with three cycles of combined oral contraceptives (COCs) containing estrogen and progesterone.
Drug-naive PCOS patients (N = 35), aged 18–35 years, were evaluated at baseline and three months after treatment with COC containing levonorgestrel (0.15 mg) plus ethinyl estradiol (30 µg). Working memory (WM), attention, and executive function domains of cognition were assessed using the auditory and visual digit span test (DST), continuous performance test-identical pair (CPT-IP), and trail-making test (TMT), respectively.
The DST results showed improvements in the maximal digit span (ML) of the auditory (p = 0.0039) and visual (p = 0.0005) WM tasks after treatment. Improvements were also observed in the mean span (MS) of the auditory (Cohen’s d = 0.94, p = 0.0009) and visual (Cohen’s d = 0.90, p < 0.0001) DST after treatment. In CPT-IP test, the mean reaction time (RT) of hit rate (Cohen’s d = 0.64, p = 0.01) and random errors (Cohen’s d = 0.64, p = 0.01) showed a significant decrease after treatment. After treatment, TMT showed a significant decrease in all parameters, except trail 1 errors (p = 0.1079).
This preliminary study suggests that three months of COCs treatment in PCOS patients improves cognitive performance in the domains of WM, attention, and executive function. However, the lack of a control group and short follow-up period limits the strength of our findings.
Infant temperament is influenced by environmental factors, such as maternal depression and anxiety. However, the association between maternal sleep and infant temperament is unclear. We examined the associations between maternal postpartum sleep and maternal perception of infant temperament and the moderating effect of maternal depression and anxiety over 6 months following delivery.
Postpartum women with a history of depression (N = 166) completed the Pittsburgh Sleep Quality Index, Edinburgh Postnatal Depression scale, Generalized Anxiety Disorder Scale-7, and Infant Behavior Questionnaire-Very Short Form once per month for 6 months post-delivery. Associations between maternal sleep and infant temperament and interactions with maternal anxiety and depression were tested via 2-level multilevel models.
At the month-level, shorter sleep duration and greater sleep disturbance were significantly associated with higher infant negative affectivity, and shorter sleep duration, greater sleep disturbance, and lower sleep efficiency were associated with significantly lower infant orienting/regulation (p’s < 0.05). At the person-level, lower sleep efficiency and greater sleep disturbance were significantly associated with higher infant negative affectivity (p’s < 0.05). Both person-level effects were significantly moderated by depression symptoms, whereas only the effect of sleep efficiency was moderated by anxiety symptoms (p’s < 0.05).
Maternal perception of infant orienting/regulation may be sensitive to acute sleep disruption, whereas maternal perception of infant negative affectivity is linked both acute and trait-like maternal sleep disruption. Lower depression symptoms may buffer trait-like effects of maternal sleep disruption on perception of infant negative affectivity, whereas higher anxiety symptoms may be sensitizing. These findings highlight the importance of maternal sleep health for infant outcomes.
While interventions to mitigate and prevent perinatal maternal distress exist, none are personalized based on participants’ daily experiences and intervention response. This study compared maternal distress outcomes (depressive symptoms, anxiety symptoms, perceived stress) between perinatal individuals receiving a personalized mobile health-enhanced cognitive-behavioral intervention and individuals receiving usual prenatal care.
Pregnant individuals ≤ 22 weeks’ gestation recruited from six prenatal care clinics were randomized to the intervention or usual prenatal care. Intervention participants received a 12-session adaptation of the Mothers and Babies intervention (MB-P), personalized by just-in-time stress reduction and mindfulness content based on elevated physiologic or self-reported stress. Primary outcomes were depressive and anxiety symptoms, and perceived stress. Secondary outcomes were behavioral activation, decentering of thoughts, social support, and mood regulation. Outcomes were measured at baseline, one-week post-intervention, one month postpartum, and three months postpartum. An intent-to-treat approach using mixed-effects models guided analysis.
Forty-nine individuals were randomized to MB-P and fifty-one to usual prenatal care. Participants were 70% White, 33.7 years old on average, and 16.2 weeks gestation. At three months postpartum, intervention participants had lower depressive symptomatology (d = 0.43) and less perceived stress (d = 0.46) than controls. Intervention participants exhibited greater behavioral activation three months postpartum (d = 0.41), greater decentering post-intervention (d = 0.37), and greater mood regulation post-intervention (d = 0.56) and three months postpartum (d = 0.55).
MB-P improved maternal depression and anxiety and mechanisms of behavioral activation, decentering, and mood regulation when compared to usual prenatal care. Future research should examine MB-P impact compared to standard MB without just-in-time content.
Trial registration: Clinical Trials.gov, NCT05052281.
One of the challenges women may face after experiencing severe burns is a shift in their social and marital roles. The process by which they reclaim these roles remains unclear.
This study was carried out to explore how women work to restore their marital and social status.
This qualitative research involved face-to-face, semi-structured interviews using open-ended questions. Sixteen women with severe burn injuries participated in the study. Data collection proceeded until no new information emerged (data saturation), and the analysis was carried out using a conventional content analysis approach. The study was conducted in accordance with the Standards for Reporting Qualitative Research (SRQR).
Two themes and six subthemes emerged: Consistency of self-position in married life (self-sacrifice, continuity of roles, normalization of sexual relations) and social interaction (social isolation, reliance on internal forces in interaction with the community, use of available support).
Following severe burn injuries, women often strive to reestablish their roles within their marital and social relationships. Healthcare professionals, including nurses and physicians, can play a vital role by educating survivors and their families (particularly their spouses) about how to effectively cope with the challenges associated with severe burns. Such educational efforts can support women in reclaiming their position and improving their overall well-being.
The discourse around menstrual cycles is often pathologized, potentially reinforcing negative perceptions of menstruation. The extent to which individuals have internalized the idea that bodily and social experiences before menstruation are the manifestation of ill-health, thereby biasing reports of premenstrual experiences towards negative emotions, remains unclear.
Using an online experimental design, we investigate whether phrasing the premenstrual experience as having both negative and positive dimensions would enable individuals to report more diverse and positive experiences than are reported in the absence of specific emotional prompts. Participants were recruited using a period tracker app and randomly allocated to one of three conditions: control (describe your premenstrual experience); treatment 1 (describe your negative and positive premenstrual experience); treatment 2 (describe your posititive and negative premenstrual experience). Sentiment analysis was used to derive polarity scores, and a two-part Bayesian model assessed the impact of phrasing order.
Among 2,637 participants, responses skewed negatively (mean -0.25). Compared to the control, treatment conditions 1 and 2 reported premenstrual experiences 64% and 62% less negative, respectively. Positive themes, notably ‘sex, libido, and energy’emerged. The absence of positive prompts in questioning led to more negative and less diverse reports.
These findings support existing literature on the predominance of negative premenstrual phases and underline the need to broaden measurements to encompass positive symptoms. The study also pioneers the use of text analysis for investigating premenstrual symptoms.
This study examines the challenges and opportunities of implementing gender-equitable substance use disorder (SUD) treatment models in Brazil by revisiting a public policy initiative carried out between 2004 and 2006. During this initiative, a structured model of care, the Women’s Drug Dependent Treatment Program (PROMUD), was replicated in two additional psychosocial care units in São Paulo. The study seeks to contribute to the visibility of a historically hidden population of women with SUD by comparing treatment retention across the three centers and identifying risk factors associated with dropout.
This observational, non-randomized post hoc analysis examined clinical data from 200 women who enrolled in PROMUD-based programs across three distinct psychosocial care centers—CAPS-AD Centro (DT), CAPS-AD Jardim Nélia (JN), and the original PROMUD site. All centers implemented the model concurrently using a standardized protocol. Treatment retention was defined as weeks between program admission and dropout (max follow-up: 104 weeks). Drop-out was defined as leaving treatment for reasons other than referral, improved discharge, administrative discharge, or death. Kaplan–Meier survival curves were used to estimate retention, and Cox proportional hazards models identified predictors of dropout.
200 women were included, PROMUD had a higher percentage of white, educated and employed participants. DT had the highest prevalence of unstable housing and prostitution history. PROMUD and JN showed comparable retention at 104 weeks (44.8% and 42.4%), whereas DT exhibited the lowest retention (17.3%). Age was a protective factor (HR = 0.94, p < 0.001), substance of choice was not significantly associated with dropout.
Gender-specific care models can be effectively implemented in resource-limited, community-responsive care units, though their success depends on local population characteristics and territorial dynamics. Despite the time gap since the original project, the challenges remain similar or have intensified.
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