Psychopharmacology in Pregnancy and the Postpartum Period

2015 ◽  
Author(s):  
Amy Wenzel ◽  
Deborah Kim
Keyword(s):  
Mental Health ◽  
Postpartum Period ◽  
Empirical Studies ◽  
Severe Depression ◽  
Mental Health Disorders ◽  
Psychotropic Medications ◽  
Future Research ◽  
Broad Array ◽  
Pregnancy And Lactation ◽  
Health Disorders

A substantial minority of pregnant and lactating women meet criteria for one or more mental health disorders and, in many of these cases, treatment with psychotropic medication is indicated. Data from empirical studies on psychopharmacology using antidepressant medications for perinatal women suggest that the risk-benefit ratio is favorable, although their usage during pregnancy is associated with a slight increase in risk of spontaneous abortion, cardiac malformations (specifically with paroxetine), preterm birth, and poor neonatal adaptation syndrome. However, these risks should be contrasted with the fact that women with moderate to severe depression who have had multiple lifetime episodes have a substantial relapse rate if they stop taking their antidepressant during pregnancy. There is more limited research on the use of other classes of psychotropic medications during pregnancy and the postpartum period. Future research should establish the efficacy and risk-benefit profile of psychotropic medications for the broad array of mental health disorders during pregnancy and lactation, as well as for postpartum mental health disorders other than depression.

scholarly journals Parental Mental Health in Childhood as a Risk Factor for Anxiety and Depression among People Seeking Help for Tinnitus and Hyperacusis

2019 ◽  
Vol 30 (09) ◽  
pp. 772-780 ◽  
Author(s):  
Hashir Aazh ◽  
Ali A. Danesh ◽  
Brian C. J. Moore
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Risk Factor ◽  
Mental Health Disorders ◽  
Anxiety And Depression ◽  
Future Research ◽  
Parental Mental Illness ◽  
Parental Mental Health ◽  
Health Disorders ◽  
The Relationship

AbstractParental mental illness is a risk factor for mental health disorders in the offspring. However, the relationship between parental illness in childhood and mental health disorders in adulthood among patients with tinnitus and/or hyperacusis is not known.The aim was to explore the relationship between parental mental health in childhood and anxiety and depression for patients experiencing tinnitus and/or hyperacusis.This was a retrospective cross-sectional study with a correlational design.Two hundred eighty-seven consecutive patients who attended a Tinnitus and Hyperacusis Therapy Specialist Clinic in the United Kingdom were included. Their average age was 52.5 years.The association was explored between anxiety and depression measured via the Generalized Anxiety Disorder questionnaire (GAD-7) and the Patient Health questionnaire (PHQ-9) and responses to the question “While you were growing up during the first 18 years of life did your parent(s) have depression or mental illness?”Thirty-nine percent of patients (111/287) responded “yes” to the question about their parents’ mental health, which is about double the incidence in the general population. Regression analysis showed that parental mental illness significantly increased the risk of anxiety and depression, with unadjusted odds ratios (ORs) of 2.7 (95% confidence interval [CI]: 1.5–4.9, p = 0.001) for the PHQ-9 and 2.6 (95% CI: 1.4–4.8, p = 0.002) for the GAD-7. However, when the models were adjusted for the effects of age, gender, tinnitus handicap as measured via the Tinnitus Handicap Inventory, hyperacusis handicap as measured via the Hyperacusis questionnaire, uncomfortable loudness levels, GAD-7 scores (for the depression model only), and PHQ-9 scores (for the anxiety model only), parental mental health was only significantly associated with depression, with an OR of 2.7 (95% CI: 1.08–6.7, p = 0.033).Audiologists offering tinnitus and hyperacusis rehabilitation should screen patients for parental mental illness in childhood, especially for those with comorbid depression, and make onward referral to appropriate mental health services when needed. Future research should analyze the breadth and type of adverse childhood experiences among patients with tinnitus and hyperacusis and their relationship with mental problems and treatment efficacy.

scholarly journals The aetiology of social deficits within mental health disorders: The role of the immune system and endogenous opioids

2019 ◽  
Author(s):  
Sarah Jane Charles ◽  
Miguel Farias ◽  
R. I. M. Dunbar
Keyword(s):  
Mental Health ◽  
Immune System ◽  
Mental Health Disorders ◽  
Social Bonding ◽  
Endogenous Opioids ◽  
Future Research ◽  
Endogenous Opioid System ◽  
Endogenous Opioid ◽  
Health Disorders

The American National Institute for Mental Health (NIMH) has put out a set of research goals that include a long-term plan to identify more reliable endogenous explanations for a wide variety of mental health disorders (Insel, 2013). In response to this, we have identified a major symptom that underlies multiple mental health disorders – social bonding dysfunction. We suggest that endogenous opioid abnormalities can lead to altered social bonding, which is a symptom of various mental health disorders, including depression, schizophrenia and ASD. This article first outlines how endogenous opioids play a role in social bonding. Then we show their association with the body’s inflammation immune function, and review recent literature linking inflammation to mental health ‘immunophenotypes’. We finish by explaining how these immunophenotypes may be caused by alterations in the endogenous opioid system. This is the first overview of the role of inflammation across multiple disorders where we provide a biochemical explanation for why immunophenotypes might exist across diagnoses. We propose a novel mechanism of how the immune system may be causing ‘sickness-type’ behaviours (fatigue, appetite change, social withdrawal and inhibited motivation) in those who have these immunophenotypes. We hope that this novel aetiology can be used as a basis for future research in mental health.

scholarly journals Smartphone-Based Interventions and Internalizing Disorders in Youth: Systematic Review and Meta-analysis

10.2196/16490 ◽  
2021 ◽  
Vol 23 (1) ◽  
pp. e16490
Author(s):  
Adrian Buttazzoni ◽  
Keshbir Brar ◽  
Leia Minaker
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Meta Analysis ◽  
Population Level ◽  
Internalizing Disorders ◽  
Mental Health Disorders ◽  
Future Research ◽  
Global Issue ◽  
Health Initiatives ◽  
Health Disorders

Background Mental health disorders in youth are a global issue that have important implications for the future quality of life and morbidity of affected individuals. In the context of public health initiatives, smartphone-based interventions have been suggested to hold the potential to be an effective strategy to reduce the symptoms of mental health disorders in youth; however, further evaluation is needed to confirm their effectiveness. This systematic review and meta-analysis documents and synthesizes existing research on smartphone-based interventions targeting internalizing disorders in youth populations. Objective This study aims to synthesize existing research on smartphone-based interventions targeting internalizing disorders in youth populations. Methods PubMed and SCOPUS were searched in 2019, and 4334 potentially relevant articles were found. A total of 12 studies were included in the final synthesis. We used the Hedges g meta-analysis approach and a random effects model for analysis. Results The results of this review note that depression and anxiety are the most commonly targeted symptoms, and unlike other similar topics, most studies reviewed were linked to a proven treatment. The overall pooled effect from the meta-analysis showed small but significant effects (κ=12; N=1370; Hedges g=0.20; 95% CI 0.02-0.38) for interventions in reducing the symptoms of internalizing disorders. In total, 4 subgroup analyses examining specific symptoms and intervention styles found varied small significant and nonsignificant effects. Conclusions Future research should focus on developing robust evaluative frameworks and examining interventions among more diverse populations and settings. More robust research is needed before smartphone-based interventions are scaled up and used at the population level to address youth internalizing disorders.

scholarly journals Smartphone-Based Interventions and Internalizing Disorders in Youth: Systematic Review and Meta-analysis (Preprint)

2019 ◽  
Author(s):  
Adrian Buttazzoni ◽  
Keshbir Brar ◽  
Leia Minaker
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Meta Analysis ◽  
Population Level ◽  
Internalizing Disorders ◽  
Mental Health Disorders ◽  
Future Research ◽  
Global Issue ◽  
Health Initiatives ◽  
Health Disorders

BACKGROUND Mental health disorders in youth are a global issue that have important implications for the future quality of life and morbidity of affected individuals. In the context of public health initiatives, smartphone-based interventions have been suggested to hold the potential to be an effective strategy to reduce the symptoms of mental health disorders in youth; however, further evaluation is needed to confirm their effectiveness. This systematic review and meta-analysis documents and synthesizes existing research on smartphone-based interventions targeting internalizing disorders in youth populations. OBJECTIVE This study aims to synthesize existing research on smartphone-based interventions targeting internalizing disorders in youth populations. METHODS PubMed and SCOPUS were searched in 2019, and 4334 potentially relevant articles were found. A total of 12 studies were included in the final synthesis. We used the Hedges <i>g</i> meta-analysis approach and a random effects model for analysis. RESULTS The results of this review note that depression and anxiety are the most commonly targeted symptoms, and unlike other similar topics, most studies reviewed were linked to a proven treatment. The overall pooled effect from the meta-analysis showed small but significant effects (κ=12; N=1370; Hedges g=0.20; 95% CI 0.02-0.38) for interventions in reducing the symptoms of internalizing disorders. In total, 4 subgroup analyses examining specific symptoms and intervention styles found varied small significant and nonsignificant effects. CONCLUSIONS Future research should focus on developing robust evaluative frameworks and examining interventions among more diverse populations and settings. More robust research is needed before smartphone-based interventions are scaled up and used at the population level to address youth internalizing disorders.

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