Prevalence of posttraumatic stress disorder (PTSD) defined according to the American Psychiatric Association’s Diagnostic and Statistical Manual fifth edition (DSM-5; 2013) and fourth edition (DSM-IV; 1994) was compared in a national sample of U.S. adults (N = 2,953) recruited from an online panel. Exposure to traumatic events, PTSD symptoms, and functional impairment were assessed online using a highly structured, self-administered survey. Traumatic event exposure using DSM-5 criteria was high (89.7%), and exposure to multiple traumatic event types was the norm. PTSD caseness was determined using Same Event (i.e., all symptom criteria met to the same event type) and Composite Event (i.e., symptom criteria met to a combination of event types) definitions. Lifetime, past-12-month, and past 6-month PTSD prevalence using the Same Event definition for DSM-5 was 8.3%, 4.7%, and 3.8% respectively. All 6 DSM-5 prevalence estimates were slightly lower than their DSM-IV counterparts, although only 2 of these differences were statistically significant. DSM-5 PTSD prevalence was higher among women than among men, and prevalence increased with greater traumatic event exposure. Major reasons individuals met DSM-IV criteria, but not DSM-5 criteria were the exclusion of nonaccidental, nonviolent deaths from Criterion A, and the new requirement of at least 1 active avoidance symptom.

CONTEXT Psychiatric disorders and substance use during pregnancy are associated with adverse outcomes for mothers and their offspring. Information about the epidemiology of psychiatric disorders and substance use in this population is lacking. OBJECTIVE To examine sociodemographic correlates, rates of DSM-IV Axis I psychiatric disorders, substance use and treatment-seeking among past-year pregnant and postpartum women in the United States. DESIGN, SETTING, AND PARTICIPANTS Face-to-face interviews were conducted in the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions (n = 43,093). MAIN OUTCOME MEASURES Prevalence of 12-month DSM-IV Axis I psychiatric disorders, substance use, and treatment seeking. RESULTS There were no significant differences in the 12-month prevalence of psychiatric disorders between past-year pregnant (25.3%), postpartum women (27.5%), and non-pregnant women of child-bearing age (30.1%), except for the significantly higher prevalence of major depressive disorder in postpartum women (9.3%) than in non-pregnant women (8.1%) (OR 1.59, 95% CI=1.15–2.20). Past-year pregnant and postpartum women had significantly lower rates of alcohol use disorders, and any substance use, except illicit drug use, than non-pregnant women. Age, marital status, health status, stressful life events, and history of traumatic experiences were all significantly associated with higher risk of psychopathology in pregnant and postpartum women. Most women with a current psychiatric disorder did not receive any mental health care in the 12-months prior to the survey regardless of pregnancy status. CONCLUSIONS Pregnancy per se is not associated with increased risk of mental disorders, though the risk of major depressive disorder may be increased during the postpartum period. Young, unmarried women with recent stressful life events, complicated pregnancies, and poor overall health were at significantly increased risk of mental disorders during pregnancy. Low rates of maternal mental health care underscore the need to improve recognition and delivery of treatment for mental disorders occurring during pregnancy and the postpartum.

Living in states with discriminatory policies may have pernicious consequences for the mental health of LGB populations. These findings lend scientific support to recent efforts to overturn these policies.

Objective To estimate the contributions of biological aging, historical trends, and birth cohort effects on trends in pre-eclampsia in the United States.Design Population based retrospective study.Setting National hospital discharge survey datasets, 1980-2010, United States.Participants 120 million women admitted to hospital for delivery. Main outcome measuresTemporal changes in rates of mild and severe pre-eclampsia in relation to maternal age, year of delivery, and birth cohorts. Poisson regression as well as multilevel age-period-cohort models with adjustment for obesity and smoking were incorporated. ResultsThe rate of pre-eclampsia was 3.4%. The age-period-cohort analysis showed a strong age effect, with women at the extremes of maternal age having the greatest risk of pre-eclampsia. In comparison with women delivering in 1980, those delivering in 2003 were at 6.7-fold (95% confidence interval 5.6-fold to 8.0-fold) increased risk of severe pre-eclampsia. Period effects declined after 2003. Trends for severe pre-eclampsia also showed a modest birth cohort effect, with women born in the 1970s at increased risk. Compared with women born in 1955, the risk ratio for women born in 1970 was 1.2 (95% confidence interval 1.1 to 1.3). Similar patterns were also evident for mild pre-eclampsia, although attenuated. Changes in the population prevalence of obesity and smoking were associated with period and cohort trends in pre-eclampsia but did not explain the trends.