Psychiatry and Obstetrics: An Imperative for Collaboration

Hoffman, M. Camille; Wisner, Katherine L.

doi:10.1176/appi.ajp.2016.16111233

Cited by 11 publications

(7 citation statements)

References 24 publications

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“…provided evidence of the gap between clinical need and education in reproductive psychiatry and argued that all psychiatrists should receive training in managing pregnant women to ensure the competent care of this vulnerable group. Improving psychiatric care for childbearing women with BD deserves further urgent clinical and research attention, to improve psychiatric treatment delivery and to optimize perinatal mental health .…”

Section: Discussionmentioning

confidence: 99%

Mood symptoms in pregnant and postpartum women with bipolar disorder: a naturalistic study

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Mood symptoms in pregnant and postpartum women with bipolar disorder: a naturalistic study

et al. 2017

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“…In the future, interdisciplinary guidelines and collaborative care between psychiatry and obstetrics would be an area of shared benefit. 70…”

Section: Bridging the Gapmentioning

confidence: 99%

Intravenous brexanolone for postpartum depression: what it is, how well does it work, and will it be used?

Faden

Citrome

2020

Therapeutic Advances in Psychopharmacology

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Postpartum depression is considered to be a subtype of major depressive disorder that occurs in approximately 10–20% of mothers worldwide. However, in actuality, these numbers are likely underreported due to minimization and the stigma of mental illness. Until recently, there were no approved medications for the treatment of postpartum depression. Allopregnanolone is a naturally occurring neuroactive steroid whose serum levels decline precipitously following childbirth. This hormonal fluctuation has been postulated as playing a role in the pathophysiology of postpartum depression. Brexanolone is the first medication approved by the US Food and Drug Administration for the treatment of postpartum depression. Brexanolone is an intravenous proprietary formulation of allopregnanolone that can be administered to produce stable serum levels comparable with third-trimester concentrations in postpartum mothers. It is hypothesized to modulate neuronal excitability by functioning as an allosteric modulator of γ-aminobutyric acid-A receptors and is administered under monitoring as a 60 h continuous infusion. In this review, we will highlight the results of the clinical trial program, including efficacy and tolerability data. Practical and logistical considerations of brexanolone will be reviewed, as will its potential place in therapy for the treatment of postpartum depression.

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“…Also, multidisciplinary teams should be involved in the care of women at the highest risk of severe illness and specialty consultation should be available for women who develop acute psychiatric illness and require more complex care. 9 Further research will be needed to determine the most effective prevention strategies for perinatal depression, how to deliver them across various communities, and how to tailor them to the needs of individuals. There was substantial heterogeneity in counseling protocols reviewed in the evidence report.…”

Section: Related Articles Pages 580 and 588mentioning

confidence: 99%

“…Therefore, options such as training of lay personnel or large-scale telehealth or internet- and smartphone-based platforms should be considered. Also, multidisciplinary teams should be involved in the care of women at the highest risk of severe illness and specialty consultation should be available for women who develop acute psychiatric illness and require more complex care …”

mentioning

confidence: 99%

Perinatal Depression

Freeman

2019

JAMA

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In this issue of JAMA, the US Preventive Services Task Force (USPSTF) recommends "that clinicians provide or refer pregnant and postpartum persons who are at increased risk of perinatal depression to counseling interventions" (B recommendation; net benefit is moderate). 1 This recommendation is supported by the accompanying evidence review that evaluated the benefits and harms of primary care-relevant interventions to prevent perinatal depression. 2 Perinatal depression, defined as a major or minor depressive episode that occurs during pregnancy or within the postpartum year, affects approximately 11.5% of new mothers annually in the United States, 3 representing a substantial burden for women and families. In addition to risks to the mother, there are important risks for the infant associated with antenatal depression, including preterm birth, low birth weight, and longer-term temperament and behavioral problems. 4,5 Postpartum depression also is associated with short-and longer-term risk factors for the infant, including effects on bonding and attachment, success of breastfeeding, cognitive and social development, and the risk of future psychopathology. 6 Therefore, the targeted prevention of perinatal depression is important, and if done successfully will improve a broad range of outcomes for women and their children.The USPSTF previously recommended broad screening for acute depression among adults, including pregnant and postpartum women. 7 The current recommendation advances the previous more broad recommendation by focusing on prevention rather than screening for acute illness, and the recommendation calls for a specific treatment intervention. 1 The recommendation to refer women at risk for perinatal depression to counseling is based on evidence from clinical trials. The task force completed a rigorous review of clinical studies to prevent perinatal depression, including psychotherapies, antidepressants, and complementary and alternative medicines. Fifty studies (49 randomized clinical trials, 1 nonrandomized controlled intervention study) met inclusion criteria. Counseling or psychotherapeutic interventions were the most widely studied and were demonstrated to be associated with a lower likelihood of onset of perinatal depression. Other treatment modalities were not supported

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Psychiatry and Obstetrics: An Imperative for Collaboration

Cited by 11 publications

References 24 publications

Mood symptoms in pregnant and postpartum women with bipolar disorder: a naturalistic study

Mood symptoms in pregnant and postpartum women with bipolar disorder: a naturalistic study

Intravenous brexanolone for postpartum depression: what it is, how well does it work, and will it be used?

Perinatal Depression

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