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Sowińska-Przepiera E, Krzyścin M, Syrenicz I, Bumbuliene Z, Wajs-Syrenicz A, Przepiera A, Brzeska A, Syrenicz A. Dilemmas concerning the course of pregnancy in patients with anorexia nervosa considering hormonal and somatic parameters. Endokrynol Pol 2024:VM/OJS/J/99255. [PMID: 38708911 DOI: 10.5603/ep.99255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 03/14/2024] [Indexed: 05/07/2024]
Abstract
Mental anorexia nervosa is a rare, potentially severe, chronic, and recurrent mental disorder that occurs more often in women than in men, especially during the childbearing years. The disorder is associated with an increased risk of mortality, mainly related to the physical consequences of severe malnutrition and suicide. Malnutrition of the body can cause serious hormonal and somatic problems. Despite significant hormonal disturbances that reduce fertility, a woman with anorexia can become pregnant. A new phenomenon now seen with increasing frequency is pregorexia, an eating disorder associated with pregnancy. It involves the use of dietary restrictions to avoid excessive weight gain during pregnancy. Pregnancy changes the hormonal economy mainly due to the development of the placenta, which secretes many hormones, not just sex hormones. Mental anorexia poses a significant risk to both mother and child if not diagnosed and treated properly. Treatment of anorexia involves simultaneous somatic and psychological treatment. During pregnancy, additional care should be taken to create an optimal environment for the developing foetus. Unfortunately, there is still a lack of research providing guidance in this area. Available studies are mainly case reports or reports focusing on specific clinical situations. It is worth noting that no study to date has attempted a comprehensive assessment of endocrine disruption in pregnant women with anorexia. Recognising the existing knowledge gap on endocrine disorders in pregnant women with anorexia nervosa, a systematic review of the literature was conducted.
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Affiliation(s)
- Elżbieta Sowińska-Przepiera
- Department of Endocrinology, Metabolic and Internal Diseases, Pomeranian Medical University in Szczecin, Szczecin, Poland
- Pediatric Adolescent Gynaecology Clinic Department of Gynaecology Endocrinology, and Gynaecological Oncology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Mariola Krzyścin
- Pediatric Adolescent Gynaecology Clinic Department of Gynaecology Endocrinology, and Gynaecological Oncology, Pomeranian Medical University in Szczecin, Szczecin, Poland.
| | - Igor Syrenicz
- Department of Endocrinology, Metabolic and Internal Diseases, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Zana Bumbuliene
- Centre for Obstetrics and Gynaecology, Vilnius University Hospital, Santaros Klinikos, Vilnius University, Faculty of Medicine, Vilnius, Lithuania
| | - Alicja Wajs-Syrenicz
- Department of Skin and Venereal Diseases, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Adam Przepiera
- Department of Urology and Urological Oncology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | | | - Anhelli Syrenicz
- Department of Endocrinology, Metabolic and Internal Diseases, Pomeranian Medical University in Szczecin, Szczecin, Poland
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Keynejad RC, Bitew T, Sorsdahl K, Myers B, Honikman S, Mulushoa A, Demissie M, Deyessa N, Howard LM, Hanlon C. Adapting brief problem-solving therapy for pregnant women experiencing depressive symptoms and intimate partner violence in rural Ethiopia. Psychother Res 2024; 34:538-554. [PMID: 37384929 DOI: 10.1080/10503307.2023.2222899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/04/2023] [Accepted: 06/05/2023] [Indexed: 07/01/2023] Open
Abstract
OBJECTIVE To adapt an evidence-based psychological intervention for pregnant women experiencing depressive symptoms and intimate partner violence (IPV) in rural Ethiopia. METHOD We conducted a desk review of contextual factors in Sodo, Ethiopia, followed by qualitative interviews with 16 pregnant women and 12 antenatal care (ANC) providers. We engaged stakeholders through participatory theory of change (ToC) workshops, to select the intervention and articulate a programme theory. We used "ADAPT" guidance to adapt the intervention to the context, before mapping potential harms in a "dark logic model". RESULTS Brief problem-solving therapy developed for South Africa was the most contextually relevant model. We adapted the delivery format (participants prioritised confidentiality and brevity) and training and supervision (addressing IPV). Consensus long-term outcomes in our ToC were ANC providers skilled in detecting and responding to emotional difficulties and IPV, women receiving appropriate support, and emotional difficulties improving. Our dark logic model highlighted the risk of more severe IPV and mental health symptoms not being referred appropriately. CONCLUSION Although intervention adaptation is recommended, the process is rarely reported in depth. We comprehensively describe how contextual considerations, stakeholder engagement, programme theory, and adaptation can tailor psychological interventions for the target population in a low-income, rural setting.
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Affiliation(s)
- Roxanne C Keynejad
- Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Tesera Bitew
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Psychology, College of Education and Behavioural Sciences, Injibara University
| | - Katherine Sorsdahl
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Bronwyn Myers
- Division of Addiction Psychiatry, Department of Psychiatry and Mental health, University of Cape Town, South Africa
- Curtin enAble Institute, Curtin University, Bentley, Western Australia
- Mental health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Simone Honikman
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Perinatal Mental Health Project, Department of Psychiatry and Mental Health, University of Cape Town, Rondebosch, Cape Town, South Africa
| | - Adiyam Mulushoa
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mekdes Demissie
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Negussie Deyessa
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Louise M Howard
- Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Charlotte Hanlon
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
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Machado FZ, da Mota MSS, Dos Santos EP, Prasad D, Cardoso TDA, Frey BN, Jansen K, Souza LDDM, Mondin TC, Kapczinski F, Moreira FP, da Silva RA. Factors associated with suicide risk in young women with premenstrual dysphoric disorder: A population-based study. Trends Psychiatry Psychother 2024. [PMID: 38315812 DOI: 10.47626/2237-6089-2023-0718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/22/2024] [Indexed: 02/07/2024]
Abstract
PURPOSE Women with premenstrual dysphoric disorder (PMDD) are more likely to report suicide ideation and behavior when compared to women without PMDD. However, there is a lack of studies investigating the risk factors for suicide risk in women with PMDD. Thus, the aim of this study is to assess the factors associated with suicide risk in young women with PMDD. METHODS This is a cross-sectional study including 128 young women with PMDD who were recruited from the community. PMDD and suicide risk were assessed by trained psychologists using the Mini International Neuropsychiatric Interview (MINI-PLUS). Suicide risk evaluation includes six questions that assess suicidal intention, planning and previous attempts. Subjects who answer yes to any of the six questions are classified as having current suicide risk. RESULTS The prevalence of current suicide risk in women with PMDD was 28.1%. The factors associated with suicide risk in this population were: presenting current panic disorder (OR: 18.71 [95% CI: 1.02 - 343.27], p=0.048), a non-white skin color (OR: 4.18 [CI 95%: 1.28 - 13.61], p=0.018), greater severity of depressive symptoms (OR: 1.22 [95% CI: 1.12 - 1.32], < 0.001), and history of childhood trauma (OR: 1.04 [95% CI: 1.01 - 1.08], 0.010). CONCLUSION Our findings indicate that there are key sociodemographic and clinical factors associated with suicide risk in young women with PMDD, enabling clinicians to identify at-risk individuals who could benefit from further screening and interventions.
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Affiliation(s)
- Francine Zanette Machado
- Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, RS, Brazil
| | - Manuela Silva Silveira da Mota
- Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, RS, Brazil. Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil. Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Ester Pereira Dos Santos
- Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, RS, Brazil
| | - Divya Prasad
- Women's Health Concerns Clinic, St Joseph's Healthcare Hamilton, ON, Canada
| | - Taiane de Azevedo Cardoso
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia
| | - Benicio N Frey
- Women's Health Concerns Clinic, St Joseph's Healthcare Hamilton, ON, Canada. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada. Mood Disorders Program, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Karen Jansen
- Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, RS, Brazil
| | | | - Thaise Campos Mondin
- Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, RS, Brazil. Pró-Reitoria de Assuntos Estudantis (PRAE), Universidade Federal de Pelotas, RS, Brazil
| | - Flavio Kapczinski
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil. Graduate Program in Psychiatry and Behavioral Sciences, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Fernanda Pedrotti Moreira
- Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, RS, Brazil
| | - Ricardo Azevedo da Silva
- Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, RS, Brazil
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Travis KJ, Huang AJ, Maguen S, Inslicht S, Byers AL, Seal KH, Gibson CJ. Military Sexual Trauma and Menopause Symptoms Among Midlife Women Veterans. J Gen Intern Med 2024; 39:411-417. [PMID: 37957529 PMCID: PMC10897107 DOI: 10.1007/s11606-023-08493-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/13/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Sexual assault and/or sexual harassment during military service (military sexual trauma (MST)) can have medical and mental health consequences. Most MST research has focused on reproductive-aged women, and little is known about the long-term impact of MST on menopause and aging-related health. OBJECTIVE Examine associations of MST with menopause and mental health outcomes in midlife women Veterans. DESIGN Cross-sectional. PARTICIPANTS Women Veterans aged 45-64 enrolled in Department of Veterans Affairs (VA) healthcare in Northern California between March 2019 and May 2020. MAIN MEASURES Standardized VA screening questions assessed MST exposure. Structured-item questionnaires assessed vasomotor symptoms (VMS), vaginal symptoms, sleep difficulty, depressive symptoms, anxiety symptoms, and posttraumatic stress disorder (PTSD) symptoms. Multivariable logistic regression analyses examined associations between MST and outcomes based on clinically relevant menopause and mental health symptom thresholds. KEY RESULTS Of 232 participants (age = 55.95 ± 5.13), 73% reported MST, 66% reported VMS, 75% reported vaginal symptoms, 36% met criteria for moderate-to-severe insomnia, and almost half had clinically significant mental health symptoms (33% depressive symptoms, 49% anxiety, 27% probable PTSD). In multivariable analyses adjusted for age, race, ethnicity, education, body mass index, and menopause status, MST was associated with the presence of VMS (OR 2.44, 95% CI 1.26-4.72), vaginal symptoms (OR 2.23, 95% CI 1.08-4.62), clinically significant depressive symptoms (OR 3.21, 95% CI 1.45-7.10), anxiety (OR 4.78, 95% CI 2.25-10.17), and probable PTSD (OR 6.74, 95% CI 2.27-19.99). Results did not differ when military sexual assault and harassment were disaggregated, except that military sexual assault was additionally associated with moderate-to-severe insomnia (OR 3.18, 95% CI 1.72-5.88). CONCLUSIONS Exposure to MST is common among midlife women Veterans and shows strong and independent associations with clinically significant menopause and mental health symptoms. Findings highlight the importance of trauma-informed approaches to care that acknowledge the role of MST on Veteran women's health across the lifespan.
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Affiliation(s)
- Kate J Travis
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco Weill Institute for Neurosciences, San Francisco, CA, USA
| | - Alison J Huang
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Shira Maguen
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco Weill Institute for Neurosciences, San Francisco, CA, USA
- San Francisco Veteran Affairs Health Care System, San Francisco, CA, USA
| | - Sabra Inslicht
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco Weill Institute for Neurosciences, San Francisco, CA, USA
- San Francisco Veteran Affairs Health Care System, San Francisco, CA, USA
| | - Amy L Byers
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco Weill Institute for Neurosciences, San Francisco, CA, USA
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- San Francisco Veteran Affairs Health Care System, San Francisco, CA, USA
| | - Karen H Seal
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco Weill Institute for Neurosciences, San Francisco, CA, USA
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- San Francisco Veteran Affairs Health Care System, San Francisco, CA, USA
| | - Carolyn J Gibson
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco Weill Institute for Neurosciences, San Francisco, CA, USA.
- San Francisco Veteran Affairs Health Care System, San Francisco, CA, USA.
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Rodríguez-Gallego I, Vila-Candel R, Corrales-Gutierrez I, Gomez-Baya D, Leon-Larios F. Evaluation of the Impact of a Midwife-Led Breastfeeding Group Intervention on Prevention of Postpartum Depression: A Multicentre Randomised Clinical Trial. Nutrients 2024; 16:227. [PMID: 38257120 PMCID: PMC10821517 DOI: 10.3390/nu16020227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 01/06/2024] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
Postpartum depression is a significant health issue affecting both mothers and newborns during the postpartum period. Group support interventions during this period have proven effective in helping women cope with depression and improving breastfeeding rates. This study aimed to assess the effectiveness of a midwife-led breastfeeding support group intervention on breastfeeding rates, postpartum depression and general self-efficacy. This was a multicentric cluster randomised controlled trial with control and intervention groups and was not blinded. It was conducted in Andalusia (southern Spain) from October 2021 to May 2023. A total of 382 women participated in the study. The results showed a significant difference in exclusive breastfeeding rates at 4 months postpartum between the groups (control 50% vs. intervention 69.9%; p < 0.001). Additionally, there was a lower mean score on the Edinburgh Postnatal Depression Scale in the intervention group (12.49 ± 3.6 vs. 13.39 ± 4.0; p = 0.044). Similarly, higher scores of general self-efficacy were observed among breastfeeding women at 2 and 4 months postpartum (77.73 ± 14.81; p = 0.002 and 76.46 ± 15.26; p < 0.001, respectively). In conclusion, midwife-led breastfeeding support groups enhanced self-efficacy, prolonged breastfeeding and reduced postpartum depression 4 months after giving birth.
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Affiliation(s)
- Isabel Rodríguez-Gallego
- Foetal Medicine, Genetics and Reproduction Unit, Virgen del Rocío University Hospital, 41009 Seville, Spain;
- Red Cross Nursing University Centre, University of Seville, 41013 Seville, Spain
| | - Rafael Vila-Candel
- Faculty of Health Sciences, Universidad Internacional de Valencia (VIU), 46002 Valencia, Spain
- La Ribera Primary Health Department, 46600 Alzira, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46020 Valencia, Spain
| | - Isabel Corrales-Gutierrez
- Surgery Department, Faculty of Medicine, University of Seville, 41009 Seville, Spain
- Foetal Medicine Unit, Virgen Macarena University Hospital, 41009 Seville, Spain
| | - Diego Gomez-Baya
- Department of Social, Developmental and Educational Psychology, Universidad de Huelva, 21007 Huelva, Spain;
| | - Fatima Leon-Larios
- Nursing Department, School of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain;
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de la Garza Iga FJ, Mejía Alvarez M, Cockroft JD, Rabin J, Cordón A, Elias Rodas DM, Grazioso MDP, Espinola M, O'Dea C, Schubert C, Stryker SD. Using the project ECHO™ model to teach mental health topics in rural Guatemala: An implementation science-guided evaluation. Int J Soc Psychiatry 2023; 69:2031-2041. [PMID: 37477264 DOI: 10.1177/00207640231188038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
BACKGROUND Mental health (MH) disorders are major causes of disability in Guatemala. Unfortunately, limited academic training and funding resources make MH care inaccessible to most people in rural Guatemala. These disparities leave many indigenous populations without care. Project ECHO™ is an educational model used globally to deliver virtual training for providers in rural/ underserved communities. The aim of this project was to implement and evaluate a Project ECHO™ program bridging MH training gaps for providers who serve rural communities in Guatemala. METHODS The Project ECHO™ curriculum was implemented through a partnership between educational and nonprofit institutions in Guatemala City and the United States. Participants were primary care physicians and nurses working in rural Guatemala as well as medical/nursing/psychology students. Evaluation of its implementation was guided by a RE-AIM framework. Reach, effectiveness, adoption, fidelity, sustainability, acceptability, feasibility, and appropriateness were evaluated using a mixed-methods approach, using a pre-post survey and semi-structured focus groups. RESULTS Forty unique participants attended the five sessions. Attitudes about mental health did not change quantitatively but self-efficacy improved in four of five modules. High quality fidelity scores were noted in two of five sessions. Sustainability scores across multiple domains were highly rated. Scores on instruments measuring acceptability, feasibility, and appropriateness were high. Focus groups showed two main themes: the curriculum filled a gap in education and further adaptation of the model might help improve the experience. CONCLUSION Implementation of the Project ECHO™ educational model appeared to have good reach/adoption, showed improvements in self-efficacy, illuminated facilitators and barriers to sustainability, and was felt to be acceptable, feasible, and appropriate. Qualitative analysis supported these conclusions. Future directions would include ongoing evaluation and monitoring of further Project ECHO™ curricular experiences through this partnership and adaptation of this project to other learners and settings in Latin America.
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Affiliation(s)
| | | | - Joshua D Cockroft
- Department of Family and Community Medicine, College of Medicine, University of Cincinnati, OH, USA
- Department of Psychiatry and Behavioral Neurosciences, College of Medicine, University of Cincinnati, OH, USA
| | - Julia Rabin
- Department of Psychology, College of Arts & Sciences, University of Cincinnati, OH, USA
| | - Ana Cordón
- Wuqu' Kawoq / Maya Health Alliance, Tecpan, Guatemala
| | | | | | - Maria Espinola
- Department of Psychiatry and Behavioral Neurosciences, College of Medicine, University of Cincinnati, OH, USA
| | - Christine O'Dea
- Department of Family and Community Medicine, College of Medicine, University of Cincinnati, OH, USA
| | - Charles Schubert
- Department of Family and Community Medicine, College of Medicine, University of Cincinnati, OH, USA
| | - Shanna D Stryker
- Department of Family and Community Medicine, College of Medicine, University of Cincinnati, OH, USA
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Osborne LM, Jan RK, Kulkarni J. Editorial: Highlights in women's mental health 2021/22. Front Glob Womens Health 2023; 4:1323318. [PMID: 38025981 PMCID: PMC10664563 DOI: 10.3389/fgwh.2023.1323318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- Lauren M. Osborne
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, Cornell University, New York, NY, United States
| | - Reem Kais Jan
- Department of Pharmacology, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Jayashri Kulkarni
- Department of Psychiatry, Monash University, Melbourne, VIC, Australia
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Szypłowska M, Tarkowski R, Kułak K. The impact of endometriosis on depressive and anxiety symptoms and quality of life: a systematic review. Front Public Health 2023; 11:1230303. [PMID: 37744486 PMCID: PMC10512020 DOI: 10.3389/fpubh.2023.1230303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Endometriosis is a common gynecological disorder affecting approximately 10-15% of women of reproductive age. The main complaints of patients with endometriosis are pain and fertility problems. Symptoms of endometriosis can impact the psychological functioning of the patients and significantly compromise their mental health. Methods The aim of this review was to assess the prevalence of depressive and anxiety symptoms and quality of life in endometriosis patients. For this systematic review, we searched the PubMed, MEDLINE, ProQuest, EMBASE, Cochrane, CINAHL, Google Scholar, Scopus, and ScienceDirect electronic databases up to March 2023 to identify potentially relevant studies. The systematic review in the present paper is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. Results Of four records identified, 18 were eligible to be reviewed on the association between endometriosis and symptoms of depression and anxiety. Of 8,901 records identified, 28 were reviewed on the association between endometriosis and quality of life. The reviewed articles showed a prevalence ranging from 9.8 to 98.5% for depressive symptoms and 11.5 to 87.5% for anxiety. The quality of life in patients with endometriosis was significantly impaired, regardless of the tool used for evaluation. Discussion This systematic review shows that endometriosis is associated with depressive and anxiety symptoms and impaired HRQoL. Broad correlating factors modulate mental health outcomes, indicating the complex relationship between the disease and the psychological health of the patients.
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Affiliation(s)
- Małgorzata Szypłowska
- Chair and Department of Oncological Gynecology and Gynecology, Medical University of Lublin, Lublin, Poland
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9
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Roberts C, Montgomery E, Richens Y, Silverio SA. (Re)activation of survival strategies during pregnancy and childbirth following experiences of childhood sexual abuse. J Reprod Infant Psychol 2023; 41:152-164. [PMID: 34510971 DOI: 10.1080/02646838.2021.1976401] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To explore the pregnancy and childbearing experiences of women-survivors of childhood sexual abuse [CSA]. We aimed to generate a theory explaining those experiences for this population (women), this phenomenon (pregnancy and childbirth), and this context (those who have survived CSA). METHOD Participants (N=6) were recruited to semi-structured interviews about their experiences of CSA and subsequent pregnancy and childbirth. Data saturated early, and were analysed using Grounded Theory (appropriate to cross-disciplinary health research). Coding was inductive and iterative, to ensure rigour and achieve thematic saturation. RESULTS Open and focused coding led to the generation of super-categories, which in-turn were collapsed into three distinct, but related themes. These themes were: Chronicity of Childhood (Sexual) Abuse; Pregnancy and Childbirth as Paradoxically (Un)safe Experiences; Enduring Nature of Survival Strategies. The relationship between these themes was explained as the theory of: (Re)activation of Survival Strategies during Pregnancy and Childbirth following Experiences of Childhood Sexual Abuse. CONCLUSION Pregnancy and childbirth can be triggering for women-survivors of CSA. Survival strategies learnt during experiences of CSA can be (re)activated as a way of not only coping, but surviving (the sometimes unconsented) procedures, such as monitoring and physical examinations, as well as the feelings of lack of control and bodily agency.
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Affiliation(s)
- Chelsey Roberts
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - Elsa Montgomery
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Yana Richens
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.,Maternity Services, University College London Hospitals NHS Foundation Trust, London, UK
| | - Sergio A Silverio
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.,Department of Women & Children's Health, King's College London, London, UK
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Rudzik AEF, Robinson-Smith L, Tugwell F, Ball HL. Relationships between postpartum depression, sleep, and infant feeding in the early postpartum: An exploratory analysis. Front Psychiatry 2023; 14:1133386. [PMID: 37032920 PMCID: PMC10079948 DOI: 10.3389/fpsyt.2023.1133386] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 03/08/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction The study objectives were to determine the relationships between postpartum depression and maternal and infant sleep parameters and to examine the impact of infant feeding method on infant and maternal sleep and postpartum depression symptomatology. Methods Participants were 61 new mothers aged 18 to 45 years old, and their full-term, normal birth-weight, singleton infants. Participants were recruited from a large teaching hospital in northeast England. Data collection took place in participants' homes. The study used a prospective longitudinal design, with data collected at six, 12 and 18 weeks postpartum. We collected data on total sleep time, longest sleep period, wake after sleep onset, and night waking for mothers and infants objectively from actigraphic records and subjectively from maternal sleep logs. Participants reported on sleep disturbances using the General Sleep Disturbances Scale, on maternal sleepiness, and on depression symptomatology using the Edinburgh Postnatal Depression Scale. Results Scores on the Edinburgh Postnatal Depression Scale and General Sleep Disturbances Scale were consistently correlated with each other (6 weeks r = 0.452, p < 0.01; 12 weeks r = 0.317, p < 0.05; 18 weeks r = 0.493, p < 0.01), and did not correlate with objective measures or subjective reports of maternal or infant sleep. Edinburgh Postnatal Depression Scale scores at six, 12 and 18 weeks were predicted by General Sleep Disturbances Scale, prior Edinburgh Postnatal Depression Scale score, or both, but not by sleep parameters. With regard to infant feeding method, EPDS score was not higher among exclusively breastfeeding than among exclusively formula-feeding participants at any time point (6 weeks t = 0.306, p = 0.762; 12 weeks t = 0.343, p = 0.733; 18 weeks t = 0.426; p = 0.673). Different pathways emerged to predict Edinburgh Postnatal Depression Scale score for exclusively breastfeeding and exclusively formula-feeding women. Discussion Postpartum depression may be associated with disturbed sleep due to negative perception of sleep among depressed women, rather than disrupted sleep causing postpartum depression. With regard to infant feeding method, exclusively breastfeeding women are not more likely to suffer from postpartum depression, and different pathways may predict development of postpartum depression symptoms in exclusively breastfeeding and exclusively formula feeding women.
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Affiliation(s)
- Alanna E. F. Rudzik
- Durham Infancy and Sleep Centre, Durham University, Durham, United Kingdom
- Department of Anthropology, Durham University, Durham, United Kingdom
- *Correspondence: Alanna E. F. Rudzik,
| | - Lyn Robinson-Smith
- Durham Infancy and Sleep Centre, Durham University, Durham, United Kingdom
- Department of Anthropology, Durham University, Durham, United Kingdom
| | - Francesca Tugwell
- Durham Infancy and Sleep Centre, Durham University, Durham, United Kingdom
- Department of Anthropology, Durham University, Durham, United Kingdom
| | - Helen L. Ball
- Durham Infancy and Sleep Centre, Durham University, Durham, United Kingdom
- Department of Anthropology, Durham University, Durham, United Kingdom
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Barkin JL, Philipsborn RP, Curry CL, Upadhyay S, Geller PA, Pardon M, Dimmock J, Bridges CC, Sikes CA, Kondracki AJ, Buoli M. Climate Change is an Emerging Threat to Perinatal Mental Health. J Am Psychiatr Nurses Assoc 2022:10783903221139831. [PMID: 36482670 DOI: 10.1177/10783903221139831] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE In this discussion, we build the case for why climate change is an emerging threat to perinatal mental health. METHOD A search of current literature on perinatal and maternal mental health and extreme weather events was conducted in PubMed/MEDLINE and Web of Science databases. Only articles focusing on maternal mental health were included in this narrative review. RESULTS The perinatal period represents a potentially challenging timeframe for women for several reasons. Necessary role adjustments (reprioritization), changes in one's ability to access pre-birth levels (and types) of social support, fluctuating hormones, changes in body shape, and possible complications during pregnancy, childbirth, or postpartum are just a few of the factors that can impact perinatal mental health. Trauma is also a risk factor for negative mood symptoms and can be experienced as the result of many different types of events, including exposure to extreme weather/natural disasters. CONCLUSION While the concepts of "eco-anxiety," "climate despair," and "climate anxiety" have garnered attention in the mainstream media, there is little to no discussion of how the climate crisis impacts maternal mental health. This is an important omission as the mother's mental health impacts the family unit as a whole.
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Affiliation(s)
- Jennifer L Barkin
- Jennifer L. Barkin, PhD, Mercer University School of Medicine, Macon, GA, USA
| | | | - Carolann L Curry
- Carolann L. Curry, MLIS, Mercer University School of Medicine, Macon, GA, USA
| | - Saswati Upadhyay
- Saswati Upadhyay, MBBS, MPH, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Pamela A Geller
- Pamela A. Geller, PhD, Drexel University, Philadelphia, PA, USA
- Pamela A. Geller, PhD, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Madelyn Pardon
- Madelyn Pardon, PhD, James Cook University, Townsville, Queensland, Australia
| | - James Dimmock
- James Dimmock, Telethon Kids Institute, Western Australia, Australia
- James Dimmock, James Cook University, Townsville, Queensland, Australia
| | - Christy C Bridges
- Christy C. Bridges, PhD, Mercer University School of Medicine, Macon, GA, USA
| | - Christina A Sikes
- Christina A. Sikes, RN, BSN, North Central Health District, Macon, GA, USA
| | - Anthony J Kondracki
- Anthony J. Kondracki, MD, PhD, Mercer University School of Medicine Savannah, Savannah, GA, USA
| | - Massimiliano Buoli
- Massimiliano Buoli, MD, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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12
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Lancaster EE, Lapato DM, Peterson RE. Understanding the genetics of peripartum depression: Research challenges, strategies, and opportunities. Front Genet 2022; 13:1022188. [PMID: 36468033 PMCID: PMC9714263 DOI: 10.3389/fgene.2022.1022188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 10/18/2022] [Indexed: 09/12/2023] Open
Abstract
Peripartum depression (PD) is a common mood disorder associated with negative outcomes for mother and child. PD is an understudied disorder in psychiatric genetics, and progress characterizing its genetic architecture has been limited by a lack of disorder-specific research, heterogeneous and evolving phenotypic definitions, inadequate representation of global populations, low-powered studies, and insufficient data amenable to large meta-analyses. The increasing availability of large-scale, population-level efforts, like biobanks, have the potential to accelerate scientific discovery and translational research by leveraging clinical, molecular, and self-report data from hundreds of thousands of individuals. Although these efforts will not fully equip researchers to confront every challenge posed by systemic issues in data collection, such as the reliance on minimal phenotyping strategies, the field is in a position to learn from other successful psychiatric genetic investigations. This review summarizes the current state of PD genetics research and highlights research challenges, including the impact of phenotype depth, measurement, and definition on the replicability and interpretability of genomic research. Recommendations for advancing health equity and improving the collection, analysis, discussion, and reporting of measures for PD research are provided.
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Affiliation(s)
- Eva E. Lancaster
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, United States
| | - Dana M. Lapato
- Department of Human and Molecular Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, United States
| | - Roseann E. Peterson
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, United States
- Department of Psychiatry and Behavioral Health, Institute for Genomics in Health, State University of New York Downstate Health Sciences University, Brooklyn, NY, United States
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13
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Nair AR, Shivanna YKG, Illimoottil JP, Rachana A, Mahasampath GS, Abraham S, Kurian S. Common mental disorders among women and its social correlates in an urban marginalized populace in South India. Int J Soc Psychiatry 2022; 68:1394-1402. [PMID: 34130540 DOI: 10.1177/00207640211025556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Common mental disorders (CMD) cause a range of health, social and economic burden, and disorders like depression and anxiety are more prevalent among women. Prevalence and factors contributing to increased vulnerability for CMDs have regional variation. Identification of factors contributing to the vulnerability is essential to both psychiatric epidemiology and in addressing mental health challenges in the community. METHODS This cross-sectional study aimed at understanding the burden of CMD and its association with social determinants of mental health. Women hailing from urban slum attending the outpatient family care facility for their medical problems constituted the sample. Data was collected using a clinical research form with variables such as sociodemographic profile, health profile, and psychosocial profile. The questionnaire had specific questions on indicators of poverty, certain stressors, and support system. Presence of CMD was assessed using Clinical Interview Schedule-Revised (CIS-R), a standard tool for CMD research in primary care settings. A cut off score of 12 and above was considered for detecting CMD. Research ethical principles were adhered to and data was analyzed using SPSS 21.0. RESULTS Among 172 women, 77 (44.8%) were diagnosed to have CMDs. Univariate analysis revealed a significant association between age, marital status, living arrangement, educational level, difficulty with buying food, presence of debt, chronic medical illness, husband's alcohol use, marital satisfaction, experiencing abuse, family support, religious participation, and a diagnosis of CMD. Multivariate analysis showed high burden with nuclear family arrangement, difficulty to buy food, experiencing abuse and, low burden with higher educational level, family support, and religious participation. CONCLUSION Considering the high prevalence and the treatment gap of CMDs in primary setting, family-physician should be sensitized for detection and management of CMDs. Social interventions targeting poverty, women's education and empowerment, and support system are likely to decrease the burden of CMDs in this population.
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Affiliation(s)
- Aiswarya R Nair
- Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India
| | | | | | - Arun Rachana
- Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India
| | - Gowri S Mahasampath
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sunil Abraham
- Department of Family Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - Suja Kurian
- Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India
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14
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Miller ML, Stevens NR, Lowell GS, Hobfoll SE. Communal mastery and associations with depressive and PTSD symptomatology among urban trauma-exposed women. Cultur Divers Ethnic Minor Psychol 2022; 28:513-522. [PMID: 34291970 PMCID: PMC9628780 DOI: 10.1037/cdp0000473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objective: Racial and ethnic minority women from low-resource urban communities experience disproportionately high rates of trauma exposure. Higher rates of lifetime trauma exposure are strongly associated with subsequent psychological sequela, specifically depression and posttraumatic stress disorder (PTSD). Communal mastery is the ability to cope with challenges and achieve goals by being closely interconnected with friends, family, and significant others. Yet, it is unknown if communal mastery is protective specifically against PTSD and depressive symptoms. Method: Participants (N = 131) were Black and Latina women (88.5% Black, mean monthly income: < $750) recruited from an urban outpatient obstetric-gynecological clinic at an academic medical center. Participants completed an online questionnaire that assessed trauma history, PTSD and depressive symptoms, types of individualistic coping, social support, and communal mastery. Results: Hierarchical multiple regression models demonstrated that communal mastery is uniquely associated with fewer PTSD symptoms (β = -.23, p = .003). More severe trauma history, more use of passive coping skills, and poorer social support were also significantly associated with PTSD symptoms, explaining over half of the variance in PTSD symptoms. Although significantly correlated, communal mastery was not uniquely associated with fewer depressive symptoms (β = -.13, p = .201). Conclusions: These findings suggest that connectedness as assessed through communal mastery serves as an important shield against the effects of traumatic stress for Black and Latina women. Future research would benefit by exploring interventions that aim to increase communal mastery in order to help highly trauma-exposed racial and ethnic minority women in low-resource environments. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Michelle L. Miller
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN
| | - Natalie R. Stevens
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Gina S. Lowell
- Department of Pediatrics, Rush University Medical Center, Chicago, IL
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15
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Lowe SR, James P, Arcaya MC, Vale MD, Rhodes JE, Rich-Edwards J, Roberts AL, Koenen KC. Do levels of posttraumatic growth vary by type of traumatic event experienced? An analysis of the Nurses' Health Study II. Psychol Trauma 2022; 14:1221-1229. [PMID: 32212776 PMCID: PMC7529660 DOI: 10.1037/tra0000554] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Posttraumatic growth (PTG) has been documented in the aftermath of a range of traumatic events, including bereavement, physical assault, and rape. However, only a handful of studies have examined whether levels of total PTG, as well as the 5 domains of PTG (Appreciation of Life, New Possibilities, Relating to Others, Personal Strength, and Spiritual Change), vary by the type of potentially traumatic event. The current study examined variation in total PTG and PTG domains, as well as posttraumatic stress (PTS), by event type using data from a large epidemiological study. METHOD Participants were from a substudy of the Nurses' Health Study 2, an epidemiologic study of female nurses in the United States (N = 1,574). RESULTS Controlling for demographic covariates, we found that rape was consistently associated with lower PTG, both total PTG and all five PTG domains, relative to other event types. Other findings were limited to specific PTG domains; for example, intimate partner violence (IPV) was associated with higher Personal Strength and New Possibilities. In contrast, rape and IPV were associated with higher PTS, and the serious illness or injury of someone close with lower PTS, relative to other event types. CONCLUSION These results add to the growing literature exploring variation in PTG by event type and suggest that different events could yield markedly different patterns of PTG domains and PTS. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Sarah R. Lowe
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
| | - Mariana C. Arcaya
- Department of Urban Studies and Planning, Massachusetts Institute of Technology, Boston, MA
| | - Mira D. Vale
- Department of Sociology, University of Michigan, Ann Arbor, MI
| | - Jean E. Rhodes
- Department of Psychology, University of Massachusetts Boston, Boston, MA
| | - Janet Rich-Edwards
- Division of Women’s Health, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
- Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Andrea L. Roberts
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA
| | - Karestan C. Koenen
- Department of Social Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA
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16
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Salomon RE, Waldrop JB, Baker M, Mandel MA, LaForett DR, Beeber LS. Integrating Maternal Depression Screening Into an Early Intervention Program: An Implementation Evaluation. J Am Psychiatr Nurses Assoc 2022; 28:355-365. [PMID: 35945819 PMCID: PMC9465503 DOI: 10.1177/10783903221116648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
BACKGROUND In all 50 states, early intervention (EI) services to improve long-term child cognitive and academic outcomes are provided to infants and toddlers with suspected or diagnosed developmental delays. When mothers of EI-enrolled children experience depressive symptoms, uptake of EI services can be compromised. AIMS The purpose of the article is to present a depressive symptom screening intervention for mothers consisting of toolkit development for EI staff and families, symptom screening for mothers and follow-up protocol. To formally evaluate the implementation of the intervention, our research team followed the consolidated framework for implementation research (CFIR). METHODS Participants were 12 EI service coordinators across two offices. Focus groups and individual interviews were used to develop the toolkit and education module. Through the five CFIR domains, we evaluated the implemented intervention in order to allow other teams to learn from our experiences. RESULTS Our team successfully partnered with SCs to develop the intended deliverables. Still, the SCs found it challenging to conduct the screenings and reported mixed success. CONCLUSIONS Preparation of EI SCs to integrate mental health screenings into their existing skillsets requires a high level of support from the research team, resulting in a rich understanding of the barriers-and potential rewards-for staff and families.
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Affiliation(s)
- Rebecca E Salomon
- Rebecca E. Salomon, PhD, RN, PMHNP-BC, Independent Researcher, Hillsborough, NC, USA
| | - Julee B Waldrop
- Julee B. Waldrop, DNP, PNP-BC, FNP-BC, CNE, FAANP, FAAN, Duke University, Durham, NC, USA
| | - Maureen Baker
- Maureen Baker, PhD, RN, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Marcia A Mandel
- Marcia A. Mandel, PhD, Independent researcher, Chapel Hill, NC, USA
| | - Doré R LaForett
- Doré R. LaForett, PhD, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Linda S Beeber
- Linda S. Beeber, PhD, PMHCNS-BC, FAAN, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Molewyk Doornbos M, Zandee GL, Greidanus A, Timmermans B, Miller K, Quist M, Heitsch E, Hammond E, Houskamp C, VanWolde A. Women Supporting Women: The Use of Art With Anxious/Depressed, Urban, Impoverished, Ethnically Diverse Women. J Am Psychiatr Nurses Assoc 2022; 28:271-282. [PMID: 35815659 DOI: 10.1177/10783903221104097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND: Depression and anxiety disproportionately affect urban, ethnically diverse, impoverished women-particularly when access to culturally sensitive care is limited. Using community-based participatory research in the context of long-term, academic/community partnerships, women supporting women, a supportive/educative group intervention piloting an art project, was offered. AIMS: The purpose of this study was to examine the impact of an artist book-making project on diverse women struggling with anxiety and depression. METHODS: A descriptive qualitative approach was used within this mixed-method study. Thirty-one participants, aged 18 to 86 years, were asked: (1) How does this book tell your story? (2) How did creating this book impact you personally? (3) How would you describe the experience of creating your book alongside women from our group? (4) How did this project help you with anxiety and depression? (5) What did you do with the book that you made? The framework method for analysis of qualitative data in multidisciplinary health research was used. RESULTS: Four themes, with corresponding subthemes, were identified: (1) personal story entailed expression of past, present, and future journey and mediums to depict the story; (2) method of coping included relaxation, diversion, and self-care; (3) creative impact encompassed affirmation of identity, empowerment, healing, pride in work, and a vehicle to connect; and (4) creating in community incorporated inspiration, sharing, and solidarity. CONCLUSIONS: These results suggest that an art project provides a culturally sensitive, clinically relevant, and cost-effective self-care intervention for vulnerable women struggling with anxiety and depression.
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Affiliation(s)
| | | | - Anna Greidanus
- Anna Greidanus, MFA, Calvin University, Grand Rapids, MI, USA
| | | | - Katherine Miller
- Katherine Miller, PhD, RN, University of Wyoming, Laramie, WY, USA
| | - Morgan Quist
- Morgan Quist, BSN, RN, Calvin University, Grand Rapids, MI, USA
| | - Emily Heitsch
- Emily Heitsch, BSN, RN, Calvin University, Grand Rapids, MI, USA
| | - Erica Hammond
- Erica Hammond, BSN, RN, Calvin University, Grand Rapids, MI, USA
| | - Christa Houskamp
- Christa Houskamp, BSN, RN, Calvin University, Grand Rapids, MI, USA
| | - Anna VanWolde
- Anna VanWolde, BSN, RN, Calvin University, Grand Rapids, MI, USA
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18
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Alvarez-Toro V. Gender-Specific Care for Women in Psychiatric Units. J Am Acad Psychiatry Law 2022:JAAPL.220015-21. [PMID: 35580911 DOI: 10.29158/jaapl.220015-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Structural inequalities in health care often result in female patients' not receiving care tailored to their needs. Women with mental illness in the peripartum period are no exception. Caan and colleagues delve into the benefits of breastfeeding in psychiatric units, highlighting the scarcity of appropriate resources due to the lack of mother-baby units in the United States. They also offer practical solutions and a legal analysis to address this problem. This commentary aims to broaden the scope of the article and emphasize how psychiatric care in the United States needs to address much more than lactation to provide gender-specific care. Elements of care to consider include types of treatment modalities offered, perinatal psychotropic choices, access to co-hospitalization options, lactation resources, and posthospitalization support. Pursuing a holistic and multi-disciplinary approach will allow psychiatric facilities in the United States to provide gender-appropriate care that will not only benefit women with mental health needs in the peripartum period, but also their infants and families as a whole.
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Affiliation(s)
- Viviana Alvarez-Toro
- Dr. Alvarez-Toro is Adult and Forensic Psychiatrist, Associate Director at The Forensic Psychiatry Fellowship Program, Saint Elizabeths Hospital, Washington, DC.
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Giron K, Noe S, Saiki L, Kuchler E, Rao S. Implementation of Postpartum Depression Screening for Women Participating in the WIC Program. J Am Psychiatr Nurses Assoc 2021; 27:443-449. [PMID: 34581225 DOI: 10.1177/10783903211047889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The national average for the occurrence of postpartum depression (PPD) is 11.5%. Women enrolled in the Women, Infants, and Children (WIC) program are at an elevated risk for PPD symptoms due to risk factors such as a low income, unemployment, low education level, and younger maternal age. AIM To implement screening for PPD symptoms using the Edinburgh Postnatal Depression Scale (EPDS) (1987) for women participating in the local WIC program with an infant <12 months old and compare results of positive screenings to the national average. The second goal was to provide community resources to those women with a positive score. METHODS Of 72 women screened, 69 scores were used in the comparison of the positive scores to the national Centers for Disease Control and Prevention average of 11.5%. Women were offered community resources after completion of the EPDS. RESULTS There were 13 positive scores out of the sample size of 69. The percentage of positive scores obtained from these data were 18.84% for the WIC population, which is higher than the national average of 11.5%. This was significant with p = .0494. One limitation of this project was a small sample size. CONCLUSION It would be beneficial for the WIC program to screen women for PPD symptoms in this high-risk population, so that recommendations for follow-up care could be made and quality of life could be increased.
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Affiliation(s)
- Kelli Giron
- Kelli Giron, DNP, RN, PMHNP-BC New Mexico State University, Las Cruces, NM, USA
| | - Shelly Noe
- Shelly Noe, DNP, RN, PMHNP-BC, New Mexico State University, Las Cruces, NM, USA
| | - Lori Saiki
- Lori Saiki, PhD, RN, New Mexico State University, Las Cruces, NM, USA
| | - Elizabeth Kuchler
- Elizabeth Kuchler, DNP, RN, FNP-BC, New Mexico State University, Las Cruces, NM, USA
| | - Satyapriya Rao
- Satyapriya Rao, PhD, New Mexico State University, Las Cruces, NM, USA
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Abstract
The mental health of women living in poverty is a growing public health concern, particularly in India where the burden of illness is compounded by critical shortages in mental health providers and fragmented services. This was an exploratory study which sought to examine low-income women's perceptions of mental illness and its management in the context of urban poverty in India. This research was prompted by the lack of empirical studies documenting how women in marginalized sections of society understand mental illness. Data were collected through a combination of 10 focus group discussions and two individual interviews with a total of 63 women residing in low-income areas of Mumbai. Social representations theory was used to explore shared meanings of mental illness among women in this setting. Thematic analysis of the data showed that women use the expression "tension" to talk about mental illness. Tension was described both as an ordinary part of life and a condition having its origins in more profound gender-related stressors, particularly pressures surrounding motherhood, chronic poverty and domestic conflict. Approaches to managing tension were pluralistic and focused on the resumption of social roles. Findings are consistent with other studies in similar cultural contexts, suggesting a shared, transnational character to women's distress and the need for scholarship on women's mental health in low-income settings to be more attuned to gendered forms of marginalization.
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Affiliation(s)
- Saloni Atal
- Primary Care Unit, Institute of Public Health, University of Cambridge
| | - Juliet Foster
- Institute of Psychiatry, Psychology and Neuroscience, King's College London
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21
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Delanerolle G, Ramakrishnan R, Hapangama D, Zeng Y, Shetty A, Elneil S, Chong S, Hirsch M, Oyewole M, Phiri P, Elliot K, Kothari T, Rogers B, Sandle N, Haque N, Pluchino N, Silem M, O'Hara R, Hull ML, Majumder K, Shi JQ, Raymont V. A systematic review and meta-analysis of the Endometriosis and Mental-Health Sequelae; The ELEMI Project. ACTA ACUST UNITED AC 2021; 17:17455065211019717. [PMID: 34053382 PMCID: PMC8182632 DOI: 10.1177/17455065211019717] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background: It is important to evaluate sequalae for complex chronic health conditions such as endometriosis and mental health disorders. Endometriosis impacts 1 in 10 women. Mental health outcomes can be a primary determinant in many physical health conditions although this is an area not well researched particularly in women’s health. This has been problematic for endometriosis patients in particular, who report mental health issues as well as other key comorbidities such as chronic pelvic pain and infertility. This could be partly due to the complexities associated with comprehensively exploring overlaps between physical and mental health disorders in the presence of multiple comorbidities and their potential mechanistic relationship. Methods: In this evidence synthesis, a systematic methodology and mixed-methods approaches were used to synthesize both qualitative and quantitative data to examine the prevalence of the overlapping sequalae between endometriosis and psychiatric symptoms and disorders. As part of this, an evidence synthesis protocol was developed which included a systematic review protocol that was published on PROSPERO (CRD42020181495). The aim was to identify and evaluate mental health reported outcomes and prevalence of symptoms and psychiatric disorders associated with endometriosis. Findings: A total of 34 papers were included in the systematic review and 15 were included in the meta-analysis. Anxiety and depression symptoms were the most commonly reported mental health outcomes while a pooled analysis also revealed high prevalence of chronic pelvic pain and dyspareunia. Interpretation: It is evident that small-scale cross-sectional studies have been conducted in a variety of settings to determine mental health outcomes among endometriosis patients. Further research is required to comprehensively evaluate the mental health sequalae with endometriosis.
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Affiliation(s)
| | - Rema Ramakrishnan
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
| | - Dharani Hapangama
- University of Liverpool, Liverpool, UK.,Liverpool Women's NHS Foundation, Liverpool, UK
| | - Yutian Zeng
- Southern University of Science and Technology, Shenzhen, China
| | - Ashish Shetty
- University College London Hospitals NHS Foundation Trust, London, UK.,University College London, London, UK
| | - Sohier Elneil
- University College London Hospitals NHS Foundation Trust, London, UK.,University College London, London, UK
| | - Sam Chong
- University College London Hospitals NHS Foundation Trust, London, UK.,University College London, London, UK
| | - Martin Hirsch
- University College London Hospitals NHS Foundation Trust, London, UK.,Oxford Health NHS Foundation Trust, Oxford, UK
| | - Molola Oyewole
- University College London Hospitals NHS Foundation Trust, London, UK.,University College London, London, UK
| | - Peter Phiri
- Southern Health NHS Foundation Trust, Southampton, UK.,School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | | | | | - Bryony Rogers
- University of Liverpool, Liverpool, UK.,Liverpool Women's NHS Foundation, Liverpool, UK
| | - Natasha Sandle
- Oxford Brain Health Clinical Trials Unit, University of Oxford, Oxford, UK
| | - Nyla Haque
- Oxford Brain Health Clinical Trials Unit, University of Oxford, Oxford, UK
| | - Nicola Pluchino
- Divisions of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Martin Silem
- University Medical Center Freiburg, Freiburg, Germany
| | - Rebecca O'Hara
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | - M Louise Hull
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | | | - Jian Qing Shi
- Southern University of Science and Technology, Shenzhen, China.,The Alan Turing Institute, London, UK
| | - Vanessa Raymont
- Oxford Brain Health Clinical Trials Unit, University of Oxford, Oxford, UK.,Department of Psychiatry, University of Oxford, Oxford, UK
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22
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Accoto A, Chiarella SG, Raffone A, Montano A, de Marco A, Mainiero F, Rubbino R, Valzania A, Conversi D. Beneficial Effects of Mindfulness-Based Stress Reduction Training on the Well-Being of a Female Sample during the First Total Lockdown Due to COVID-19 Pandemic in Italy. Int J Environ Res Public Health 2021; 18:5512. [PMID: 34063864 PMCID: PMC8196575 DOI: 10.3390/ijerph18115512] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/13/2021] [Accepted: 05/18/2021] [Indexed: 12/16/2022]
Abstract
The global pandemic caused by COVID-19 and the subsequent lockdown have been widely recognized as traumatic events that pose threats to psychological well-being. Recent studies reported that during such traumatic events, women tend to be at greater risk than men for developing symptoms of stress, anxiety, and depression. Several studies reported that a mindfulness-based stress reduction protocol (MBSR) provides useful skills for dealing with traumatic events. In our study, a sample of Italian females received an 8-week MBSR course plus 6 weeks of video support for meditation practice during the first total lockdown in Italy. We assessed the participants with questionnaires before and after this period to investigate their mindfulness skills, psychological well-being, post-traumatic growth, and psychological flexibility. After the intervention, the meditators group reported improvement in measures associated with self-acceptance, purpose in life, and relation to others compared to the control group. Furthermore, our results showed that participants with greater mindfulness scores showed high levels of psychological flexibility, which in turn was positively associated with higher levels of psychological well-being. We concluded that the MBSR could support psychological well-being, at least in female subjects, even during an unpredictable adverse event, such as the COVID-19 lockdown, by reinforcing key psychological aspects.
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Affiliation(s)
- Alessandra Accoto
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (A.A.); (S.G.C.); (A.R.); (A.d.M.); (F.M.)
| | - Salvatore Gaetano Chiarella
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (A.A.); (S.G.C.); (A.R.); (A.d.M.); (F.M.)
| | - Antonino Raffone
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (A.A.); (S.G.C.); (A.R.); (A.d.M.); (F.M.)
- School of Buddhist Studies, Philosophy and Comparative Religions, Nalanda University, Rajgir 803116, India
| | | | - Adriano de Marco
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (A.A.); (S.G.C.); (A.R.); (A.d.M.); (F.M.)
| | - Francesco Mainiero
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (A.A.); (S.G.C.); (A.R.); (A.d.M.); (F.M.)
| | - Roberta Rubbino
- A.T. Beck Institute, 00185 Rome, Italy; (A.M.); (R.R.); (A.V.)
| | | | - David Conversi
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (A.A.); (S.G.C.); (A.R.); (A.d.M.); (F.M.)
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23
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Serati M, Grassi S, Redaelli M, Pergoli L, Cantone L, La Vecchia A, Barkin JL, Colombo E, Tiso G, Abbiati C, Bollati V, Buoli M. Is There an Association Between Oxytocin Levels in Plasma and Pregnant Women's Mental Health? J Am Psychiatr Nurses Assoc 2021; 27:222-230. [PMID: 31782341 DOI: 10.1177/1078390319890400] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND: Mood and anxiety disorders are prevalent in women during peripartum. AIMS: Purpose of the present article was to study the relationship between oxytocin (OT) plasma levels and affective symptoms in women during the third trimester of pregnancy. METHODS: Thirty-four pregnant women (13 with an affective disorder, 9 with preeclampsia, and 12 controls) were evaluated through the Edinburgh Postnatal Depression Scale (EPDS), the State/Trait Anxiety Inventory Form Y (STAI-Y), and the Prenatal Attachment Inventory (PAI). A blood sample was collected from all participants, and OT plasma levels have been compared between diagnostic groups. The total sample has been divided into two groups, according to OT median plasma levels, and compared using (a) χ2 tests for qualitative variables and (b) a multivariate analysis of covariance for quantitative ones. RESULTS: No statistically significant difference was found among the diagnostic groups in terms of OT plasma levels (F = 0.49, p = .62). Women with lower OT plasma levels, independent from the presence of preeclampsia or an affective disorder, showed worse EPDS and STAI-S total scores than individuals with higher hormone levels (F = 5.93, p = .02 and F = 7.57, p = .01, respectively). CONCLUSIONS: OT may play a role in the etiology of anxious/depressive symptoms during perinatal period independent from a medical or psychiatric diagnosis. This result has a clear effect on the quality of the relationship of patients with mental health professionals, including nurses, and higher levels of this hormone, in the light of its anxiolytic and antidepressive effect, may make easier medical and nursing procedures.
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Affiliation(s)
- Marta Serati
- Marta Serati, MD, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvia Grassi
- Silvia Grassi, MD, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marta Redaelli
- Marta Redaelli, PsyD, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Pergoli
- Laura Pergoli, ScD, University of Milan, Milan, Italy
| | - Laura Cantone
- Laura Cantone, ScD, University of Milan, Milan, Italy
| | - Adriano La Vecchia
- Adriano La Vecchia, MD, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Jennifer L Barkin
- Jennifer L. Barkin, PhD, Mercer University School of Medicine, Macon, GA, USA
| | - Elisa Colombo
- Elisa Maria Colombo, MD, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giulia Tiso
- Giulia Tiso, MD, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Cristina Abbiati
- Cristina Abbiati, PMHCNS, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Massimiliano Buoli
- Massimiliano Buoli, MD, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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24
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Wierzbicka A, Mańkowska-Wierzbicka D, Cieślewicz S, Stelmach-Mardas M, Mardas M. Interventions Preventing Vaginitis, Vaginal Atrophy after Brachytherapy or Radiotherapy Due to Malignant Tumors of the Female Reproductive Organs-A Systematic Review. Int J Environ Res Public Health 2021; 18:3932. [PMID: 33918070 PMCID: PMC8070443 DOI: 10.3390/ijerph18083932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 04/02/2021] [Accepted: 04/07/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Radiotherapy, as a method of treatment of cervical and uterine cancers, may induce severe late-onset vaginal side effects. Unfortunately, little evidence on the management of adverse effects has been presented. This study aimed to evaluate the available interventions which reduce symptoms of vaginitis and vaginal atrophy by improving dyspareunia, mucosal inflammation, vaginal pH and vaginal dryness in women who have undergone brachytherapy or radiotherapy due to uterine or cervical malignancies. MATERIALS AND METHODS A comprehensive literature search was performed following PRISMA guidelines. The systematic search was conducted using electronic databases, namely Scopus, Web of Science and PubMed, between October and November 2020 to identify randomized controlled trials (RCT) and, prospective randomized studies (PRS). RESULTS The analyzed population consists of 376 patients with uterine or cervical cancer, treated with hyaluronic acid, vitamin A, vitamin E, alpha-tocopherol acetate and dienestrol. Intervention with HA along with vitamin A and vitamin E revealed advantage in endpoints such as reduced dyspareunia, vaginal mucosal inflammation, vaginal dryness, bleeding, fibrosis and cellular atypia. Administration of alpha-tocopherol acetate reduced vaginal mucosal inflammation and improved vaginal acanthosis, whereas dienestrol resulted in reduced dyspareunia, vaginal caliber and bleeding. CONCLUSIONS Vaginal suppositories were found to be clinically effective at the management of late-onset vulvovaginal side effects after radiotherapy.
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Affiliation(s)
- Adrianna Wierzbicka
- Department of Obesity Treatment, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Science, Szamarzewskiego 84 St, 60-569 Poznan, Poland
| | - Dorota Mańkowska-Wierzbicka
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Heliodor Święcicki Hospital, Przybyszewskiego 49, 60-355 Poznań, Poland
| | - Stanisław Cieślewicz
- Department of Oncology, Poznan University of Medical Science, Szamarzewskiego 82/84 St, 60-569 Poznan, Poland
| | - Marta Stelmach-Mardas
- Department of Obesity Treatment, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Science, Szamarzewskiego 84 St, 60-569 Poznan, Poland
| | - Marcin Mardas
- Department of Oncology, Poznan University of Medical Science, Szamarzewskiego 82/84 St, 60-569 Poznan, Poland
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25
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Edinoff AN, Silverblatt NS, Vervaeke HE, Horton CC, Girma E, Kaye AD, Kaye A, Kaye JS, Garcia AJ, Neuchat EE, Eubanks TN, Varrassi G, Viswanath O, Urits I. Hyperprolactinemia, Clinical Considerations, and Infertility in Women on Antipsychotic Medications. Psychopharmacol Bull 2021; 51:131-148. [PMID: 34092827 PMCID: PMC8146565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Infertility, the inability to establish a clinical pregnancy after 12 months of regular unprotected sexual intercourse, is caused by a wide variety of both male and female factors. Infertility is estimated to affect between 8-12% of couples trying to conceive globally. Female factor infertility can be subdivided into the following broad categories: ovulatory dysfunction, fallopian tubal disease, uterine causes, and oocyte quality. Hyperprolactinemia causes ovulary dysfunction along with other hormonal abnormalities, such as decreased estrogen, which can lead to infertility. In this regard, antipsychotics are commonly used for both schizophrenia and bipolar disorder. The use of these medications can be associated with hyperprolactinemia and hyperprolactinemia associated infertility. Antipsychotic-induced hyperprolactinemia occurs through blockade of D2 receptors on lactotroph cells of the anterior pituitary gland. Discontinuation of the hyperprolactinemia-inducing antipsychotic is an option, but this may worsen the patient's psychosis or mood. If antipsychotics are determined to be the culprit of infertility, the degree of hyperprolactinemia symptoms, length of treatment with the antipsychotic, and risk of relapse should be assessed prior to discontinuation, reduction, or switching of antipsychotic medications. The treatment of a women's mental health and her desire to have children should always be considered as treatment may influence fertility while on the medication.
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Affiliation(s)
- Amber N Edinoff
- Amber N. Edinoff, Nancy S. Silverblatt, Eden Girma, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Hayley E. Vervaeke, Cassidy C, Horton, Louisiana State University Shreveport School of Medicine. Alan D. Kaye, Treniece N. Eubanks, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Adam Kaye, Jessica S. Kaye, Andrew J. Garcia, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Elisa E. Neuchat, Department of Biological Sciences, Florida International University, Miami, FL. Giustino Varrassi, Paolo Procacci Foundation, Via Tacito 7, Roma, Italy. Omar Viswanath, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; University of Arizona College of Medicine-Phoenix, Phoenix, AZ; Valley Anesthesiology and Pain Consultants - Envision Physician Services, Phoenix, AZ. Ivan Urits, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
| | - Nancy S Silverblatt
- Amber N. Edinoff, Nancy S. Silverblatt, Eden Girma, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Hayley E. Vervaeke, Cassidy C, Horton, Louisiana State University Shreveport School of Medicine. Alan D. Kaye, Treniece N. Eubanks, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Adam Kaye, Jessica S. Kaye, Andrew J. Garcia, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Elisa E. Neuchat, Department of Biological Sciences, Florida International University, Miami, FL. Giustino Varrassi, Paolo Procacci Foundation, Via Tacito 7, Roma, Italy. Omar Viswanath, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; University of Arizona College of Medicine-Phoenix, Phoenix, AZ; Valley Anesthesiology and Pain Consultants - Envision Physician Services, Phoenix, AZ. Ivan Urits, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
| | - Hayley E Vervaeke
- Amber N. Edinoff, Nancy S. Silverblatt, Eden Girma, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Hayley E. Vervaeke, Cassidy C, Horton, Louisiana State University Shreveport School of Medicine. Alan D. Kaye, Treniece N. Eubanks, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Adam Kaye, Jessica S. Kaye, Andrew J. Garcia, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Elisa E. Neuchat, Department of Biological Sciences, Florida International University, Miami, FL. Giustino Varrassi, Paolo Procacci Foundation, Via Tacito 7, Roma, Italy. Omar Viswanath, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; University of Arizona College of Medicine-Phoenix, Phoenix, AZ; Valley Anesthesiology and Pain Consultants - Envision Physician Services, Phoenix, AZ. Ivan Urits, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
| | - Cassidy C Horton
- Amber N. Edinoff, Nancy S. Silverblatt, Eden Girma, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Hayley E. Vervaeke, Cassidy C, Horton, Louisiana State University Shreveport School of Medicine. Alan D. Kaye, Treniece N. Eubanks, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Adam Kaye, Jessica S. Kaye, Andrew J. Garcia, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Elisa E. Neuchat, Department of Biological Sciences, Florida International University, Miami, FL. Giustino Varrassi, Paolo Procacci Foundation, Via Tacito 7, Roma, Italy. Omar Viswanath, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; University of Arizona College of Medicine-Phoenix, Phoenix, AZ; Valley Anesthesiology and Pain Consultants - Envision Physician Services, Phoenix, AZ. Ivan Urits, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
| | - Eden Girma
- Amber N. Edinoff, Nancy S. Silverblatt, Eden Girma, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Hayley E. Vervaeke, Cassidy C, Horton, Louisiana State University Shreveport School of Medicine. Alan D. Kaye, Treniece N. Eubanks, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Adam Kaye, Jessica S. Kaye, Andrew J. Garcia, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Elisa E. Neuchat, Department of Biological Sciences, Florida International University, Miami, FL. Giustino Varrassi, Paolo Procacci Foundation, Via Tacito 7, Roma, Italy. Omar Viswanath, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; University of Arizona College of Medicine-Phoenix, Phoenix, AZ; Valley Anesthesiology and Pain Consultants - Envision Physician Services, Phoenix, AZ. Ivan Urits, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
| | - Alan D Kaye
- Amber N. Edinoff, Nancy S. Silverblatt, Eden Girma, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Hayley E. Vervaeke, Cassidy C, Horton, Louisiana State University Shreveport School of Medicine. Alan D. Kaye, Treniece N. Eubanks, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Adam Kaye, Jessica S. Kaye, Andrew J. Garcia, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Elisa E. Neuchat, Department of Biological Sciences, Florida International University, Miami, FL. Giustino Varrassi, Paolo Procacci Foundation, Via Tacito 7, Roma, Italy. Omar Viswanath, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; University of Arizona College of Medicine-Phoenix, Phoenix, AZ; Valley Anesthesiology and Pain Consultants - Envision Physician Services, Phoenix, AZ. Ivan Urits, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
| | - Adam Kaye
- Amber N. Edinoff, Nancy S. Silverblatt, Eden Girma, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Hayley E. Vervaeke, Cassidy C, Horton, Louisiana State University Shreveport School of Medicine. Alan D. Kaye, Treniece N. Eubanks, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Adam Kaye, Jessica S. Kaye, Andrew J. Garcia, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Elisa E. Neuchat, Department of Biological Sciences, Florida International University, Miami, FL. Giustino Varrassi, Paolo Procacci Foundation, Via Tacito 7, Roma, Italy. Omar Viswanath, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; University of Arizona College of Medicine-Phoenix, Phoenix, AZ; Valley Anesthesiology and Pain Consultants - Envision Physician Services, Phoenix, AZ. Ivan Urits, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
| | - Jessica S Kaye
- Amber N. Edinoff, Nancy S. Silverblatt, Eden Girma, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Hayley E. Vervaeke, Cassidy C, Horton, Louisiana State University Shreveport School of Medicine. Alan D. Kaye, Treniece N. Eubanks, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Adam Kaye, Jessica S. Kaye, Andrew J. Garcia, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Elisa E. Neuchat, Department of Biological Sciences, Florida International University, Miami, FL. Giustino Varrassi, Paolo Procacci Foundation, Via Tacito 7, Roma, Italy. Omar Viswanath, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; University of Arizona College of Medicine-Phoenix, Phoenix, AZ; Valley Anesthesiology and Pain Consultants - Envision Physician Services, Phoenix, AZ. Ivan Urits, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
| | - Andrew J Garcia
- Amber N. Edinoff, Nancy S. Silverblatt, Eden Girma, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Hayley E. Vervaeke, Cassidy C, Horton, Louisiana State University Shreveport School of Medicine. Alan D. Kaye, Treniece N. Eubanks, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Adam Kaye, Jessica S. Kaye, Andrew J. Garcia, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Elisa E. Neuchat, Department of Biological Sciences, Florida International University, Miami, FL. Giustino Varrassi, Paolo Procacci Foundation, Via Tacito 7, Roma, Italy. Omar Viswanath, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; University of Arizona College of Medicine-Phoenix, Phoenix, AZ; Valley Anesthesiology and Pain Consultants - Envision Physician Services, Phoenix, AZ. Ivan Urits, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
| | - Elisa E Neuchat
- Amber N. Edinoff, Nancy S. Silverblatt, Eden Girma, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Hayley E. Vervaeke, Cassidy C, Horton, Louisiana State University Shreveport School of Medicine. Alan D. Kaye, Treniece N. Eubanks, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Adam Kaye, Jessica S. Kaye, Andrew J. Garcia, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Elisa E. Neuchat, Department of Biological Sciences, Florida International University, Miami, FL. Giustino Varrassi, Paolo Procacci Foundation, Via Tacito 7, Roma, Italy. Omar Viswanath, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; University of Arizona College of Medicine-Phoenix, Phoenix, AZ; Valley Anesthesiology and Pain Consultants - Envision Physician Services, Phoenix, AZ. Ivan Urits, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
| | - Treniece N Eubanks
- Amber N. Edinoff, Nancy S. Silverblatt, Eden Girma, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Hayley E. Vervaeke, Cassidy C, Horton, Louisiana State University Shreveport School of Medicine. Alan D. Kaye, Treniece N. Eubanks, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Adam Kaye, Jessica S. Kaye, Andrew J. Garcia, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Elisa E. Neuchat, Department of Biological Sciences, Florida International University, Miami, FL. Giustino Varrassi, Paolo Procacci Foundation, Via Tacito 7, Roma, Italy. Omar Viswanath, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; University of Arizona College of Medicine-Phoenix, Phoenix, AZ; Valley Anesthesiology and Pain Consultants - Envision Physician Services, Phoenix, AZ. Ivan Urits, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
| | - Giustino Varrassi
- Amber N. Edinoff, Nancy S. Silverblatt, Eden Girma, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Hayley E. Vervaeke, Cassidy C, Horton, Louisiana State University Shreveport School of Medicine. Alan D. Kaye, Treniece N. Eubanks, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Adam Kaye, Jessica S. Kaye, Andrew J. Garcia, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Elisa E. Neuchat, Department of Biological Sciences, Florida International University, Miami, FL. Giustino Varrassi, Paolo Procacci Foundation, Via Tacito 7, Roma, Italy. Omar Viswanath, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; University of Arizona College of Medicine-Phoenix, Phoenix, AZ; Valley Anesthesiology and Pain Consultants - Envision Physician Services, Phoenix, AZ. Ivan Urits, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
| | - Omar Viswanath
- Amber N. Edinoff, Nancy S. Silverblatt, Eden Girma, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Hayley E. Vervaeke, Cassidy C, Horton, Louisiana State University Shreveport School of Medicine. Alan D. Kaye, Treniece N. Eubanks, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Adam Kaye, Jessica S. Kaye, Andrew J. Garcia, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Elisa E. Neuchat, Department of Biological Sciences, Florida International University, Miami, FL. Giustino Varrassi, Paolo Procacci Foundation, Via Tacito 7, Roma, Italy. Omar Viswanath, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; University of Arizona College of Medicine-Phoenix, Phoenix, AZ; Valley Anesthesiology and Pain Consultants - Envision Physician Services, Phoenix, AZ. Ivan Urits, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
| | - Ivan Urits
- Amber N. Edinoff, Nancy S. Silverblatt, Eden Girma, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Hayley E. Vervaeke, Cassidy C, Horton, Louisiana State University Shreveport School of Medicine. Alan D. Kaye, Treniece N. Eubanks, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Adam Kaye, Jessica S. Kaye, Andrew J. Garcia, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Elisa E. Neuchat, Department of Biological Sciences, Florida International University, Miami, FL. Giustino Varrassi, Paolo Procacci Foundation, Via Tacito 7, Roma, Italy. Omar Viswanath, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; University of Arizona College of Medicine-Phoenix, Phoenix, AZ; Valley Anesthesiology and Pain Consultants - Envision Physician Services, Phoenix, AZ. Ivan Urits, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
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Abstract
Despite significant biological, psychological, and social challenges in the perimenopause, most women report an overall positive well-being and appear to be resilient to potentially negative effects of this life phase. The objective of this study was to detect psychosocial variables which contribute to resilience in a sample of perimenopausal women. A total of 135 healthy perimenopausal women aged 40-56 years completed a battery of validated psychosocial questionnaires including variables related to resilience, well-being, and mental health. First, using exploratory factor analysis, we examined which of the assessed variables related to resilience can be assigned to a common factor. Second, linear regression analyses were performed to investigate whether a common resilience factor predicts well-being and mental health in the examined sample of women. Optimism (LOT-R-O), emotional stability (BFI-K-N), emotion regulation (ERQ), self-compassion (SCS-D), and self-esteem (RSES) in perimenopausal women can be allocated to a single resilience-associated factor. Regression analyses revealed that this factor is related to higher life satisfaction (SWLS; β = .39, p < .001, adj. R2 = .20), lower perceived stress (PSS-10; β = - .55, p < .001, adj. R2 = .30), lower psychological distress (BSI-18; β = - .49, p < .001, adj. R2 = .22), better general psychological health (GHQ-12; β = - .49, p < .001, adj. R2 = .22), milder menopausal complaints (MRS II; β = - .41, p < .001, adj. R2 = .18), and lower depressive symptoms (ADS-L; β = - .32, p < .001, adj. R2 = .26). The α levels were adjusted for multiple testing. Our findings confirm that several psychosocial variables (optimism, emotional stability, emotion regulation, self-compassion, and self-esteem) can be allocated to one common resilience-associated factor. This resilience factor is strongly related to women's well-being as well as mental health in perimenopause.
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Affiliation(s)
- Hannah Süss
- Clinical Psychology and Psychotherapy, University of Zurich, Binzmühlestrasse 14, 8050 Zurich, Switzerland ,URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Jasmine Willi
- Clinical Psychology and Psychotherapy, University of Zurich, Binzmühlestrasse 14, 8050 Zurich, Switzerland ,URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Jessica Grub
- Clinical Psychology and Psychotherapy, University of Zurich, Binzmühlestrasse 14, 8050 Zurich, Switzerland ,URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Binzmühlestrasse 14, 8050, Zurich, Switzerland. .,URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland.
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Burns CJ, Saint Arnault DM. Silently Screaming in the Dark: Gender-Based Dynamics of Distress in Japanese Migrants. Issues Ment Health Nurs 2021; 42:38-45. [PMID: 32644835 PMCID: PMC8969672 DOI: 10.1080/01612840.2020.1779882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Prior literature has shown the female Japanese population experiences higher susceptibility to mental health disorders. The causal influences of help-seeking for distressed women were investigated through analysis of 24 interviews of Japanese immigrant women in the Detroit Metropolitan Area. The Clinical Ethnographic Narrative Interview (CENI) was utilized as the interviewing technique, investigating Japanese culture as a determinant of personal wellness. This study was a grounded theory examination of the interactions among gender, social context, cultural displacement, and a causal model for Japanese women's distress experiences. The resulting theoretical model revealed the familial and social dynamics traditional to Japanese culture developed feelings of poor self-worth common amongst study participants. This negative perception of self was exacerbated by gendered challenges of expatriation and intense pressures within this region's Japanese migrant community. These findings show the need for increased contact with at-risk populations to understand their causal models and help-seeking behaviors and expectations.
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Islam MJ, Broidy L, Mazerolle P, Baird K, Mazumder N, Zobair KM. Do Maternal Depression and Self-Esteem Moderate and Mediate the Association Between Intimate Partner Violence After Childbirth and Postpartum Suicidal Ideation? Arch Suicide Res 2020; 24:609-632. [PMID: 31462186 DOI: 10.1080/13811118.2019.1655507] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Intimate partner violence (IPV) during the perinatal period is believed to have an adverse effect on maternal mental health. Given the risks of suicide and related public health concerns, the aim of this study is to examine (1) the association of experiencing physical, psychological, and sexual IPV after childbirth on postpartum suicidal ideation (SI), and (2) whether postpartum depression and self-esteem act to mediate or moderate the relationship between IPV and postpartum SI. A cross-sectional survey was conducted from October 2015 to January 2016 in the Chandpur District of Bangladesh among 426 new mothers, aged 15 to 49 years, who were in the first 6 months postpartum. Multivariate logistic regression models were used to examine the association between experiencing IPV and postpartum SI, controlling for a range of other known influences. The prevalence of postpartum SI was 30.8%. Accounting the influence of other confounders, the odds of postpartum SI were significantly higher among women who reported physical IPV victimization (adjusted odds ratio: 2.65; 95% confidence interval = 1.36, 5.18) at any point during the first 6 months following childbirth as opposed to those who did not. In addition, postpartum depression increased postpartum SI, while high self-esteem significantly reduced reports of SI. Both postpartum depression and maternal self-esteem notably mediate and moderate the effect of physical IPV after childbirth on postpartum SI. The findings illuminate that IPV victimization after childbirth significantly increases the odds of postpartum SI. This study reinforces the need to detect women with a history of IPV who may be at risk for SI, not only to offer them help and support but also to prevent or reduce SI.
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Matiz A, Fabbro F, Paschetto A, Cantone D, Paolone AR, Crescentini C. Positive Impact of Mindfulness Meditation on Mental Health of Female Teachers during the COVID-19 Outbreak in Italy. Int J Environ Res Public Health 2020; 17:E6450. [PMID: 32899739 PMCID: PMC7559290 DOI: 10.3390/ijerph17186450] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/26/2020] [Accepted: 09/02/2020] [Indexed: 12/13/2022]
Abstract
The Covid-19 pandemic and subsequent public health measures were shown to impact negatively on people's mental health. In particular, women were reported to be at higher risk than men of developing symptoms of stress/anxiety/depression, and resilience was considered a key factor for positive mental health outcomes. In the present study, a sample of Italian female teachers (n = 66, age: 51.5 ± 7.9 years) was assessed with self-report instruments one month before and one month after the start of the Covid-19 lockdown: mindfulness skills, empathy, personality profiles, interoceptive awareness, psychological well-being, emotional distress and burnout levels were measured. Meanwhile, they received an 8-week Mindfulness-Oriented Meditation (MOM) course, through two group meetings and six individual video-lessons. Based on baseline personality profiles, analyses of variance were performed in a low-resilience (LR, n = 32) and a high-resilience (HR, n = 26) group. The LR and HR groups differed at baseline in most of the self-report measures. Pre-post MOM significant improvements were found in both groups in anxiety, depression, affective empathy, emotional exhaustion, psychological well-being, interoceptive awareness, character traits and mindfulness levels. Improvements in depression and psychological well-being were higher in the LR vs. HR group. We conclude that mindfulness-based training can effectively mitigate the psychological negative consequences of the Covid-19 outbreak, helping in particular to restore well-being in the most vulnerable individuals.
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Affiliation(s)
- Alessio Matiz
- Department of Languages and Literatures, Communication, Education and Society, University of Udine, 33100 Udine, Italy; (F.F.); (A.P.); (A.R.P.); (C.C.)
| | - Franco Fabbro
- Department of Languages and Literatures, Communication, Education and Society, University of Udine, 33100 Udine, Italy; (F.F.); (A.P.); (A.R.P.); (C.C.)
- Perceptual Robotics (PERCRO) Laboratory Scuola Superiore Sant’Anna, 56010 Pisa, Italy
| | - Andrea Paschetto
- Department of Languages and Literatures, Communication, Education and Society, University of Udine, 33100 Udine, Italy; (F.F.); (A.P.); (A.R.P.); (C.C.)
| | - Damiano Cantone
- Department of Psychology, University of Rome La Sapienza, 00185 Rome, Italy;
| | - Anselmo Roberto Paolone
- Department of Languages and Literatures, Communication, Education and Society, University of Udine, 33100 Udine, Italy; (F.F.); (A.P.); (A.R.P.); (C.C.)
| | - Cristiano Crescentini
- Department of Languages and Literatures, Communication, Education and Society, University of Udine, 33100 Udine, Italy; (F.F.); (A.P.); (A.R.P.); (C.C.)
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30
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Miller ML, O’Hara MW. Obsessive-compulsive symptoms, intrusive thoughts and depressive symptoms: a longitudinal study examining relation to maternal responsiveness. J Reprod Infant Psychol 2020; 38:226-242. [PMID: 31431052 PMCID: PMC7031018 DOI: 10.1080/02646838.2019.1652255] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 07/30/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND The postpartum period is a vulnerable time for the development of depression. While perinatal depression has been well studied, intrusive thoughts related to the infant and classic obsessive-compulsive (OC) symptoms (e.g. chequering, ordering and cleaning) are also common in the postpartum and less well understood. OBJECTIVE The present study investigated the associations among depressive symptoms, intrusive thoughts, and OC symptoms and their relation to the quality of the mother-infant relationship, particularly in the realm of maternal responsiveness. METHODS Participants (N = 228) were recruited after delivery from a large Midwestern academic medical centre. At 2 and 12-week postpartum, participants completed self-report questionnaires that assessed demographics, depressive and OC symptoms, postpartum-specific intrusive thoughts and accompanying neutralising strategies, and maternal responsiveness. RESULTS At 12-week postpartum, maternal responsiveness was significantly lower for participants that endorsed intrusive thoughts, neutralising strategies or OC symptoms of clinical significance. More severe intrusive thoughts and neutralising strategies were associated with maternal responsiveness but not predictive after accounting for depressive symptoms; depressive symptoms were associated with lower levels of maternal responsiveness across the postpartum. CONCLUSIONS A sizable number of postpartum women experience clinically significant postpartum-specific intrusive thoughts and utilise neutralising strategies, especially in the context of postpartum depressive symptoms. Depressive symptoms have the most influence on maternal responsiveness but it is also important to target intrusive thoughts and OC symptoms in the context of postpartum depression to promote the welfare of new mothers and their offspring.
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Affiliation(s)
- Michelle L. Miller
- Department of Psychological and Brain Sciences, W311 Seashore Hall, University of Iowa, Iowa City, IA, 52242, USA
| | - Michael W. O’Hara
- Department of Psychological and Brain Sciences, W311 Seashore Hall, University of Iowa, Iowa City, IA, 52242, USA
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31
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Schoretsanitis G, Spigset O, Stingl JC, Deligiannidis KM, Paulzen M, Westin AA. The impact of pregnancy on the pharmacokinetics of antidepressants: a systematic critical review and meta-analysis. Expert Opin Drug Metab Toxicol 2020; 16:431-440. [PMID: 32238008 DOI: 10.1080/17425255.2020.1750598] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Introduction: Pregnancy-related physiological changes exert a crucial impact on the pharmacokinetics of antidepressants; however, the current evidence presents inconsistencies. A clearer understanding of pregnancy-related effects on antidepressant disposition may facilitate the development of guidelines for appropriate dose adjustments during the course of pregnancy based on therapeutic drug monitoring.Areas covered: We systematically reviewed studies comparing antidepressant levels in the same individuals during pregnant and non-pregnant states. Using dose-adjusted plasma concentration measurements, we estimated alteration ratios between the 3rd trimester and baseline (before or after pregnancy). Additionally, we performed a meta-analysis for changes in dose-adjusted concentrations to estimate mean differences.Expert opinion: Data for several antidepressants display clear alteration patterns during pregnancy. On the basis of the alteration ratios trimipramine, fluvoxamine, and nortriptyline show a prominent decrease in dose-adjusted levels, especially in the 3rd trimester. Clomipramine, imipramine, citalopram, and paroxetine show smaller decreases in dose-adjusted concentrations in the third trimester. For escitalopram, venlafaxine and fluoxetine, changes are considered negligible. For sertraline, there was a tendency toward increased dose-adjusted concentrations in pregnancy. Available evidence suffers from major limitations and factors affecting pharmacokinetics have been insufficiently addressed. Further research is required to promote knowledge on pregnancy effects on antidepressant pharmacokinetics.
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Affiliation(s)
- Georgios Schoretsanitis
- The Zucker Hillside Hospital, Department of Psychiatry Research, Northwell Health, Glen Oaks, NY, USA
| | - Olav Spigset
- Department of Clinical Pharmacology, St Olav University Hospital, Trondheim, Norway.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Julia C Stingl
- Institute of Clinical Pharmacology, University Hospital of RWTH Aachen, Aachen, Germany
| | - Kristina M Deligiannidis
- The Zucker Hillside Hospital, Department of Psychiatry Research, Northwell Health, Glen Oaks, NY, USA.,Zucker School of Medicine, Hempstead, New York, Manhasset, New York, USA.,The Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Michael Paulzen
- Alexianer Hospital Aachen, Aachen, Germany and Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, and JARA - Translational Brain Medicine, Aachen, Germany
| | - Andreas A Westin
- Department of Clinical Pharmacology, St Olav University Hospital, Trondheim, Norway
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32
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Crowley SK, Rebellon J, Huber C, Leonard AJ, Henderson D, Magal M. Cardiorespiratory fitness, sleep, and physiological responses to stress in women. Eur J Sport Sci 2020; 20:1368-1377. [PMID: 31939334 DOI: 10.1080/17461391.2020.1716855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Epidemiological studies suggest that cardiorespiratory fitness (CRfitness) is associated with reduced risk of depression and anxiety in women, however, the mechanisms by which CRfitness may be protective against the development of these disorders are less clear. Because sleep problems are associated with both a higher risk for mental illness and altered physiological responses to stress, this study investigated whether sleep quality might influence the relationship between CRfitness and physiological stress responses in women. Thirty healthy women (18-45 y) who were medication-free, with regular menstrual cycles completed: (1) enrolment visit [including the assessment of CRfitness via maximal oxygen consumption during exercise]; (2) one-week sleep monitoring period including subjective (daily sleep diaries) and objective (wrist actigraphy) sleep measures; and (3) psychosocial stressor protocol (the Trier Social Stress Test; TSST) for the collection of heart rate (HR), blood pressure (BP), and salivary cortisol stress responses. Higher CRfitness was associated with reduced wake after sleep onset (WASO) duration (r = -.38, p = 0.04), higher self-reported sleep quality (higher scores reflect poorer sleep quality; r = -.37, p = 0.05), and lower HR (r = -.43, p = 0.02) during the stressor. Higher sleep quality was associated with a lower HR during the stressor (r = .44, p = 0.01). Increased WASO duration and WASO number were associated with blunted cortisol output during the stressor (r = -.44, p = 0.02, and r = -.46, p = 0.02, respectively). Results suggest that, in women, CRfitness may be protective against the deleterious effects of stress via improved sleep quality.
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Affiliation(s)
- Shannon K Crowley
- Department of Exercise Science, North Carolina Wesleyan College, Rocky Mount, NC, USA.,Department of Health Promotion, North Carolina Wesleyan College, Rocky Mount, NC, USA
| | - Julia Rebellon
- Department of Exercise Science, North Carolina Wesleyan College, Rocky Mount, NC, USA
| | - Christina Huber
- Department of Exercise Science, North Carolina Wesleyan College, Rocky Mount, NC, USA
| | - Abigail J Leonard
- Department of Exercise Science, North Carolina Wesleyan College, Rocky Mount, NC, USA
| | - Daniel Henderson
- Department of Exercise Science, North Carolina Wesleyan College, Rocky Mount, NC, USA
| | - Meir Magal
- Department of Exercise Science, North Carolina Wesleyan College, Rocky Mount, NC, USA
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Taylor P. Hunting to Feel Human, the Process of Women's Help-Seeking for Suicidality After Intimate Partner Violence: A Feminist Grounded Theory and Photovoice Study. Glob Qual Nurs Res 2020; 7:2333393619900893. [PMID: 32133388 PMCID: PMC7042558 DOI: 10.1177/2333393619900893] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 12/04/2019] [Accepted: 12/16/2019] [Indexed: 11/16/2022] Open
Abstract
Women reach out to health care providers for a multitude of health problems in the aftermath of intimate partner violence, including suicidality; however, little is known about how they seek help. The purpose of this study was to explore how women seek help for suicidality after intimate partner violence using a feminist grounded theory and photovoice multiple qualitative research design. Interviews were conducted with 32 women from New Brunswick, Canada, and seven from this sample also participated in five photovoice meetings where they critically reflected on self-generated photos of their help-seeking experiences. Data were analyzed using the constant comparative analysis of grounded theory. Hunting to Feel Human involves fighting for a sense of belonging and personal value by perceiving validation from health care providers. Women battled System Entrapment, a feeling of being dehumanized, by Gauging for Validation and Taking the Path of Least Entrapment. Implications for health care providers include prioritizing validating interactions and adopting a relational approach to practice.
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Affiliation(s)
- Petrea Taylor
- University of New Brunswick, Moncton, New
Brunswick, Canada
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34
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Abstract
UNLABELLED The current worldwide outbreak of COVID-19 has changed the modus operandi of all segments of society. While some pandemic-related stressors affect nearly everyone, many especially affect women. PURPOSE To review what is known about the pandemic's effect on women's mental health, what makes them more predisposed to vulnerabilities and adverse impacts, and strategies for preventing and treating these mental health consequences in the female population during specific stages across the lifespan. METHODS The authors performed a narrative review in combination with their observations from clinical experience in the field of women's mental health and reproductive psychiatry. Articles on women's mental health and COVID-19 up to May 30, 2020, were searched using the electronic PubMed and PsychInfo databases, as well as publications by major health entities (e.g., World Health Organization, Centers for Disease Control and Prevention, the United Nations) and press releases from prime communication outlets (e.g., National Public Radio). RESULTS AND CONCLUSIONS Women who are pregnant, postpartum, miscarrying, or experiencing intimate partner violence are at especially high risk for developing mental health problems during the pandemic. Proactive outreach to these groups of women and enhancement of social supports could lead to prevention, early detection, and prompt treatment. Social support is a key protective factor. Similarly, parenting may be substantially more stressful during a pandemic. Gender disparities may be accentuated, particularly for employed women or single parents, as women are disproportionately responsible for the bulk of domestic tasks, including childcare and eldercare.
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Affiliation(s)
- Marcela Almeida
- Department of Psychiatry, Harvard Medical School;Cambridge Health Alliance, Cambridge, MA, 02139, USA.
- Department of Psychiatry, Cambridge Health Alliance, Cambridge, MA, 02139, USA.
| | | | | | - Laura J Miller
- Loyola University Stritch School of Medicine, Maywood, IL, USA
- Edward Hines Jr. VA Hospital, Hines, IL, USA
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Perich T, Ussher J, Parton C. "Is it menopause or bipolar?": a qualitative study of the experience of menopause for women with bipolar disorder. BMC Womens Health 2017; 17:110. [PMID: 29145856 PMCID: PMC5689207 DOI: 10.1186/s12905-017-0467-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 11/07/2017] [Indexed: 12/25/2022]
Abstract
Background Menopause can be a time of change for women and may be marked by disturbances in mood. For women living with a mental illness, such as bipolar disorder, little is known about how they experience mood changes during menopause. This study aimed to explore how women with bipolar disorder constructed mood changes during menopause and how this impacted on treatment decisions. Methods Semi-structured interviews were undertaken with fifteen women who reported they had been diagnosed with bipolar disorder. Data was analysed using thematic analysis guided by a social constructionist framework. Results Themes identified included ‘Constructions of mood change: menopause or bipolar disorder?’,‘ Life events, bipolar disorder and menopause coming together’; ‘Treatment choices for mood change during menopause’. Conclusions The accounts suggested that women related to the experience of mood changes during menopause through the lens of their existing framework of bipolar disorder, with implications for understanding of self and treatment choices. Electronic supplementary material The online version of this article (10.1186/s12905-017-0467-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tania Perich
- Clinical and Health Psychology Research Initiative (CaHPRI), School of Social Sciences and Psychology, Western Sydney University, Sydney, Australia. .,School of Psychiatry, University of New South Wales, Sydney, Australia.
| | - Jane Ussher
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
| | - Chloe Parton
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
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Signal TL, Paine SJ, Sweeney B, Muller D, Priston M, Lee K, Gander P, Huthwaite M. The prevalence of symptoms of depression and anxiety, and the level of life stress and worry in New Zealand Māori and non-Māori women in late pregnancy. Aust N Z J Psychiatry 2017; 51:168-176. [PMID: 26792830 DOI: 10.1177/0004867415622406] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To describe the prevalence of symptoms of depression and anxiety, and the level of life stress and worry in late pregnancy for Māori and non-Māori women. METHODS In late pregnancy, women completed a questionnaire recording their prior history of mood disorders; self-reported current depressive symptoms (⩾13 on the Edinburgh Postnatal Depression Scale), current anxiety symptoms (⩾6 on the anxiety items from the Edinburgh Postnatal Depression Scale), significant life stress (⩾2 items on life stress scale) and dysfunctional worry (>12 on the Brief Measure of Worry Scale). RESULTS Data were obtained from 406 Māori women (mean age = 27.6 years, standard deviation=6.3 years) and 738 non-Māori women (mean age = 31.6 years, standard deviation=5.3 years). Depressive symptoms (22% vs 15%), anxiety symptoms (25% vs 20%), significant life stress (55% vs 30%) and a period of poor mood during the current pregnancy (18% vs 14%) were more prevalent for Māori than non-Maori women. Less than 50% of women who had experienced ⩾2 weeks of poor mood during the current pregnancy had sought help. Being young was an independent risk factor for depressive symptoms, significant life stress and dysfunctional worry. A prior history of depression was also consistently associated with a greater risk of negative affect in pregnancy. CONCLUSION Antenatal mental health requires at least as much attention and resourcing as mental health in the postpartum period. Services need to specifically target Māori women, young women and women with a prior history of depression.
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Affiliation(s)
- T Leigh Signal
- 1 Sleep/Wake Research Centre, College of Health, Massey University, Wellington, New Zealand
| | - Sarah-Jane Paine
- 1 Sleep/Wake Research Centre, College of Health, Massey University, Wellington, New Zealand
| | - Bronwyn Sweeney
- 1 Sleep/Wake Research Centre, College of Health, Massey University, Wellington, New Zealand
| | - Diane Muller
- 1 Sleep/Wake Research Centre, College of Health, Massey University, Wellington, New Zealand
| | - Monique Priston
- 2 School of Population Health, The University of Western Australia, Crawley, Australia
| | - Kathryn Lee
- 3 School of Nursing, University of California, San Francisco, CA, USA
| | - Philippa Gander
- 1 Sleep/Wake Research Centre, College of Health, Massey University, Wellington, New Zealand
| | - Mark Huthwaite
- 4 Department of Psychological Medicine, University of Otago, Wellington, New Zealand
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Abstract
The Movement for Global Mental Health's (MGMH) efforts to scale up the availability of mental health services have been moderately successful. Investigations in resource-poor countries like South Africa have pointed to the value of an integrated primary mental health care model and multidisciplinary collaboration to support mental health needs in underserved and underresourced communities. However, there remains a need to explore how these policies play out within the daily realities of communities marked by varied environmental and relational complexities. Arguably, the lived realities of mental health policy and service delivery processes are best viewed through ethnographic approaches, which remain underutilised in the field of global mental health. This paper reports on findings from a case study of mental health services for HIV-affected women in a rural South African setting, which employed a motivated ethnography in order to explore the realities of the primary mental health care model and related policies in South Africa. Findings highlighted the influence of three key symbolic (intangible) factors that impact on the efficacy of the primary mental health care model: power dynamics, which shaped relationships within multidisciplinary teams; stigma, which limited the efficacy of task-shifting strategies; and the silencing of women's narratives of distress within services. The resultant gap between policy ideals and the reality of practice is discussed. The paper concludes with recommendations for building on existing successes in the delivery of primary mental health care in South Africa.
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Affiliation(s)
- Rochelle Ann Burgess
- London Metropolitan University; University of Kwa-Zulu Natal; London School of Economics
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Abstract
The aim of this study was to assess the psychological state of women who have undergone surgery for breast cancer or cardiac surgery, including examination of the role of social support in both groups. The study included 48 women (mean age: 66.04 ± 8.3 years). They were divided into two groups according to diagnosis: 23 women (mean age: 69.2 ± 8.6 years) who underwent heart surgery (cardiac group, CG) and 25 women (mean age: 63.2 ± 7.0 years) treated for breast cancer and associated with the Women After Mastectomy Club (oncology group, OG). In addition to the assessment of socio-demographic variables, the following self-report questionnaires were administered: Satisfaction with Life Scale, Acceptance of Illness Scale, Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory as well as Berlin Social Support Scale. In the CG, the severity of depressive symptoms was two times higher than in OG (p = .003). In both groups, there was a high percentage (80%) of women with severe symptoms of anxiety (p = .37). In both groups, the level of life satisfaction was similar (p = .58), but OG was characterized by a higher level of acceptance of the disease (p = .003). The correlation analysis showed that in both groups, social support was related differently to the parameters of emotional state. Women treated for breast cancer were in a better mental condition than women treated for heart disease. The support coming from other women in similar circumstances (Women After Mastectomy Club) seems to be more effective than the support coming from the patient's immediate environment. The results for social support ought to be interpreted not only through the prism of mean values of received support, but also with regard to the information on the sources of support.
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Affiliation(s)
- Iwona Malicka
- a The Faculty of Physiotherapy , University of Physical Education in Wroclaw , Wydział Fizjoterapii AWF Wrocław, al. I. J. Paderewskiego 35, 51 612 Wrocław , Poland
| | - Aleksandra Kozłowska
- a The Faculty of Physiotherapy , University of Physical Education in Wroclaw , Wydział Fizjoterapii AWF Wrocław, al. I. J. Paderewskiego 35, 51 612 Wrocław , Poland
| | - Marek Woźniewski
- a The Faculty of Physiotherapy , University of Physical Education in Wroclaw , Wydział Fizjoterapii AWF Wrocław, al. I. J. Paderewskiego 35, 51 612 Wrocław , Poland
| | - Joanna Rymaszewska
- b Department of Psychiatry , Wroclaw Medical University , Wrocław , Poland
| | - Joanna Szczepańska-Gieracha
- a The Faculty of Physiotherapy , University of Physical Education in Wroclaw , Wydział Fizjoterapii AWF Wrocław, al. I. J. Paderewskiego 35, 51 612 Wrocław , Poland
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Burgess RA. Supporting mental health in South African HIV-affected communities: primary health care professionals' understandings and responses. Health Policy Plan 2014; 30:917-27. [PMID: 25161270 DOI: 10.1093/heapol/czu092] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2014] [Indexed: 11/14/2022] Open
Abstract
How do practitioners respond to the mental distress of HIV-affected women and communities? And do their understandings of patients' distress matter? The World Health Organization (WHO) along with advocates from the Movement for Global Mental Health (MGMH) champion a primary mental health care model to address burgeoning mental health needs in resource-poor HIV-affected settings. Whilst a minority of studies have begun to explore interventions to target this group of women, there is a dearth of studies that explore the broader contexts that will likely shape service outcomes, such as health sector dynamics and competing definitions of mental ill-health. This study reports on an in-depth case study of primary mental health services in a rural HIV-affected community in Northern KwaZulu-Natal. Health professionals identified as the frontline staff working within the primary mental health care model (n = 14) were interviewed. Grounded thematic analysis of interview data highlighted that practitioners employed a critical and socially anchored framework for understanding their patients' needs. Poverty, gender and family relationships were identified as intersecting factors driving HIV-affected patients' mental distress. In a divergence from existing evidence, practitioner efforts to act on their understandings of patient needs prioritized social responses over biomedical ones. To achieve this whilst working within a primary mental health care model, practitioners employed a series of modifications to services to increase their ability to target the sociostructural realities facing HIV-affected women with mental health issues. This article suggests that beyond attention to the crucial issues of funding and human resources that face primary mental health care, attention must also be paid to promoting the development of policies that provide practitioners with increased and more consistent opportunities to address the complex social realities that frame the mental distress of HIV-affected women.
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Affiliation(s)
- Rochelle Ann Burgess
- Health, Community and Development Research Group, Department of Social Psychology, London School of Economics, Houghton Street, WC2A 2AE, London, UK and Health Economics and HIV/AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
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Molewyk Doornbos M, Zandee GL, DeGroot J. Attending to Communication and Patterns of Interaction: Culturally Sensitive Mental Health Care for Groups of Urban, Ethnically Diverse, Impoverished, and Underserved Women. J Am Psychiatr Nurses Assoc 2014; 20:239-249. [PMID: 25080464 DOI: 10.1177/1078390314543688] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The United States is ethnically diverse. This diversity presents challenges to nurses, who, without empirical evidence to design culturally congruent interventions, may contribute to mental health care disparities. OBJECTIVE Using Leininger's theory of culture care diversity and universality, this study documented communication and interaction patterns of ethnically diverse, urban, impoverished, and underserved women. DESIGN Using a community-based participatory research framework, 61 Black, Hispanic, and White women participated in focus groups around their experiences with anxiety/depression. Researchers recorded verbal communication, nonverbal behavior, and patterns of interaction. RESULTS The women's communication and interaction patterns gave evidence of three themes that were evident across all focus groups and five subthemes that emerged along ethnic lines. CONCLUSIONS The results suggest cultural universalities and cultural uniquenesses relative to the communication and interaction patterns of urban, ethnically diverse, impoverished, and underserved women that may assist in the design of culturally sensitive mental health care.
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Affiliation(s)
| | | | - Joleen DeGroot
- Joleen DeGroot, BSN, RN, Spectrum Health, Grand Rapids, MI, USA
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Sz Makó H, Péley B. [Decision making for termination of pregnancies and the pre-abortion period in the context of women's mental health]. Orv Hetil 2014; 155:647-52. [PMID: 24755446 DOI: 10.1556/oh.2014.29882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Based on statistical figures of the past 30 years, the number of induced abortions in Hungary is constantly decreasing. However, compared to the number of live births, even today approximately one third of pregnancies conceived eventuate in termination. Various international studies confirm the negative consequences of the intervention exerting influence on women's mental health. The aim of this publication is to give a summary on the psychological aspects of the decision making process in the pre-abortion period, from the diagnosis of pregnancy to the surgical intervention. The authors present a detailed overview on the background for the reasons of the decision, the stages of the period from conception until termination, as well as factors related to difficulties in decision making, and possible psychological consequences.
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Affiliation(s)
- Hajnalka Sz Makó
- Pécsi Tudományegyetem, Bölcsészettudományi Kar Személyiség- és Egészségpszichológia Tanszék, Pszichológia Intézet Pécs Ifjúság u. 6. 7623
| | - Bernadette Péley
- Pécsi Tudományegyetem, Bölcsészettudományi Kar Fejlődés- és Klinikai Pszichológia Tanszék, Pszichológia Intézet Pécs
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Abas M, Ostrovschi NV, Prince M, Gorceag VI, Trigub C, Oram S. Risk factors for mental disorders in women survivors of human trafficking: a historical cohort study. BMC Psychiatry 2013; 13:204. [PMID: 23914952 PMCID: PMC3737054 DOI: 10.1186/1471-244x-13-204] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Accepted: 07/23/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous studies have found high levels of symptoms of depression, anxiety, and post-traumatic stress disorder among women survivors of human trafficking. No previous research has described risk factors for diagnosed mental disorders in this population. METHODS A historical cohort study of women survivors of trafficked women aged 18 and over who returned to Moldova and registered for assistance with the International Organisation for Migration (IOM). Women were approached by IOM social workers and, if they gave informed consented to participate in the study, interviewed by the research team. At 2-12 months post-return to Moldova, a psychiatrist assessed DSM-IV mental disorders blind to information about women's pre-trafficking and post-trafficking experiences using the Structured Clinical Interview for DSM-IV (SCID). A backwards stepwise selection procedure was used to create a multivariable regression model of risk factors for DSM-IV mental disorder measured at an average of 6 months post-return. RESULTS 120/176 (68%) eligible women participated. At an average of 6 months post-return, 54% met criteria for any DSM-IV mental disorder: 35.8% of women had PTSD (alone or co-morbid), 12.5% had depression without PTSD and 5.8% had another anxiety disorder. Multivariable regression analysis found that childhood sexual abuse (Adjusted Odds Ratio [AOR] 4.68, 95% CI 1.04-20.92), increased number of post-trafficking unmet needs (AOR 1.80; 95% CI 1.28-2.52) and post-trafficking social support (AOR 0.64; 95% CI 0.52-0.79) were independent risk factors for mental disorder, and that duration of trafficking showed a borderline association with mental disorder (AOR 1.12, 95% CI 0.98-1.29). CONCLUSIONS Assessment for mental disorders should be part of re-integration follow-up care for women survivors of human trafficking. Mental disorders at that time, most commonly PTSD and depression, are likely to be influenced by a range of predisposing, precipitating and maintaining factors. Care plans for survivors of trafficking must be based on individual needs, and must apply clinical guidelines for the treatment of PTSD and of depression. Evidence is needed on the effectiveness of therapy for PTSD in survivors of human trafficking.
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Affiliation(s)
- Melanie Abas
- Institute of Psychiatry, Kings College London, London, UK.
| | | | - Martin Prince
- Institute of Psychiatry, Kings College London, London, UK
| | | | | | - Siân Oram
- Institute of Psychiatry, Kings College London, London, UK
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Witt WP, Wisk LE, Cheng ER, Hampton JM, Hagen EW. Preconception mental health predicts pregnancy complications and adverse birth outcomes: a national population-based study. Matern Child Health J 2012; 16:1525-41. [PMID: 22124801 PMCID: PMC3605892 DOI: 10.1007/s10995-011-0916-4] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Pregnancy complications and poor birth outcomes can affect the survival and long-term health of children. The preconception period represents an opportunity to intervene and improve outcomes; however little is known about women's mental health prior to pregnancy as a predictor of such outcomes. We sought to determine if and to what extent women's preconception mental health status impacted subsequent pregnancy complications, non-live birth, and birth weight using a nationally representative, population-based sample. We used pooled 1996-2006 data from the nationally-representative Medical Expenditure Panel Survey (MEPS). Poor preconception mental health was defined as women's global mental health rating of "fair" or "poor" before conception. Logistic regression was used to assess the association between preconception mental health and pregnancy complications, non-live birth, and having a low birth weight baby within the follow up period. Poor preconception mental health was associated with increased odds of experiencing any pregnancy complication (AOR 1.40, 95% CI: 1.02-1.92), having a non-live birth (AOR 1.48, 95% CI: 0.96-2.27), and having a low birth weight baby (AOR 1.99, 95% CI: 1.00-3.98), all controlling for maternal age, race/ethnicity, marital status, education, health insurance status, income, and number of children in the household. Significant racial and ethnic disparities exist for pregnancy complications and non-live births, but not for low birth weight. Women's preconception mental health is a modifiable risk factor that stands to reduce the incidence of adverse pregnancy complications and birth outcomes.
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Affiliation(s)
- Whitney P. Witt
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, 610 North Walnut Street, Office 503, Madison, WI 53726, USA,
| | - Lauren E. Wisk
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, 610 North Walnut Street, Office 558, Madison, WI 53726, USA,
| | - Erika R. Cheng
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, 610 North Walnut Street, Office 530, Madison, WI 53726, USA,
| | | | - Erika W. Hagen
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, 610 North Walnut Street, Office 630, Madison, WI 53726, USA,
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Abstract
BACKGROUND Much recent debate on excess rates of compulsory detention and coercive routes to care has focused on young black men; evidence is less clear regarding ethnic variations among women and factors that may mediate these. AIM To explore ethnic variations in compulsory detentions of women, and to explore the potential role of immediate pathways to admission and clinician-rated reasons for admission as mediators of these differences. METHOD All women admitted to an acute psychiatric inpatient ward or a women's crisis house in four London boroughs during a 12-week period were included. Data were collected regarding their pathways to care, clinician-rated reasons for admission, hospital stays, and social and clinical characteristics. RESULTS Two hundred and eighty seven (287) women from white British, white other, black Caribbean, black African and black other groups were included. Adjusting for social and clinical characteristics, all groups of black patients and white other patients were significantly more likely to have been compulsorily admitted than white British patients; white British patients were more likely than other groups to be admitted to a crisis house and more likely than all the black groups to be admitted because of perceived suicide risk. Immediate pathways to care differed: white other, black African and black other groups were less likely to have referred themselves in a crisis and more likely to have been in contact with the police. When adjustment was made for differences in pathways to care, the ethnic differences in compulsory admission were considerably reduced. DISCUSSION There are marked ethnic inequities not only between white British and black women, but also between white British and white other women in experiences of acute admission. Differences between groups in help-seeking behaviours in a crisis may contribute to explaining differences in rates of compulsory admission.
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Holsen LM, Spaeth SB, Lee JH, Ogden LA, Klibanski A, Whitfield-Gabrieli S, Goldstein JM. Stress response circuitry hypoactivation related to hormonal dysfunction in women with major depression. J Affect Disord 2011; 131:379-87. [PMID: 21183223 PMCID: PMC3073153 DOI: 10.1016/j.jad.2010.11.024] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2010] [Revised: 11/01/2010] [Accepted: 11/24/2010] [Indexed: 02/05/2023]
Abstract
BACKGROUND Women have approximately twice the risk of major depressive disorder (MDD) than men, yet this difference remains largely unexplained. Previous MDD research suggests high rates of endocrine dysfunction, which may be related to deficits in brain activity in stress response circuitry [hypothalamus, amygdala, hippocampus, anterior cingulate cortex (ACC), orbitofrontal cortex (OFC)]. This functional magnetic resonance imaging (fMRI) study investigated the relationship between hypothalamic-pituitary-gonadal (HPG)-axis hormones and stress response circuitry dysfunction in MDD in women. METHODS During the late follicular/midcycle phase of the menstrual cycle, female participants (10 with extensive histories of MDD, in remission, 10 healthy controls) were scanned while viewing negative and neutral arousal pictures. Group differences in blood oxygen-level dependent (BOLD) signal changes were analyzed using SPM2. Baseline gonadal hormones included estradiol, progesterone, and testosterone. RESULTS fMRI results showed greater BOLD signal intensity changes in controls versus MDD in hypothalamus, amygdala, hippocampus, OFC, ACC, and subgenual ACC, findings unrelated to medication status. MDD women had a lower serum estradiol and higher serum progesterone compared to controls. Hypoactivations in hypothalamus, subgenual ACC, amygdala and OFC in MDD were associated with low estradiol and high progesterone. LIMITATIONS Generalizability of our findings is limited by small sample size and restriction to females, although this did not affect the internal validity of the results. CONCLUSIONS Hypoactivation of the stress response circuitry in MDD women is associated with dysregulation of the HPG-axis. Associations between brain activity deficits and hormonal disruption in MDD may ultimately contribute to understanding sex differences in MDD.
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Affiliation(s)
- Laura M. Holsen
- Harvard Medical School, Departments of Psychiatry and Medicine, Brigham and Women's Hospital, Connors Center for Women's Health and Gender Biology,Massachusetts General Hospital & Massachusetts Institute of Technology, Athinoula Martinos Center for Biomedical Imaging
| | - Sarah B. Spaeth
- Harvard Medical School, Departments of Psychiatry and Medicine, Brigham and Women's Hospital, Connors Center for Women's Health and Gender Biology,Massachusetts General Hospital & Massachusetts Institute of Technology, Athinoula Martinos Center for Biomedical Imaging
| | - Jong-Hwan Lee
- Harvard Medical School, Department of Radiology, Brigham and Women's Hospital
| | - Lauren A. Ogden
- Harvard Medical School, Departments of Psychiatry and Medicine, Brigham and Women's Hospital, Connors Center for Women's Health and Gender Biology,Massachusetts General Hospital & Massachusetts Institute of Technology, Athinoula Martinos Center for Biomedical Imaging
| | - Anne Klibanski
- Harvard Medical School, Department of Medicine, Massachusetts General Hospital
| | - Susan Whitfield-Gabrieli
- Massachusetts General Hospital & Massachusetts Institute of Technology, Athinoula Martinos Center for Biomedical Imaging,Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology
| | - Jill M. Goldstein
- Harvard Medical School, Departments of Psychiatry and Medicine, Brigham and Women's Hospital, Connors Center for Women's Health and Gender Biology,Massachusetts General Hospital & Massachusetts Institute of Technology, Athinoula Martinos Center for Biomedical Imaging,Corresponding author: Jill M. Goldstein, Ph.D.; Brigham and Women’s Hospital, Division of Women’s Health; One Brigham Circle; 1620 Tremont St., Boston, MA 02120; Phone: 617-525-7517; Fax: 617-525-7746;
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