Publications - Perinatal Emotional Concerns

States may now broaden mental health treatment under Medicaid, by Michael Nedelman, CNN, Nov 13 2018.

“The Centers for Medicare and Medicaid Services may now allow for states to pursue Medicaid reimbursements for short-term inpatient treatment in mental health facilities despite a decades-old exclusion, Health and Human Services Secretary Alex Azar announced Tuesday. In a letter to state Medicaid directors, CMS detailed a new Medicaid waiver opportunity through which states may bypass longstanding reimbursement restrictions on inpatient psychiatric treatment, which apply to mental health facilities with more than 16 beds. Azar said the original policy has posed a "significant barrier" to people getting the treatments they need. ”

Study: Most Psychoactive Drugs Taken During Pregnancy Do Not Increase Risk of Autism, by Rick Nauert, PhD, Psych Central, Nov 1 2018.

“New research finds that a mother’s use of antidepressants and antipsychotic drugs while pregnant does not place the baby at risk for autism. But the rates of autism were higher among children of mothers with worse general health before pregnancy, suggesting that the mother’s health plays a more critical role in a child’s development than the medications she takes. ”

Absence of Daylight Linked to Postnatal Depression, by Rick Nauert, PhD, Psych Central, Sep 29 2018.

“New research suggests women in late pregnancy during darker months of the year may have a greater risk of developing postpartum depression once their babies are born. The analysis suggested that the number of daylight hours a woman was exposed to during her final month of pregnancy and just after birth had a major influence on the likelihood that she developed depressive symptoms. Investigators discovered the lowest risk for depression (26 per cent) occurred among women whose final trimester coincided with seasons with longer daylight hours. ”

Breastfeeding might benefit babies by reducing stress, by Lisa Rapaport, Reuters, Sep 26 2018.

“Mothers have long been told that “breast is best” when it comes to feeding newborn babies, but a small experiment suggests at least some of the benefits may have nothing to do with the milk itself...While the current study in humans is small, and doesn’t span multiple generations, the results do suggest that nurturing behavior by human mothers can make their babies less reactive to stress...Bonding during breastfeeding may be a different experience than the nurturing babies get from bottle feedings, Wright said. It’s possible that the increased maternal bonding that occurs with breastfeeding may alter babies’ stress response and make infants more resilient when they have stressful experiences, Wright added. ”

Maternal depression can impact baby's physical and mental health, by Linda Carroll, Reuters, Aug 24 2018.

“Children with depressed mothers may end up with altered immune responses and at greater risk for psychological disorders, a new study suggests. Maternal depression may have a significant effect on the way children’s brains work, the researchers write in the journal Depression & Anxiety...Feldman and her colleagues determined that depressed moms had higher levels of cortisol and secretory immunoglobulin. Moreover, the depressed moms also displayed more negative parenting. 'Depressed mothers are less engaged, less empathetic,' Feldman said. They 'show more negative and inconsistent (mood). They are more critical and hostile and are less sensitive to the child’s non-verbal and verbal social communication.' ”

New dads need depression screening, too, by Lisa Rapaport, Reuters, Jul 23 2018.

“Fathers of young children may be almost as likely as new mothers to experience symptoms of depression, a U.S. study suggests. Researchers examined results from depression screenings done for parents during more than 9,500 visits to pediatrics clinics with their children. Overall, 4.4 percent of fathers and five percent of mothers screened positive for depression...Because parental depression can have lasting physical and mental health affects for young children, the American Academy of Pediatrics recommends that all parents - both mothers and fathers - get screened for depression during well-baby and well-child checkups. ”

More women may be experiencing depression during pregnancy, by Linda Carroll, Reuters, Jul 13 2018.

“Today’s moms-to-be are more likely than women from their mothers’ generation to become depressed while pregnant, a study suggests...'Our data suggest that the symptoms driving the increase in total scores were those related to feeling overwhelmed and stress and anxiety rather than feelings of being down and unmotivated,' Pearson said. 'This supports theories that it is potentially a consequence of the fast-paced modern world.' ”

Pilot Study Screens for Postpartum Depression in the ER, by Traci Pedersen, Psych Central, Jun 30 2018.

“Although new mothers are supposed to be screened routinely for PPD at postpartum visits with their maternal or pediatric health care providers, these screenings often don’t happen, either because doctors aren’t following the recommendations or parents aren’t attending these visits due to barriers to healthcare access or other issues. According to a new study, providing PPD screening for new moms in the emergency department (ED) could help identify women suffering from the often debilitating disorder...Jarvis and colleagues launched a pilot study in the Children’s ED to screen for PPD. For eight months beginning in June 2015, the researchers invited English- and Spanish-speaking mothers who came to the ED with infants 6 months old or younger with complaints that didn’t necessitate immediate emergency care to take a short questionnaire on a computer tablet..Based on the results of the study, the researchers implemented a range of interventions. All mothers who participated in the study were given an informational booklet from the March of Dimes on PPD. ”

Mom's depression tied to kids' emotional, intellectual development, by Cheryl Platzman Weinstock, Reuters, Apr 25 2018.

“A mother’s depression is linked with her children’s development from infancy through adolescence, according to a new study. Researchers studied 875 middle- or lower-class mothers in Chile and their healthy children over a 16-year period, evaluating participants roughly every four years....At age five, children with severely depressed mothers had an average verbal IQ score of 7.3 (on a scale of 1 to 19), compared to a higher score of 7.8 in children without depressed mothers...These children will have a smaller vocabulary and poorer comprehension skills, East said...The American Academy of Pediatrics (AAP) recommends screening new mothers for depression during the months after childbirth. ”

ADHD drug use in pregnancy increases risk of heart defects, study finds, by Susan Scutti, CNN, Dec 13 2017.

“The attention-deficit hyperactivity disorder drug methylphenidate is associated with an increased risk of heart defects in infants whose mothers take the medication during pregnancy, according to a study published Wednesday in the journal Jama Psychiatry. Specifically, the researchers found a 28% increased prevalence of cardiac malformations after first-trimester exposure to the stimulant, which is the active ingredient in Ritalin, Concerta, Daytrana, Methylin and other ADHD medications. ”

Postpartum Depression: Signs and Resources for Help, by Nursing@Georgetown, Georgetown University, Oct 2 2017.

“'I was so excited I decorated the nursery months before the baby arrived. But when she came, it was not a dream. I had no energy to smile or even to cry. I didn’t even want to pick her up. This was not how I thought it was going to be, and I was ashamed of how I felt.'  Such sentiments are often expressed by women with postpartum depression (PPD), a serious condition that affects 10 to 15 percent External link  of new mothers, according to the Office on Women’s Health (OWH). The crippling sadness and overwhelming fatigue associated with PPD can disrupt a woman’s ability to care for herself and her child. By recognizing the symptoms and getting the right help from health care providers — such as Nurse-Midwives — PPD can be treated so a new mom can better enjoy her baby and this special time in her life. ”

Antenatal Exposure to Antidepressant and Risk of Psychiatric Illness in the Child, by Ruta Nonacs, MD PhD, MGH Center For Women's Mental Health, Sep 11 2017.

“When we provide consultations regarding the use of antidepressants during pregnancy, one of the most difficult questions we have to answer is related to the long-term effects of prenatal antidepressant exposure. Specifically, do antidepressants used by the mother during pregnancy affect the long term development of the fetus?  While many studies have attempted to look at the effects of prenatal antidepressant exposure on neurodevelopment and behavior, most of these studies have been relatively small and have followed children over shorter periods of time.  Thus, it is difficult to fully appreciate the long-term consequences of prenatal exposure to antidepressants.   The analysis of large medical databases have given us the opportunity to assess outcomes in larger numbers of children exposed to antidepressants during pregnancy.  A recent study, using Danish medical registers, assesses risk for psychiatric illness in children exposed to antidepressants in utero. ”

Dads Can Develop Postpartum Depression if ‘T’ Drops, by Rick Nauert, PhD, Psych Central, Sep 7 2017.

“Postpartum depression is a relatively common occurrence among females. Now, a new study finds that an elevation or a decline in a father’s testosterone level after childbirth may play a significant role in emotional health and relationship satisfaction...fathers whose testosterone levels spiked faced a greater risk of experiencing stress due to parenting and experienced a greater risk of acting hostile. Characteristics of hostile behaviors include showing emotional, verbal, or physical aggression toward their partners.  ”

Maximizing children's resilience, by Kirsten Weir , American Psychological Association , Sep 2017.

“They call them "the formative years" for a reason. A wealth of research has shown that stress and hardship in childhood—such as that caused by abuse, neglect, exposure to violence and mental illness in caregivers—can alter the brain architecture of a developing child. Those physiological changes, in turn, raise the risk of cognitive and developmental delays, physical health problems such as diabetes and heart disease, and behavioral and mental health problems such as substance abuse and depression. Yet some people flourish despite those long odds, and psychologists are homing in on the factors that boost resilience...Researchers agree that, of all the factors that boost resilience, good parenting is often the most significant. 'The thing that makes the biggest difference, over and above one's genetic blueprint, is the relationship a child has with a primary caregiver,' says Philip Fisher, PhD, a professor of psychology at the University of Oregon who studies early childhood interventions to improve the functioning of children from disadvantaged backgrounds. 'The presence of a supportive, consistent and protective primary caregiver—especially when the underlying stress systems are activated—is the factor that makes the biggest difference in healthy development.' ”

Exercise may stave off postpartum depression, by Carolyn Crist, Reuters, Jun 16 2017.

“Physical activity during and after pregnancy improves psychological wellbeing and may protect against postpartum depression, according to a new analysis of existing research. Even low-intensity exercise, such as walking with a baby stroller, was linked to a lower likelihood of depressive symptoms in new mothers, researchers found...Compared to women who didn’t exercise, those who did had lower scores on depression symptom tests during the postpartum period, the researchers found. The apparent benefit of having fewer depression symptoms was seen even among women who did not meet the cutoff for a depression diagnosis. ”