Using Telehealth to Train Providers of a Cancer Support Intervention.

Background: Group interventions are effective for addressing the transition from cancer treatment to survivorship but are not widely available outside of urban areas. In addition, minimal training is available for group facilitators outside of the mental healthcare discipline. Telehealth as a medium can facilitate conversation and interactive learning and make learning accessible to individuals in areas that lack resources for traditional classroom teaching.

Nonpharmacologic treatments for depression related to reproductive events.

There is a growing body of evidence suggesting that nonpharmacological interventions have an appropriate place in the treatment of major depressive disorders (MDDs) as both stand-alone and supplemental treatments. Because women may be reluctant to use psychotropic medications due to strong values or treatment preferences during specific reproductive events, clinicians need to be able to offer empirically based alternatives to medication. In this review, we present recent findings from studies of acupuncture, bright light therapy, electroconvulsive therapy, omega fatty acid supplementation, physical activity, and psychosocial intervention for women experiencing depressive symptoms in the contexts of menstruation, pregnancy, postpartum, and menopause.

Psychosocial interventions for substance use during pregnancy.

Psychosocial and behavioral interventions are used to address substance use and dependence during pregnancy, having particular value when providers and pregnant women are seeking to minimize drug exposures to the fetus. Numerous factors, including difficulty recruiting participants and the ethical challenges to conducting randomized controlled trials with women during pregnancy, have limited research in this area. The existing literature, however, does contain early investigations into the practicality and efficacy of contingency management, motivational support, and cognitive behavioral therapies adapted for pregnant women.

Screening to Treatment: Obstacles and Predictors in Perinatal Depression (STOP-PPD) in the Dallas Healthy Start program.

Healthy Start programs have made tremendous contributions toward improving the health of mothers and infants through the screening and early detection of perinatal depression. In a collaborative partnership with the Dallas Healthy Start (DHS) program, this pilot study investigated rates of follow-up to systematic referrals for the treatment of perinatal depression in the DHS, as well as identified specific barriers and predictors or treatment follow-up. Results of this study support strengthening existing community-based treatment programs for perinatal depression.

Adolescents, pregnancy, and mental health.

Study Objective: Pregnancy during adolescence is a risk factor for adverse medical and psychosocial outcomes, including psychiatric illness. Psychiatric illness is linked with obstetric complications along with impaired maternal functioning in the postpartum period. This article provides a comprehensive review of the research examining the intersection of psychopathology and adolescent pregnancy and the postpartum period.

Evaluating the clinical effectiveness of a specialized perinatal psychiatry inpatient unit.

Women experiencing severe perinatal mental illness during pregnancy or postpartum have unique needs when psychiatric hospitalization is indicated. Although many countries have established mother-baby psychiatric units, similar facilities have not been available in the US. In 2011, the University of North Carolina at Chapel Hill inaugurated the first Perinatal Psychiatry Inpatient Unit in the US.

Impact of reproductive status and age on response of depressed women to cognitive therapy.

Objective: Previous research suggests that reproductive hormones are potential affective modulators in mood disorders and may influence response to antidepressant medications. To our knowledge, there are no data on relationships between hormonal status and response to psychotherapy for recurrent major depressive disorder (MDD).

Methods: At two sites, female outpatients (n=353), aged 18-70, with recurrent MDD received 12-14 weeks of cognitive therapy (CT).

Proof of concept: Partner-Assisted Interpersonal Psychotherapy for perinatal depression.

Although poor partner support is a key risk factor for depression in pregnant and postpartum women, partners are not generally involved in treatment beyond psychoeducation. The aim of this "proof of concept" study was to test safety, acceptability, and feasibility of Partner-Assisted Interpersonal Psychotherapy (PA-IPT), an intervention that includes the partner as an active participant throughout treatment. Women more than 12 weeks estimated gestational age and less than 12 weeks postpartum were invited to participate if they fulfilled DSM-IV criteria for Major Depressive Disorder and reported moderate symptom severity (HAM-D(17) ≥16).

When she says "no" to medication: psychotherapy for antepartum depression.

Many women suffering from major depressive disorder during pregnancy are hesitant to initiate or continue antidepressant treatment during preconception planning, conception, pregnancy, and lactation (perinatal period). Over the past few decades, various psychotherapeutic approaches have been found to be efficacious for depression in general population research. Several observational and quasi-experimental studies also suggest that psychotherapy can be a safe first-line treatment for perinatal women with mild to moderate depression.

Antenatal depression: a rationale for studying exercise.

Background: Major depressive disorder (MDD) in pregnancy or antenatal depression poses unique treatment challenges and has serious consequences for mothers, unborn babies, and families when untreated. This review presents current knowledge on exercise during pregnancy, antidepressant effects of exercise, and the rationale for the specific study of exercise for antenatal depression.

Method: A systematic literature review was performed using English language articles published in Medline, PsycINFO, CINAHL, and the Cochrane Library from 1985 to January 2010.

A systematic review of the combined use of electroconvulsive therapy and psychotherapy for depression.

Objective: Electroconvulsive therapy (ECT) is one of the most effective treatments for severe major depressive disorder. However, after acute-phase treatment and initial remission, relapse rates are significant. Strategies to prolong remission include continuation phase ECT, pharmacotherapy, psychotherapy, or their combinations.

Ethical issues in perinatal mental health research.

Purpose Of Review: To review the background of current ethical standards for the conduct of perinatal mental health research and describe the ethical challenges in this research domain.

Recent Findings: Current literature reflects a growing sentiment in the scientific community that having no information regarding the impact of psychiatric treatment on the mother and developing fetus/infant poses dangers that may exceed the risks involved in research. However, without sufficient consensus across the scientific community, both regulatory bodies and perinatal researchers find themselves without a framework for decision making that satisfactorily limits the risks and facilitates the benefits of participation of pregnant and lactating women in clinical research.

A HISTORY OF THE THEORY OF PRENATAL ATTACHMENT.

John Bowlby's theory of human attachment has become widely applied across disciplines and across the stages of human development. This discussion explores the evolution of an application of Bowlby's theory to the experience of pregnancy, from both maternal and paternal perspectives. Although the theoretical construct of maternal fetal attachment (MFA) requires continued theoretically-driven research, existing studies have associated this proposed construct with health behaviors, marital relationship, depressive symptoms, and the postpartum mother-infant relationship, pointing toward its relevance for academicians and clinicians devoted to the service of women and infants.

Prenatal depression in women hospitalized for obstetric risk.

Objective: Little is known about depression during pregnancy in women with high maternal or fetal risk, as this population is often excluded from research samples. The aim of this study was to evaluate depressive symptoms and known risk factors for depression in a group of women hospitalized with severe obstetric risk.

Method: In the antenatal unit, 129 inpatients completed the Edinburgh Postnatal Depression Scale (EPDS), the Dyadic Adjustment Scale (DAS), and the Maternal Antenatal Attachment Scale (MAAS) from October 2005 through December 2006.