Partnerships with Primary Care for the Treatment of Preschoolers.

This article reviews mental health access issues relevant to preschool children and data on this population obtained through the Michigan Child Collaborative Care Program (MC3). The MC3 program provides telephonic consultation to primary care physicians (PCPs) in 40 counties in Michigan and video telepsychiatric consultation to patients and families. Attention-deficit/hyperactivity disorder and disruptive behavioral disorders are frequent initial presenting diagnoses, but autism spectrum disorders, parent-child relational issues, trauma, and posttraumatic stress disorder should also be considered.

Executive Functioning at Baseline Prospectively Predicts Depression Treatment Response.

Objective: Existing cognitive and clinical predictors of treatment response to date are not of sufficient strength to meaningfully impact treatment decision making and are not readily employed in clinical settings. This study investigated whether clinical and cognitive markers used in a tertiary care clinic could predict response to usual treatment over a period of 4 to 6 months in a sample of 75 depressed adults.

Methods: Patients (N = 384) were sequentially tested in 2 half-day clinics as part of a quality improvement project at an outpatient tertiary care center between August 2003 and September 2007; additional subjects evaluated in the clinic between 2007 and 2009 were also included.

Vitamin D levels and perinatal depressive symptoms in women at risk: a secondary analysis of the mothers, omega-3, and mental health study.

Background: Vitamin D insufficiency may be associated with depressive symptoms in non-pregnant adults. We performed this study to evaluate whether low maternal vitamin D levels are associated with depressive symptoms in pregnancy.

Methods: This study was a secondary analysis of a randomized trial designed to assess whether prenatal omega-3 fatty acid supplementation would prevent depressive symptoms.

Contraception and mental health: a commentary on the evidence and principles for practice.

Among the most prevalent and disabling chronic diseases affecting reproductive-aged women worldwide, depression and anxiety can contribute to adverse reproductive health outcomes, including an increased risk of unintended pregnancy and its health and social consequences. For women with these common mental health conditions who want to avoid an unintended pregnancy, effective contraception can be an important strategy to maintain and even improve health and well-being. Reproductive health clinicians play a critical role in providing and managing contraception to help women with mental health considerations achieve their desired fertility.

Development of a screening and recruitment registry to facilitate perinatal depression research in obstetrics settings in the USA.

Objective: To create a multi-site registry to enable future large-scale studies of perinatal depression among women attending obstetrics clinics in the USA.

Methods: A screening and recruitment registry was developed that included women aged at least 18 years who attended seven obstetric clinics in the University of Michigan Health System (Ann Arbor, MI, USA) for prenatal care between September 8, 2008, and June 9, 2011. Participants completed depression screening and research recruitment materials.

Parenting stress and depressive symptoms in postpartum mothers: bidirectional or unidirectional effects?

Despite the consistent link between parenting stress and postpartum depressive symptoms, few studies have explored the relationships longitudinally. The purpose of this study was to test bidirectional and unidirectional models of depressive symptoms and parenting stress. Uniquely, three specific domains of parenting stress were examined: parental distress, difficult child stress, and parent-child dysfunctional interaction (PCDI).

Hazardous drinking and family functioning in National Guard veterans and spouses postdeployment.

The current study examined rates of alcohol misuse among National Guard (NG) service members and their spouses/partners, concordance of drinking behaviors among couples, and the effects of alcohol misuse, depression, and posttraumatic stress disorder (PTSD) on three measures of family functioning. This study is important because it addresses the topics of heavy drinking and family functioning in an at-risk population-NG service members returning from a combat zone deployment. We surveyed NG service members (1,143) and their partners (674) 45-90 days after returning from a military deployment.

The Mothers, Omega-3, and Mental Health Study: a double-blind, randomized controlled trial.

Objectives: Maternal deficiency of the omega-3 fatty acid, docosahexaenoic acid (DHA), has been associated with perinatal depression, but there is evidence that supplementation with eicosapentaenoic acid (EPA) may be more effective than DHA in treating depressive symptoms. This trial tested the relative effects of EPA- and DHA-rich fish oils on prevention of depressive symptoms among pregnant women at an increased risk of depression.

Study Design: We enrolled 126 pregnant women at risk for depression (Edinburgh Postnatal Depression Scale score 9-19 or a history of depression) in early pregnancy and randomly assigned them to receive EPA-rich fish oil (1060 mg EPA plus 274 mg DHA), DHA-rich fish oil (900 mg DHA plus 180 mg EPA), or soy oil placebo.

Predictors of recovery from prenatal depressive symptoms from pregnancy through postpartum.

Background: Identifying predictors of the course of depressive symptoms from pregnancy through postpartum is important to inform clinical interventions.

Methods: This longitudinal study investigated predictors of recovery from prenatal elevated depressive symptoms in the postpartum period. Forty-one pregnant women completed demographic, interpersonal, and psychosocial self-report assessment measures at 32 weeks of gestation and again 12 weeks postpartum.

Lengthened predelivery stay and antepartum complications in women with depressive symptoms during pregnancy.

Unlabelled: Abstract Background: It is crucial to understand the timing and mechanisms behind depression's effect on peripartum stay because attempts to intervene will vary based on the time period involved. We designed this study to compare predelivery and postdelivery length of stay in women with and without elevated depressive symptoms during pregnancy.

Methods: This study involved secondary data analysis of a larger study exploring antepartum depression.

Risk factors for depressive symptoms during pregnancy: a systematic review.

The purpose of this study was to evaluate risk factors for antepartum depressive symptoms that can be assessed in routine obstetric care. We evaluated articles in the English-language literature from 1980 through 2008. Studies were selected if they evaluated the association between antepartum depressive symptoms and > or =1 risk factors.

Peripartum length of stay for women with depressive symptoms during pregnancy.

Background: Approximately 1 in 10 women suffers from depression during pregnancy. Little is known about whether antepartum depression affects a mother's length of stay at delivery. We aimed to compare peripartum length of stay in women with and without depressive symptoms during pregnancy.

When depression complicates childbearing: guidelines for screening and treatment during antenatal and postpartum obstetric care.

Prevalence studies show that 1 in 5 women experience an episode of major depressive disorder during their lifetime. The peripartum period is a prime time for symptom exacerbation and relapse of depressive episodes. Health care providers, specifically those in obstetric care, should be aware of: (1) the frequency of depression in pregnant and postpartum women; (2) signs, symptoms, and appropriate screening methods; and (3) the health risks for the mother and growing fetus if depression is undetected or untreated.

The relationship between obstetrical outcomes and alcohol use in the year prior to pregnancy.

Objectives: The purpose of this study was to examine problems related to alcohol use as reported covering the year prior to pregnancy in a general prenatal care seeking sample. The relationship of alcohol use to a number of pregnancy and birth complications (premature rupture of membrane, birthweight, weeks gestation and APGAR) was examined.

Methods: A total of 940 prenatal care-seeking women completed the TWEAK, a brief measure of alcohol use problems during the previous year.

Depression in childbearing women: when depression complicates pregnancy.

Prevalence studies show that one in five women experience an episode of major depressive disorder during their lifetime. It is important for health care providers to be aware of (1) the frequency of depression in this population; (2) signs, symptoms, and appropriate screening methods; and (3) health risks for the mother and growing fetus if depression is undetected or untreated. Because management of depressed pregnant women also includes care of a growing fetus, treatment may be complicated and primary care providers should consider a multidisciplinary approach, including an obstetrician, psychiatrist, and pediatrician, to provide optimal care.

Depression during pregnancy: rates, risks and consequences--Motherisk Update 2008.

Affective illness is common in women, and the puerperium is a time of particular vulnerability. Gender differences in the expression of affective disorders have been attributed to the impact of hormonal influence, socialization, and genetics. Dramatic fluctuations in gonadal hormones that occur following childbirth, influences the increased incidence of mood disorders during this time.

Sex differences in depression symptoms in treatment-seeking adults: confirmatory analyses from the Sequenced Treatment Alternatives to Relieve Depression study.

Background: Although epidemiologic research consistently reports greater prevalence of major depressive disorder in women, small sample sizes in many studies do not allow for full elaboration of illness characteristics. This article examines sex differences in terms of illness attributes in a cohort of 2541 outpatients from across the United States who enrolled in the Sequenced Treatment Alternatives to Relieve Depression study.

Methods: Confirmatory analyses were performed in 2541 outpatients comparing men and women with regard to sociodemographic features, comorbid Axis I and Axis III conditions, and illness characteristics.

Depression, antidepressant medication, and functioning outcomes among pregnant women.

Objectives: To describe prenatal patterns of antidepressant use and their relationship to depression in pregnancy.

Methods: A total of 276 high risk women completed a structured clinical interview to investigate use of antidepressant medication.

Results: Of the women interviewed, 13% (n=36) reported current use of antidepressant medication; there were no differences in depression or health functioning outcomes between women taking antidepressants and those not using them.

Rates and predictors of depression treatment among pregnant women in hospital-affiliated obstetrics practices.

Objective: The purpose of this study was to provide information on rates of depression treatment among pregnant women at risk for depression and among those with clinician-diagnosed current major depressive disorder (MDD) and to examine predictors of depression treatment.

Method: Women seeking prenatal care completed a screening survey (including the Center for Epidemiological Studies-Depression Scale) in several hospital-based obstetrics clinics. Women identified as high risk for depression completed diagnostic interviews (n=276) during pregnancy, consisting of the Structured Clinical Interview for DSM-IV, measures of depression symptom severity (Beck Depression Inventory-II), health functioning (SF-36) and current and past psychiatric treatment.

Increasing lifestyle physical activity in patients with depression or other serious mental illness.

People with severe and persistent mental illness are more likely to be overweight and to suffer from obesity-related illnesses such as diabetes and heart disease than healthy individuals. Lifestyle change interventions that emphasize integrating physical activity into daily life have not been studied extensively in people with mental illness. The authors present the results of an initial feasibility study of a lifestyle modification program for individuals with serious mental illness.

Gender differences in depression: findings from the STAR*D study.

Background: Epidemiologic research consistently reports gender differences in the rates and course of major depressive disorder (MDD). The STAR*D (Sequenced Treatment Alternatives to Relieve Depression) multicenter trial provides a unique opportunity to explore gender differences in outpatients with nonpsychotic MDD.

Methods: This sample included the first 1500 outpatients with MDD who enrolled in STAR*D.

Rates of maternal depression in pediatric emergency department and relationship to child service utilization.

This cross-sectional study aimed to (a) identify rates and correlates of untreated elevated depression in mothers of young children in a pediatric emergency department (ED) setting and (b) examine the association of depression and other key variables to child healthcare use. Mothers (n=176) bringing their child ( View Article and Find Full Text PDF