Psychiatric Disorders During The Postpartum Period In Light Of Current Advances

Childbirth is one of the most important social and psychological life events for women. In addition to the social context of including a new family member, this period is highly associated with the occurrence or recurrence of psychiatric disorders. Psychiatric disorders during this period have some negative effects on children as well as functional impairments in mothers. The prevalence of psychiatric diagnosis -- especially depression and anxiety disorders -- is high in the postpartum period. Recently, there has been growing interest in psychiatric disorders in the perinatal period. This book summarizes classical information and recent advances regarding epidemiology, clinical features, pathogenesis, prognosis, the long-term effects on children, and treatments of psychiatric disorders during the postpartum period.

Biomarkers of Postpartum Psychiatric Disorders provides an up-to-date reference on the current research relating to biomarkers in psychiatric disorders, including major depressive disorder, OCD and bipolar disorder in the immediate postpartum time-period. It is the only reference on the market that synthesizes and interprets available data and reviews clinical phenotypes. Topics cover hormonal contributions, immunology, epigenetics and neuroimaging. While the risk of psychiatric illness during pregnancy appears to be equivalent to the risk at any other time in a woman’s life, the risk in the immediate postpartum time period is dramatically increased, hence the importance of the discussions in this title. Identifies epigenetic, hormonal, immunological and neuroimaging biomarkers Provides biomarkers for depression, OCD and psychosis Includes clinical phenotypes for psychiatric disorders Discusses future research and directions in the field

A panel of top experts in perinatal psychiatry reviews the many recent studies on the use of psychiatric medications in pregnancy and postpartum and assesses their impact on the diagnosis and treatment of pregnant/postpartum women. The authors focus on each of the major psychiatric illnesses, including depression, anxiety disorder, bipolar disorder, schizophrenia, substance abuse, eating disorders, and mental illness, as well as on the potential impact of these illnesses on infants and children. Interpreting conflicting and inconclusive clinical findings, they spell out the lesser-known risks of prenatal medication exposure and illuminate a variety of issues that must be taken into account in choosing such treatments as medications, psychotherapy, parental education, and social skills training.

This comprehensive reference and text synthesizes a vast body of clinically useful knowledge about women's mental health and health care. Coverage includes women's psychobiology across the life span--sex differences in neurobiology and psychopharmacology and psychiatric aspects of the reproductive cycle--as well as gender-related issues in assessment and treatment of frequently encountered psychiatric disorders. Current findings are presented on sex differences in epidemiology, risk factors, presenting symptoms, treatment options and outcomes, and more. Also addressed are mental health consultation to other medical specialties, developmental and sociocultural considerations in service delivery, and research methodology and health policy concerns.

Mood and Anxiety Disorders During Pregnancy and Postpartum earns its important place in the literature by detailing our current understanding of the course, diagnosis, and treatment of psychiatric illness during pregnancy and postpartum, including breast-feeding -- a top priority today because we now know that active maternal psychiatric illness during pregnancy and postpartum can exert long-term negative effects on child development and cause significant morbidity for the mother. In just five concise richly informative chapters, the nine distinguished contributors to Mood and Anxiety Disorders During Pregnancy and Postpartum dispel prevailing beliefs and offer invaluable guidance in treating women during pregnancy and postpartum: Course of Psychiatric Illness During Pregnancy and the Postpartum Period -- Despite the enduring belief that pregnancy is a time of emotional well-being for women, emerging data show that pregnancy is instead a time of increased vulnerability to psychiatric illness. Diagnosis and Treatment of Mood and Anxiety Disorders During Pregnancy -- Though the use of psychotropic medications during pregnancy and postpartum raises concerns, the accumulating data support the use of certain SSRIs/tricyclic antidepressants, especially when balanced against the risk to both mother and child of depression during pregnancy. Management of Bipolar Disorder During Pregnancy and the Postpartum Period: Weighing the Risks and Benefits -- Although the onset of bipolar disorder (BP) tends to occur during women's reproductive years, surprisingly little is known about the impact of the menstrual cycle, pregnancy, postpartum, breast-feeding, and menopause on the course and treatment of bipolar disorder. Postpartum Mood Disorders -- Women experience a dramatic increase in their risk of developing severe psychiatric illness during postpartum for a full year after delivery. Often overlooked, postpartum disorders must be identified and treated as early as possible to reduce the mother's risk for recurrent and treatment-refractory illness and the child's risk for long-term development problems due to the detrimental effect of maternal depression. Use of Antidepressants and Mood Stabilizers in Breast-feeding Women -- This expanded clinical appraisal of the literature on antidepressant and mood stabilizer use in breast-feeding women shows that additional detailed pharmacokinetic investigations are urgently needed to enhance our understanding of nursing infant exposure and the role(s) of pharmacogenomics in determining infant exposure. Meticulously referenced and remarkably succinct, Mood and Anxiety Disorders During Pregnancy and Postpartum provides critical information about the course of illness during pregnancy and postpartum to help guide effective individualized treatment decisions-decisions that are ultimately based on the patient's wishes.

Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.

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