Marks Psychiatry

A study out of the University of Manitoba conducted by Ann Guevremont MEd. and Marni Bromwell PhD. concluded that depression in a woman occurring at anytime between one year before and nine years after birth is a risk factor for the child later developing ADHD. They also found the chances of the child developing ADHD is greater the more chronic the depression. In fact, maternal depression increased the chances 1.5 – 2 fold.

I’m not sure what to make of this information. There have been previous studies linking maternal depression and ADHD, but this is the first that has established a time frame for which the maternal depression impacts the child.

This data suggests that ADHD is not solely biological since the mother’s mental condition even after birth can influence the development of ADHD. It makes me wonder how much of a role maternal nurturance and attention to the child play in the child’s ability to focus and attend to things. If a depressed mother doesn’t pay enough attention to her child because she is depressed, does the child compensate for this in a way that causes them to have trouble with attention or impulsivity?

Many more questions need to be answered about this. But for now, it emphasizes the importance of mental health before and after pregnancy. Many women go undiagnosed and suffer silently. But knowing a mother’s mental state can have a far reaching impact on her family, perhaps more women will talk with their doctors about how they feel and more clinicians will be more vigilant in screening for maternal depression even years after childbirth.

Popularity: 40%

Two studies published in the New England Journal of Medicine in June 2007 reported on the risks of birth defects when women took selective serotonin-reuptake inhibitors (SSRIs) during pregnancy (sources: Louik, C et. al NEJM Volume 356:2675-2683 June 28, 2007 Number 26 and Alwan S. et al. NEJM Volume 356:2684-2692 June 28, 2007 Number 26). Both articles conclude that SSRIs taken during the first trimester of pregnancy increase the risk of certain birth defects, but the increased risk was considered to be small. Given that untreated depression carries its own risks to the unborn baby, the researchers were said to have considered these finding reassuring in terms of weighing the risks and benefits of treating depressed women during pregnancy.

Further analysis of their data showed that women with a body mass index of 30 and greater showed an even further increase in risk defects. For example, obesity plus SSRI use resulted in 3.5 times greater chance of certain heart defects and 5.9 greater chance of certain cranial defects. These numbers were in comparison to non-obese women taking SSRIs.

We don’t know why having more body fat makes a difference, but we do know SSRIs are absorbed more quickly in fat. Thus, it would stand to reason that perhaps more drug is absorbed and/or retained and this may amplify the effects of the drugs.

Women taking antidepressants and considering getting pregnant should consult with their doctor about whether to continue on the medication during pregnancy.

Your body mass index is calculated based on you height and weight. Want to know yours? Get you BMI

Popularity: 24%

I did a double take when I saw this tiny article about Breastfeeding and Post-Traumatic Stress Disorder (PTSD). Some investigators at Boston University studied a group of children whose average ages were 13. The 102 children were hospitalized at two different hospitals in Boston for traumatic injuries including burns, motor vehicle accidents, gunshot wounds and assaults. About half of all of the children had been breastfed as infants.

They tested the children for PTSD using the Child PTSD Reaction Index which is a PTSD assessment scale for children. The children who had been breastfed scored in the mild range for PTSD, whereas the children who had not been breastfed scored in the moderate range.

Currently we know that breastfeeding has a positive impact on mental health, but there isn’t much research data on the specifics of the benefits. This study gives us something specific, but we can’t consider these findings to be definite just yet given the small number of people in the study. Also a study like this would need to be replicated by others who get the same results. But, despite the shortcomings of these findings, it is positive result and could have tremendous implications in the role of breastfeeding on an individual’s future mental health.

Popularity: 27%

Postpartum depression hurts mom and the entire family.  Some epidemiologic studies have revealed that postpartum depression can have the following negative consequences:

• increases the chance of alcohol and illicit drug use in teenaged mothers
• adversely affects temperament and cognitive development in the infant
• increase the negative interactions with their toddlers and preschoolers

There are other negative consequences that impact other close relationships, such as the relationship with a spouse/significant other or friends.

In addition to seeking treatment from a health provider, support groups can be an invaluable resource. 

Postpartum Support International has many resources including local support groups.

Another resource is Depression After Delivery which is more of an information resource.

Popularity: 25%

Postpartum depression is defined as depression that develops within the first four weeks after childbirth and occurs in about 10% of women. Postpartum depression statistics have shown the following risk factors:

• a history of a mood disorder
• unwanted pregnancy
• unemployment of the mother
• lack of breast-feeding
• the mother as head of the household (source: Journal of Clinical Psychiatry)

Regarding other postpartum depression statistics, women who have had depression in the past have a 24% chance of developing postpartum depression. Depression during pregnancy increases the chances of developing postpartum depression to 35%.

Depression that develops for the first time during pregnancy is more likely to become bipolar disorder later on. Likewise, postpartum psychosis is usually a manisfestation of preexisting bipolar disorder.

Postpartum psychosis occurs infrequently in about 0.1-0.2% of women.

Popularity: 27%