Articles de revues : « Perinatal psychopathology »

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Sutter-Dallay, A. L. « Parental perinatal psychopathology and infant development ». European Psychiatry 22 (mars 2007) : S18. http://dx.doi.org/10.1016/j.eurpsy.2007.01.073.

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Díaz-Pérez, Elisa, Gonzalo Haro et Iván Echeverria. « Psychopathology Present in Women after Miscarriage or Perinatal Loss : A Systematic Review ». Psychiatry International 4, n^o 2 (6 mai 2023) : 126–35. http://dx.doi.org/10.3390/psychiatryint4020015.

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Miscarriage or perinatal loss constitutes one of the most important emotional stressors a woman can experience and can be associated with bereavement. This mourning is a way of adapting and coping with the circumstances. However, inadequate management of this process can lead to the development of complicated grief and psychopathologies such as anxiety, depression, and post-traumatic stress disorder. The aim of this systematic review was to evaluate the prevalence of psychopathology (anxiety, depression, and post-traumatic stress disorder) in women with a history of miscarriage or perinatal loss in the year prior, and to compare these results with women without this history. A peer review was conducted in PubMed, Cochrane, Scopus, and Web of Science databases. We included (1) articles that included women of any age who had had a miscarriage or perinatal loss in the year prior, and (2) articles with a longitudinal cohort design with a comparison group of women without a history of miscarriage or perinatal loss. After the screening process, three articles met these inclusion criteria and were included in this study. Psychopathology in women after miscarriage or perinatal loss was higher than in the control groups. In addition, it was observed that these psychopathologies gradually decreased over the first year from the loss. In conclusion, abortion and perinatal loss pose a risk factor for the development of psychopathology. Therefore, we emphasize the importance of implementing a mental health plan for these women.

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Jacobson, Melanie H., Akhgar Ghassabian, Andrea C. Gore et Leonardo Trasande. « Exposure to environmental chemicals and perinatal psychopathology ». Biochemical Pharmacology 195 (janvier 2022) : 114835. http://dx.doi.org/10.1016/j.bcp.2021.114835.

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ALLEN, NICHOLAS B., PETER M. LEWINSOHN et JOHN R. SEELEY. « Prenatal and perinatal influences on risk for psychopathology in childhood and adolescence ». Development and Psychopathology 10, n^o 3 (septembre 1998) : 513–29. http://dx.doi.org/10.1017/s0954579498001722.

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The relationship between a range of prenatal and perinatal events and risk for psychopathology in offspring was examined. Prenatal and perinatal events investigated included maternal experiences, health, and substance use during pregnancy, obstetric complications, feeding practices, and infant health during the first year of life. Offspring diagnosis was based on structured interviews conducted with 579 adolescents on two occasions. Risk for later psychopathology was associated with a number of prenatal and perinatal factors. Major depression was associated with not being breast fed and maternal emotional problems during the pregnancy. Anxiety was chiefly associated with fever and illness during the first year of life and maternal history of miscarriage and stillbirth. Disruptive behavior disorder was associated with poor maternal emotional health during the pregnancy and birth complications. Risk for substance use disorder was associated with maternal use of substances during the pregnancy. Mediating effects of maternal depression, maternal–child conflict, and physical symptoms in the child, and moderating effects of gender of child and parental education were also evaluated. The limitations of this study are discussed and future research directions are suggested.

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Valleau, Jeanette C., et Elinor L. Sullivan. « The impact of leptin on perinatal development and psychopathology ». Journal of Chemical Neuroanatomy 61-62 (novembre 2014) : 221–32. http://dx.doi.org/10.1016/j.jchemneu.2014.05.001.

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Otieno Oginga, Fredrick, Kulimankudya Dominic Vasco et Thabisile Mpofana. « Developmental Impact of Early Life Stress and Schizophrenia : An up to Date Review on the Psycho-Neurobiological Dysregulation ». International Journal of Research and Scientific Innovation XI, n^o XV (2024) : 30–43. http://dx.doi.org/10.51244/ijrsi.2024.1115003p.

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Rationale; The study of the possible effects of early life stress (ELS) on later human behavior and neurobiology is a rapidly growing field. While epidemiological and neurobiological studies paint a grim picture of negative consequences, little attention has been paid to integrating the diverse evidence on possible cognitive and emotional deficits associated with ELS. Longitudinal studies examining the effects of perinatal mental disorders such as schizophrenia provide a new framework for understanding the mechanisms underlying ELS sequelae ranging from psychopathology to alterations in brain morphology. Objective: The aim of this review was threefold. The first was to summarize the results of longitudinal data on the effects of perinatal stress on the development of mental illness in children. The second goal was to interpolate the effects of parental psychopathology on cognition. Third, to use this framework of normative brain development to interpret changes in developmental trajectories associated with deficits in cognitive and affective functioning after ELS. Results: While ELS is associated with a variety of effects later in life, five normative principles of brain development were identified and used in this review to discuss the behavioral and neural consequences of ELS. Early adversity has been associated with deficits in a variety of cognitive (cognitive performance, memory, and executive functions) and affective (reward processing, processing of social and affective stimuli, and emotion regulation) functions. Conclusion; we reached three general conclusions: (1) complex higher-order cognitive and affective functions associated with brain regions that have undergone prolonged postnatal development are particularly vulnerable to the deleterious effects of ELS (2) astrocytes in the hippocampus and orbital frontal cortices are particularly sensitive to early ELS; and (3) several deficits, particularly in the affective domain, appear to persist years after the end of ELS. However, there is no clear correlation between parental psychopathology during the perinatal period and the other two domains, cognitive and psychomotor, which may further explain the increased risk for later psychopathology.

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Glynn, Laura M., Mariann A. Howland et Molly Fox. « Maternal programming : Application of a developmental psychopathology perspective ». Development and Psychopathology 30, n^o 3 (août 2018) : 905–19. http://dx.doi.org/10.1017/s0954579418000524.

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AbstractThe fetal phase of life has long been recognized as a sensitive period of development. Here we posit that pregnancy represents a simultaneous sensitive period for the adult female with broad and persisting consequences for her health and development, including risk for psychopathology. In this review, we examine the transition to motherhood through the lens of developmental psychopathology. Specifically, we summarize the typical and atypical changes in brain and behavior that characterize the perinatal period. We highlight how the exceptional neuroplasticity exhibited by women during this life phase may account for increased vulnerability for psychopathology. Further, we discuss several modes of signaling that are available to the fetus to affect maternal phenotypes (hormones, motor activity, and gene transfer) and also illustrate how evolutionary perspectives can help explain how and why fetal functions may contribute to maternal psychopathology. The developmental psychopathology perspective has spurred advances in understanding risk and resilience for mental health in many domains. As such, it is surprising that this major epoch in the female life span has yet to benefit fully from similar applications.

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Depino, Amaicha Mara. « Perinatal inflammation and adult psychopathology : From preclinical models to humans ». Seminars in Cell & ; Developmental Biology 77 (mai 2018) : 104–14. http://dx.doi.org/10.1016/j.semcdb.2017.09.010.

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Cooke, Danielle. « 11989 The Impact of a Perinatal Mental Health Clinic on Psychopathology ». Journal of Clinical and Translational Science 5, s1 (mars 2021) : 69–70. http://dx.doi.org/10.1017/cts.2021.582.

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ABSTRACT IMPACT: This research is intended to provide researchers and clinicians information on factors that impact psychiatric health outcomes in a specialty perinatal mood disorders clinic. OBJECTIVES/GOALS: The present study seeks to examine factors that impact psychiatric outcomes at the University of Florida Department of Obstetrics and Gynecology Perinatal Mood Disorders Clinic (PMDC). METHODS/STUDY POPULATION: A hierarchical multinomial logistic regression will be conducted to evaluate predictors that may influence patients receiving a referral to specialty care, a return to primary care or being lost to follow up. Included predictors are changes in insurance status, baseline depression scores, and baseline obsessive-compulsive symptoms (OCS). A multinomial logistic regression will be conducted to determine if OCS and depressive symptoms predict referral to/establishment of psychotherapeutic care. A secondary binary logistic regression will be conducted to evaluate predictors that may predict reduction in depressive symptoms among women seen for more than one session. Included predictors of outcome include time (weeks in psychiatric treatment), OCS at baseline, and referral to psychological therapy. RESULTS/ANTICIPATED RESULTS: Data collection is multiphasic and ongoing via a retrospective chart review of patients seen in the PMDC. Hypotheses include that experiencing a change in insurance will significantly increase the risk of being lost to follow up, as compared to referral to specialty clinic or returning to primary care. It is also predicted that individuals with higher depressive symptoms or OCS will be more likely likely to be assigned to specialty care than to be lost to follow up or primary care. It is believed that greater time in psychiatric care, and lower OCS will increase the likelihood of reductions in depressive symptoms. DISCUSSION/SIGNIFICANCE OF FINDINGS: This study seeks to provide information on predictors that influence outcome this specialty clinic, while extending the limited literature that has examined the influence of OCS on depressive symptoms. It is the hope of the authors to provide information on intervenable factors that influence psychiatric outcomes in a perinatal specialty clinic.

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Petrilli, G., G. Rizzi, R. Anniverno, C. Mencacci et J. M. C. Blom. « P02-392 - Perinatal psychopathology : characterisation of a selected italian women sample ». European Psychiatry 25 (2010) : 1408. http://dx.doi.org/10.1016/s0924-9338(10)71394-8.

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Essau, Cecilia A., Satoko Sasagawa, Peter M. Lewinsohn et Paul Rohde. « The impact of pre- and perinatal factors on psychopathology in adulthood ». Journal of Affective Disorders 236 (août 2018) : 52–59. http://dx.doi.org/10.1016/j.jad.2018.04.088.

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Werner, Emmy E. « Risk, resilience, and recovery : Perspectives from the Kauai Longitudinal Study ». Development and Psychopathology 5, n^o 4 (1993) : 503–15. http://dx.doi.org/10.1017/s095457940000612x.

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AbstractThis article summarizes the major findings of a longitudinal study that traced the developmental paths of a multiracial cohort of children who had been exposed to perinatal stress, chronic poverty, and a family environment troubled by chronic discord and parental psychopathology. Individuals are members of the Kauai Longitudinal Study, which followed all children born in 1955 on a Hawaiian island from the perinatal period to ages 1, 2, 10, 18, and 32 years. Several clusters of protective factors and processes were identified that enabled most of these high-risk individuals to become competent and caring adults. Implications of the findings for developmental theory and social action programs are discussed, and issues for future research are identified.

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Callahan, Stacey, et Anne Denis. « Irrational beliefs and motherhood : “Hot cognitions” and their relationship to perinatal psychopathology ». Journal de Thérapie Comportementale et Cognitive 23, n^o 1 (mars 2013) : 3–8. http://dx.doi.org/10.1016/j.jtcc.2013.01.003.

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Ingersoll, Karen S., Janet S. Knisely, Kathryn S. Dawson et Sidney H. Schnoll. « Psychopathology and treatment outcome of drug dependent women in a perinatal program ». Addictive Behaviors 29, n^o 4 (juin 2004) : 731–41. http://dx.doi.org/10.1016/j.addbeh.2004.02.002.

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Røhder, Katrine, Angus MacBeth, Kirstine Agnete Davidsen, Andrew Gumley, Jessica Brennan, Carol George et Susanne Harder. « Antenatal caregiving representations and perinatal behavior in mothers with severe lifetime psychopathology ». Infant Mental Health Journal 41, n^o 1 (2 septembre 2019) : 56–68. http://dx.doi.org/10.1002/imhj.21824.

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Verdoux, H�l�ne, et Anne-Laure Sutter. « Perinatal risk factors for schizophrenia : Diagnostic specificity and relationships with maternal psychopathology ». American Journal of Medical Genetics 114, n^o 8 (27 novembre 2002) : 898–905. http://dx.doi.org/10.1002/ajmg.10906.

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Marceau, Kristine, Nastassia Hajal, Leslie D. Leve, David Reiss, Daniel S. Shaw, Jody M. Ganiban, Linda C. Mayes et Jenae M. Neiderhiser. « Measurement and associations of pregnancy risk factors with genetic influences, postnatal environmental influences, and toddler behavior ». International Journal of Behavioral Development 37, n^o 4 (26 juin 2013) : 366–75. http://dx.doi.org/10.1177/0165025413489378.

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This study demonstrates the unique contributions of perinatal risk and genetic and environmental influences on child behavior using data from 561 domestic US adoption triads (birth mothers, adopted child, and adoptive parents). Findings show distinct patterns of associations among genetic (birth mother psychopathology), prenatal (six maternal reported aggregate scores characterizing total obstetric complications, perinatal internalizing symptoms, pregnancy complications, exposure to toxins, substance use, and neonatal complications), and postnatal influences (adoptive parent 18-month internalizing symptoms and over-reactive parenting) and toddler behavior problems (CBCL subscales at 27 months). Findings highlight multiple pathways for toddler’s behavioral development, including genetic, pregnancy, and postnatal main effects. Findings suggest distinct types of pregnancy risk may transmit genetic influences for specific behavior problems rather than broadband problems.

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Di Bartolomeo, Martina, Tibor Stark, Serena Di Martino, Fabio Arturo Iannotti, Jana Ruda-Kucerova, Giovanni Luca Romano, Martin Kuchar et al. « The Effects of Peripubertal THC Exposure in Neurodevelopmental Rat Models of Psychopathology ». International Journal of Molecular Sciences 24, n^o 4 (15 février 2023) : 3907. http://dx.doi.org/10.3390/ijms24043907.

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Adolescent exposure to cannabinoids as a postnatal environmental insult may increase the risk of psychosis in subjects exposed to perinatal insult, as suggested by the two-hit hypothesis of schizophrenia. Here, we hypothesized that peripubertal Δ9-tetrahydrocannabinol (aTHC) may affect the impact of prenatal methylazoxymethanol acetate (MAM) or perinatal THC (pTHC) exposure in adult rats. We found that MAM and pTHC-exposed rats, when compared to the control group (CNT), were characterized by adult phenotype relevant to schizophrenia, including social withdrawal and cognitive impairment, as revealed by social interaction test and novel object recognition test, respectively. At the molecular level, we observed an increase in cannabinoid CB1 receptor (Cnr1) and/or dopamine D2/D3 receptor (Drd2, Drd3) gene expression in the prefrontal cortex of adult MAM or pTHC-exposed rats, which we attributed to changes in DNA methylation at key regulatory gene regions. Interestingly, aTHC treatment significantly impaired social behavior, but not cognitive performance in CNT groups. In pTHC rats, aTHC did not exacerbate the altered phenotype nor dopaminergic signaling, while it reversed cognitive deficit in MAM rats by modulating Drd2 and Drd3 gene expression. In conclusion, our results suggest that the effects of peripubertal THC exposure may depend on individual differences related to dopaminergic neurotransmission.

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Choi, Karmel W., et Kathleen J. Sikkema. « Childhood Maltreatment and Perinatal Mood and Anxiety Disorders ». Trauma, Violence, & ; Abuse 17, n^o 5 (8 juillet 2016) : 427–53. http://dx.doi.org/10.1177/1524838015584369.

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Perinatal mood and anxiety disorders (PMADs) compromise maternal and child well-being and may be influenced by traumatic experiences across the life course. A potent and common form of trauma is childhood maltreatment, but its specific impact on PMADs is not well understood. A systematic review was undertaken to synthesize empirical literature on the relationship between maternal histories of childhood maltreatment and PMADs. Of the 876 citations retrieved, 35 reports from a total of 26,239 participants met inclusion criteria, documenting substantial rates of childhood maltreatment and PMADs. Robust trends of association were observed between childhood maltreatment and perinatal depression, as well as post-traumatic stress disorder, but findings for anxiety were less consistent. Examining multivariate results suggested that childhood maltreatment predicts PMADs above and beyond sociodemographic, psychiatric, perinatal, and psychosocial factors, but may also be partially mediated by variables such as later victimization and moderated by protective early relationships. Future research should test mediating and moderating pathways using prospective cohorts, expanding to cross-cultural settings and other disorder outcomes. Treatment and prevention of childhood maltreatment and its sequelae may help mitigate risk for perinatal psychopathology and its impact on maternal and child outcomes.

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Pompili, S., L. Orsolini, A. Mauro, V. Salvi et U. Volpe. « The impact of the Covid-19 pandemic on peripartum affective psychopathology ». European Psychiatry 65, S1 (juin 2022) : S103—S104. http://dx.doi.org/10.1192/j.eurpsy.2022.295.

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Introduction Despite COVID-19 pandemic significantly impacting mental health, few studies evaluated effects on perinatal mental health. Objectives Therefore, we aimed at assessing pregnant and puerperal women during first and second COVID-19 waves. Methods 70 women (41 pregnant and 29 puerperal) consecutively afferent to our outpatient service for Perinatal Mental Health (March 2020-March 2021) were administered Edinburgh Postnatal Depression Scale (EPDS), Fear of COVID-19 (FCV-19-S), Coronavirus Anxiety Scale (CAS) and Wijma Delivery Expectancy/Experience questionnaire (WDEQ). Results Women who reported last menstruation date (LMD) in 2019 second semester showed higher EPDS scores (p=0.026), those with estimated delivery date (EDD) in 2021 second semester showed higher CAS scores than those with EDD in 2020 first semester (p=0.020) or in 2021 first semester (p<0.001). Women with clinically significant EPDS Scores reported higher FCV-S-19 (p=0.005) and CAS (p=0.003). Subjects with a previous psychiatric hospitalization showed higher FCV-S-19 (p=0.003). A weak positive correlation (r=0,290; R2=0,084; p=0.015) has been observed between FCV-S-19 and EPDS. Furthermore, there was a strong positive correlation (r=0,377; R2=0,142; P=0.001) between CAS and EPDS and between CAS and FCV-S-19 (r=0,641; R2=0.410; p<0.001). All subjects showed high scores for tocophobia after experiencing delivery. Conclusions COVID-19 pandemic significantly impacted pregnant and/or postpartum women also without a previous psychiatric condition. Early identification and screening tools should be routinely provided to all pregnant and postpartum women. Disclosure No significant relationships.

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Flensborg-Madsen, Trine, Erik Lykke Mortensen, Jesper Dammeyer et Cathrine Lawaetz Wimmelmann. « Early Motor Developmental Milestones and Personality Traits in Midlife : A 50-Year Follow-Up Study ». Children 10, n^o 4 (13 avril 2023) : 718. http://dx.doi.org/10.3390/children10040718.

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Background The purpose of this study was to investigate if infants’ age at attaining motor developmental milestones is associated with the big five personality traits 50 years later. Methods Mothers of 8395 infants from the Copenhagen Perinatal Cohort recorded a total of 12 motor developmental milestones during the first year of their infant’s life. Information on at least one milestone was available for 1307 singletons with adult follow-up scores on the NEO-Five-Factor Inventory. The mean age at personality testing was 50.1 years. Results Slower attainment of motor milestones was associated with increased neuroticism and lower conscientiousness in midlife. All 12 motor developmental milestones explained a total of 2.4% of the variance in neuroticism, while they explained 3.2% of the variance in conscientiousness. These results remained significant after adjustment for the included family and perinatal covariates, as well as adult intelligence. Discussion The personality trait of neuroticism is a general risk factor for psychopathology and has in young adulthood been found to be associated with early motor development. However, evidence on associations of motor developmental milestones with other personality traits has been non-existent. These findings suggest that delays in early motor development may not only characterise individuals with later psychopathology, including schizophrenia, but may also be associated with personality traits such as neuroticism and conscientiousness through the life course.

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Benes, Francine M. « Developmental changes in stress adaptation in relation to psychopathology ». Development and Psychopathology 6, n^o 4 (1994) : 723–39. http://dx.doi.org/10.1017/s0954579400004752.

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AbstractAs modern neuroscience seeks to understand the neural bases for mental illness, it is becoming increasingly important to define how and when complex neural circuits may be altered in individuals who carry the genetic vulnerability for psychopathology. One factor that could potentially play a contributory role in mental illness is the stress response. A variety of studies suggest that stress can alter the activity of several key cortical neurotransmitters, including glutamate, γ-aminobutyric acid, dopamine, and serotonin. Specifically, exposure to neurotoxic levels of adrenal steroid hormone, particularly if this occurs early in life, could potentially induce permanent changes of these transmitter systems in corticolimbic regions, such as the hippocampal formation and cingulate gyrus, that have a high density of glucocorticoid receptors. Overall, exposure to severe stress during the perinatal period could potentially induce alterations in the circuitry of the anterior cingulate cortex and hippocampal formation and interfere with the normal mechanisms underlying attention and learning.

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Dhaliwal, Sammy, Philip Gehrman, Katherine Sharkey et Hyunh-Nhu Le. « 0257 Testing the directionality of sleep and stress during the perinatal period : what's the impact on perinatal depression ? » Sleep 45, Supplement_1 (25 mai 2022) : A115—A116. http://dx.doi.org/10.1093/sleep/zsac079.255.

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Abstract Introduction Pregnancy is a time of pronounced sleep disturbance, with a majority (~85%) of women endorsing shorter, more fragmented sleep as gestation progresses. While new-onset antenatal depression (AND) is a known risk factor for postpartum depression, its etiology remains less understood, despite well-established evidence that incidence is the same among healthy first-time mothers as compared to women with established riskfactors inclusive of family or personal history of psychopathology. Heightened daily stress appraisals may be one critical pathway through which disrupted sleep gives rise to AND. The current study tested the directionality of the relationship between habitual nighttime sleep parameters and daytime stress ratings using a prospective amulatory field study design. Methods Fifty primiparous women (38% White; 32% Black; 30% Other race/ethnicity; mean age = 32 years, 28 weeks gestation) without a history of sleep disorders nor psychopathology completed 10-days (9-nights) of actigraphy and sleep diaries. They also engaged in 3-days of superimposed ecological momentary assessments (EMA) rating stress, positive, and negative affect at four intervals throughout the day. Analyses examined negative affective responses to social conflict and task-based demand througout days of EMA, at the within-person and between-women levels. Sleep variables explored included total sleep time (TST), sleep efficiency (SE; log-transformed), sleep onset latency (SOL) and sleep quality as measured by the Pittsburgh Sleep Quality Index. Cross-lagged hierarchical mixed models tested directionality of sleep-stress relationship. Time-varying covariates included time-of-day, previous day stress for sleep outcomes, and previous night sleep for stress outcomes, at the within-person levels. Results After days of greater stress (demand and conflict), women experienced significantly shorter, less efficient sleep and took longer to fall asleep (by both diary and actigraphy; [Beta(SE)=-6.3(1.4); 1.2(.12,), R^2=.27, .32, respectively; ps<.01]. Following nights of shorter sleep, women endorsed greater negative affective responses to stress (Beta=.12, SE=.01, p<.001; R^2=.27). Over the assessment period, women who had shorter, less efficient sleep experienced greater frequency, higher severity stressors, after adjusting for time-of-day, and baseline sleep characteristics, depression and anxiety levels (Betas = -7.4(2.6); .14(.01), ps<.001, respectively). Given this bidirectional support, stress was examined as a moderator of the relationship between TST and depression severity at 34-36 weeks gestation, indicating that greater stress explained the relationship between shorter TST and heightened AND after adjustment for baseline measures. Conclusion This is the first study to explore directionality of sleep-stress relationships in a perinatal sample; results provide support for the idea that heightened daily stress engenders greater sleep disturbance (difficulty initiating and maintaining sleep; shorter duration). Bidirectional support for shorter sleep duration and increased stress appraisal was also found. The current project provides preliminary evidence for stress "spill-over" effects (i.e., stress transmission) as a potential mechanism for heightened antenatal depression symptoms. Support (If Any) NIMH 1R36MH118000-01, CTSI89431, SRS Mentor/Mentee Grant; T32 HL007713

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Medland, Victoria, Aoife Nechowska et Panos Prevezanos. « Perinatal mental health : an overview of pathology, services and the law ». Obstetrician & ; Gynaecologist 27, n^o 1 (janvier 2025) : 57–67. https://doi.org/10.1111/tog.12963.

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Key content Perinatal mental health problems are the commonest complication of pregnancy, with adjustment disorder affecting as many as one in four, and maternal suicide the leading direct cause of death in the first postnatal year. Plans are in place to expand Perinatal Mental Health (PNMH) Services. The team structure of PNMH services available in primary and secondary care. Psychopathology, referencing pre‐pregnancy counselling, antenatal and postnatal care, with an overview of adjustment disorder, depressive and anxiety disorders, OCD, schizophrenia, personality disorder, bipolar affective disorder and puerperal psychosis. Commonly‐used medications and associated considerations. ‘Red flags’ requiring urgent psychiatric input, and how to escalate appropriately. Learning objectives Understand key features of the common and serious psychiatric complications presenting in and around pregnancy. Understand the perinatal implications of commonly‐used psychotropics. Recognise features of emergency presentations, and how to refer urgently. Ethical issues Safeguarding considerations are complex: the mother and unborn/ neonate must be protected; however, fear of referral can inhibit disclosure of mental illness. Use of the Mental Health Act limits personal freedoms but must be balanced with patients' risk to themselves and others.

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Buhagiar, Rachel, et Kristina Bettenzana. « The point prevalence of post-partum perinatal mental health disorders and associated psychosocial characteristics in Malta : a study protocol ». International Journal of Clinical Trials 9, n^o 1 (25 janvier 2022) : 45. http://dx.doi.org/10.18203/2349-3259.ijct20220111.

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Background: Perinatal mental health disorders are considered to be a major public health concern. Left untreated, maternal psychopathology can extent to the rest of the family unit, and increase the risk of psychological and psychiatric co-morbidity in the child. Thus, a better understanding of the overall burden of these disorders is fundamental to inform policy makers and produce practice change. Worldwide, perinatal mental health disorders are known to affect approximately 20% of pregnant and postnatal women. However, the prevalence of these disorders in Malta, an island in the center of the Mediterranean Sea with approximately 4,000 births annually, remains unknown. The primary objective of this cross-sectional study will be to address this gap in knowledge and define the local prevalence of perinatal psychopathology.Methods: A representative sample of 300 postnatal women from birth up to one year after childbirth, resident in Malta, will be recruited through a stratified random technique. Participation will involve two phases. In the first stage, selected participants will be asked to self-complete the Edinburgh postnatal depression scale (EPDS), the generalized anxiety disorder-7 item (GAD-7), the Yale Brown obsessive compulsive scale (YBoCS), the Post-Traumatic Stress Disorder Checklist for DSM-V (PCL-5), and the difficulties in emotional regulation scale (DERS) questionnaires. In the second stage, those women who score equal or above the cut-off values in any of these questionnaires, will be assessed using the diagnostic mini-international neuropsychiatric interview (MINI) to confirm or refute a diagnosis of a mental health disorder.Conclusions: In addition to determining the local prevalence, scores from the self-report instruments will be correlated with MINI diagnostic outcomes to determine the best cut-off value for a provisional diagnosis for each of these tools. Basic demographic details and psychosocial characteristics will be recorded.

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Carona, Carlos, Cristina Canavarro, Manuel Quartilho et Ana Fonseca. « A clinically informative screening for perinatal depression : bringing psychopathology and positive mental health together ». Perinatal Journal 30, n^o 3 (31 octobre 2022) : 244–49. http://dx.doi.org/10.2399/prn.22.0303003.

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Goodman, Sherryl H., et Sona Dimidjian. « The Developmental Psychopathology of Perinatal Depression : Implications for Psychosocial Treatment Development and Delivery in Pregnancy ». Canadian Journal of Psychiatry 57, n^o 9 (septembre 2012) : 530–36. http://dx.doi.org/10.1177/070674371205700903.

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Hallmayer, J. « Perinatal environmental factors and parental psychopathology were associated with risk of autism in Danish children ». Evidence-Based Medicine 10, n^o 6 (1 décembre 2005) : 184. http://dx.doi.org/10.1136/ebm.10.6.184.

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Livingston, Julianne D., George J. Youssef, Jennifer StGeorge, Karen Wynter, Eileen Dowse, Lauren M. Francis, Laura Di Manno et al. « Paternal coping and psychopathology during the perinatal period : A mixed studies systematic review and meta-analysis ». Clinical Psychology Review 86 (juin 2021) : 102028. http://dx.doi.org/10.1016/j.cpr.2021.102028.

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Lin, Betty, Parisa R. Kaliush, Elisabeth Conradt, Sarah Terrell, Dylan Neff, Ashley K. Allen, Marcela C. Smid, Catherine Monk et Sheila E. Crowell. « Intergenerational transmission of emotion dysregulation : Part I. Psychopathology, self-injury, and parasympathetic responsivity among pregnant women ». Development and Psychopathology 31, n^o 3 (8 mai 2019) : 817–31. http://dx.doi.org/10.1017/s0954579419000336.

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AbstractThe World Health Organization recently reported that maternal mental health is a major public health concern. As many as one in four women suffer from psychiatric disorders at some point during pregnancy or the first postpartum year. Furthermore, self-injurious thoughts and behaviors (SITBs) represent one of the leading causes of death among women during this time. Thus, efforts to identify women at risk for serious forms of psychopathology and especially for SITBs are of utmost importance. Despite this urgency, current single-diagnostic approaches fail to recognize a significant subset of women who are vulnerable to perinatal stress and distress. The current study was among the first to investigate emotion dysregulation—a multilevel, transdiagnostic risk factor for psychopathology—and its associations with stress, distress, and SITBs in a sample of pregnant women (26–40 weeks gestation) recruited to reflect a range of emotion dysregulation. Both self-reported emotion dysregulation and respiratory sinus arrhythmia, a biomarker of emotion dysregulation, demonstrated expected associations with measures of mental health, including depression, anxiety, borderline personality pathology, and SITBs. In addition, self-reported emotion dysregulation was associated with blunted respiratory sinus arrhythmia responsivity to an ecologically valid infant cry task. Findings add to the literature considering transdiagnostic risk during pregnancy using a multiple-levels-of-analysis approach.

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Flensborg-Madsen, T., H. J. Sørensen, R. Revsbech et E. L. Mortensen. « Early motor developmental milestones and level of neuroticism in young adulthood : a 23-year follow-up study of the Copenhagen Perinatal Cohort ». Psychological Medicine 43, n^o 6 (14 septembre 2012) : 1293–301. http://dx.doi.org/10.1017/s0033291712001997.

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BackgroundStudies investigating early developmental factors in relation to psychopathology have mainly focused on schizophrenia. The personality dimension of neuroticism seems to be a general risk factor for psychopathology, but evidence on associations between early developmental precursors and personality traits is almost non-existent. This study is therefore the first to investigate associations between early motor developmental milestones and neuroticism in adulthood.MethodMothers of 9125 children of the Copenhagen Perinatal Cohort recorded 12 developmental milestones during the child's first year of life. A subsample of the cohort comprising 1182 individuals participated in a follow-up when they were aged 20–34 years and were administered the Eysenck Personality Questionnaire (EPQ). Associations between motor developmental milestones and level of neuroticism, extraversion and psychoticism were analysed by multiple linear regression adjusting for for sex, single-mother status, parity, mother's age, father's age, parental social status and birth weight.ResultsAmong the 1182 participants with information on the EPQ, information on milestones was available for 968 participants. Infants who developed high levels of neuroticism as adults tended to sit without support, crawl, and walk with and without support significantly later than individuals with low levels of neuroticism (p values <0.05). These results remained significant after adjustment for the included covariates and for adult intelligence.ConclusionsThe findings are the first of their kind and suggest that delays in early motor development may not only characterize psychopathological disorders such as schizophrenia, but may also be associated with the personality dimension of neuroticism in adulthood.

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Harmsen van der Vliet-Torij, H. W., A. A. Venekamp, H. J. M. van Heijningen-Tousain, E. Wingelaar-Loomans, J. Scheele, J. P. de Graaf, M. P. Lambregtse-van den Berg, E. A. P. Steegers et M. J. B. M. Goumans. « Development of a Blueprint for Integrated Care for Vulnerable Pregnant Women ». Maternal and Child Health Journal 26, n^o 3 (9 janvier 2022) : 451–60. http://dx.doi.org/10.1007/s10995-021-03340-y.

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Abstract Purpose There has been increasing awareness of perinatal health and organisation of maternal and child health care in the Netherlands as a result of poor perinatal outcomes. Vulnerable women have a higher risk of these poor perinatal outcomes and also have a higher chance of receiving less adequate care. Therefore, within a consortium, embracing 100 organisations among professionals, educators, researchers, and policymakers, a joint aim was defined to support maternal and child health care professionals and social care professionals in providing adequate, integrated care for vulnerable pregnant women. Description Within the consortium, vulnerability is defined as the presence of psychopathology, psychosocial problems, and/or substance use, combined with a lack of individual and/or social resources. Three studies focussing on population characteristics, organisation of care and knowledge, skills, and attitudes of professionals regarding vulnerable pregnant women, were carried out. Outcomes were discussed in three field consultations. Assessment The outcomes of the studies, followed by the field consultations, resulted in a blueprint that was subsequently adapted to local operational care pathways in seven obstetric collaborations (organisational structures that consist of obstetricians of a single hospital and collaborating midwifery practices) and their collaborative partners. We conducted 12 interviews to evaluate the adaptation of the blueprint to local operational care pathways and its’ embedding into the obstetric collaborations. Conclusion Practice-based research resulted in a blueprint tailored to the needs of maternal and child health care professionals and social care professionals and providing structure and uniformity to integrated care provision for vulnerable pregnant women.

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Cohen, Patricia, C. Noemi Velez, Judith Brook et Jesse Smith. « Mechanisms of the Relation between Perinatal Problems, Early Childhood Illness, and Psychopathology in Late Childhood and Adolescence ». Child Development 60, n^o 3 (juin 1989) : 701. http://dx.doi.org/10.2307/1130735.

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Giannopoulou, Ioanna, Marianna A. Pagida, Despina D. Briana et Maria T. Panayotacopoulou. « Perinatal hypoxia as a risk factor for psychopathology later in life : the role of dopamine and neurotrophins ». Hormones 17, n^o 1 (mars 2018) : 25–32. http://dx.doi.org/10.1007/s42000-018-0007-7.

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Loo, Jiann Lin, et Andrea Taylor-Clutton. « Leadership Development as a Medical Educational Fellow in Psychiatry : Reflection After Two Years ». BJPsych Open 10, S1 (juin 2024) : S109. http://dx.doi.org/10.1192/bjo.2024.307.

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AimsThe disruptive force of the COVID pandemic has highlighted the importance of leadership for all medical educationists to prepare the future workforce with the ever-changing healthcare practice. Early career medical educators must attain leadership skills as early as possible. The only way to learn leadership is through experiential learning, i.e. learning while leading. Therefore, this self-study is aimed to share the reflection on the journey of a psychiatrist specialist trainee from North Wales in leading different psychiatric educational projects.MethodsThis is self-study research on the reflective experience of working as a medical educational fellow while undergoing specialist training in psychiatry from January 2022 to December 2023. The data reflected were sourced from publications, end-of-project reports, meeting minutes, participant and peer feedback, personal records, educational portfolios, and appraisals.ResultsNine psychiatric educational quality improvement projects (QIPs) had been conceptualised and implemented, i.e. three series of mock exams (Special Preparation in CASC Exam), continuous coaching and mentoring in portfolio-based learning (Café of RCPsych Portfolio), continuous mentorship in academic writing (Mini North Wales-Academic and Research Clinic), continuous peer supervision in psychotherapy (Gogledd Cymru-Peer Supervision in Psychiatry), mock interview for job application, digitalisation of departmental induction, psychopathology training (3P: Psychopathology for Postgraduate Psychiatrists Trainee), and two international collaborative educational programmes (Perinatal Psychiatry Perinatal and Infant Psychiatry Educational Programme of Wales, Tanzania, and Malaysia; and Bhutan Old Age Psychiatry Educational programme). Five peer-reviewed publications had been completed while the other academic writings were ongoing. Three of the projects (33.3%) were expanded from a Welsh initiative to the whole United Kingdom and a bigger team was formed to ensure sustainability could be achieved. Two projects (22.2%) started as an international collaborative project. All projects provided opportunities for the members of the QIP to obtain workplace-based assessments and evidence for yearly appraisal while improving the educational experience of trainees and professionals in the field of mental health.ConclusionAll challenges come with the opportunities to be innovative in problem-solving. Communication skills and people management are crucial for resource gathering and conflict resolution. Lastly, talent development is required as part of the effort to sustain all the projects.

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Letourneau, N., D. Dewey, B. J. Kaplan, H. Ntanda, J. Novick, J. C. Thomas, A. J. Deane, B. Leung, K. Pon et G. F. Giesbrecht. « Intergenerational transmission of adverse childhood experiences via maternal depression and anxiety and moderation by child sex ». Journal of Developmental Origins of Health and Disease 10, n^o 1 (3 septembre 2018) : 88–99. http://dx.doi.org/10.1017/s2040174418000648.

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AbstractAdverse childhood experiences (ACEs) of parents are associated with a variety of negative health outcomes in offspring. Little is known about the mechanisms by which ACEs are transmitted to the next generation. Given that maternal depression and anxiety are related to ACEs and negatively affect children’s behaviour, these exposures may be pathways between maternal ACEs and child psychopathology. Child sex may modify these associations. Our objectives were to determine: (1) the association between ACEs and children’s behaviour, (2) whether maternal symptoms of prenatal and postnatal depression and anxiety mediate the relationship between maternal ACEs and children’s behaviour, and (3) whether these relationships are moderated by child sex. Pearson correlations and latent path analyses were undertaken using data from 907 children and their mothers enrolled the Alberta Pregnancy Outcomes and Nutrition study. Overall, maternal ACEs were associated with symptoms of anxiety and depression during the perinatal period, and externalizing problems in children. Furthermore, we observed indirect associations between maternal ACEs and children’s internalizing and externalizing problems via maternal anxiety and depression. Sex differences were observed, with boys demonstrating greater vulnerability to the indirect effects of maternal ACEs via both anxiety and depression. Findings suggest that maternal mental health may be a mechanism by which maternal early life adversity is transmitted to children, especially boys. Further research is needed to determine if targeted interventions with women who have both high ACEs and mental health problems can prevent or ameliorate the effects of ACEs on children’s behavioural psychopathology.

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Viaux-Savelon, Sylvie, Ouriel Rosenblum, Antoine Guedeney, Gwenaelle Diene, Sophie Çabal-Berthoumieu, Pascale Fichaux-Bourin, Catherine Molinas et al. « Dyssynchrony and perinatal psychopathology impact of child disease on parents-child interactions, the paradigm of Prader Willi syndrom ». Journal of Physiology-Paris 110, n^o 4 (novembre 2016) : 427–33. http://dx.doi.org/10.1016/j.jphysparis.2017.08.001.

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McNamara, Robert K. « Role of perinatal long-chain omega-3 fatty acids in cortical circuit maturation : Mechanisms and implications for psychopathology ». World Journal of Psychiatry 5, n^o 1 (2015) : 15. http://dx.doi.org/10.5498/wjp.v5.i1.15.

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Fernandes Santos, C. « Women’s Mental Health and Pregnancy Loss : What Should We Be Aware Of ? » European Psychiatry 65, S1 (juin 2022) : S862. http://dx.doi.org/10.1192/j.eurpsy.2022.2234.

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Introduction Pregnancy loss (PL) – by induced or spontaneous termination of pregnancy – is common, although its consequences on women’s mental health are often neglected in clinical practice. Objectives To understand the existence of psychiatric morbidity in women, associated with PL, as well as related risk factors. Methods Non-systematic review of literature through search on PubMed/MEDLINE for publications up to 2021, following the terms ‘pregnancy loss’, ‘psychiatry disorder’, ‘depression’ and ‘anxiety’. Results After a PL, anxiety is the most frequent symptomatology in 41% of women. Depression occurs in 22-36% of women in the first two weeks after PL, declining over time. Symptoms compatible with Post Traumatic Stress Disorder (PTSD) are found in 25% of women with PL in the first month. Women who meet criteria for PTSD are more likely to present criteria for Depressive Episode. Substance Use Disorder and Prolonged Grief Disorder are also reported, the latter having, as predictors, previous relational difficulties, poor social support and absence of descendants. Risk factors associated with significant psychopathology within PL are, for example, nulliparity, infertility, previous PL, longer gestation time, lower marital satisfaction, previous psychiatric illness, and history of abuse. Conclusions In clinical practice, the risk of psychopathology in women with PL should be considered. This population should be actively questioned about the presence of symptoms, as well as their persistence and impact, requiring timely and appropriate pharmacological and psychotherapeutic intervention. Perinatal Mental Health interventions show important gains in the overall health of women and their offspring. Disclosure No significant relationships.

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Langley, Kate, Joanna Martin, Sharifah Shameem Agha, Charlotte Davies, Evangelia Stergiakouli, Peter Holmans, Nigel Williams, Michael Owen, Michael O'Donovan et Anita Thapar. « Clinical and cognitive characteristics of children with attention-deficit hyperactivity disorder, with and without copy number variants ». British Journal of Psychiatry 199, n^o 5 (novembre 2011) : 398–403. http://dx.doi.org/10.1192/bjp.bp.111.092130.

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BackgroundSubmicroscopic, rare chromosomal copy number variants (CNVs) contribute to neurodevelopmental disorders but it is not known whether they define atypical clinical cases.AimsTo identify whether large, rare CNVs in attention-deficit hyperactivity disorder (ADHD) are confined to a distinct clinical subgroup.MethodA total of 567 children with ADHD aged 5–17 years were recruited from community clinics. Psychopathology was assessed using the Child and Adolescent Psychiatric Assessment. Large, rare CNVs (>500 kb, <1% frequency) were defined from single nucleotide polymorphism data.ResultsCopy number variant carriers (13.6%) showed no differences from non-carriers in ADHD symptom severity, symptom type, comorbidity, developmental features, family history or pre-/ perinatal markers. The only significant difference was a higher rate of intellectual disability (24% v. 9%, χ2 = 15.5, P = 0.001). Most CNV carriers did not have intellectual disability.ConclusionsLarge, rare CNVs are not restricted to an atypical form of ADHD but may be more highly enriched in children with cognitive problems.

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Lannoy, Séverine, Henrik Ohlsson, Mallory Stephenson, Kenneth S. Kendler, Jan Sundquist, Kristina Sundquist et Alexis C. Edwards. « Prediction of suicide attempt in a Swedish population‐based cohort ». Acta Psychiatrica Scandinavica 151, n^o 1 (24 septembre 2024) : 92–101. https://doi.org/10.1111/acps.13761.

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AbstractBackgroundSuicidal behaviors are prevalent public health concerns, and we need to improve our predictive ability to better inform prevention efforts.MethodsUsing nationwide longitudinal Swedish registers, we included 344,490 males and 323,177 females born 1982–1990 with information on genetic liability and environmental exposures from birth to age 16: perinatal variables, parental psychopathology (suicide attempt, substance use disorder, major depression), family status, socioeconomic difficulties, peers' psychopathology, and school grades. We conducted sex‐specific analysis and developed data‐driven predictive models including risk factors that occurred between ages 0 and 16 using structural equation modeling.ResultsIn both females and males, the best‐fitting models reveal a complex risk pathway to suicide attempt. In females, the model indicates four direct effects on suicide attempt risk: the occurrence of suicide attempt in parents during childhood (β = 0.159, 95% CI: 0.118; 0.199) and adolescence (β = 0.115, 95% CI: 0.077; 0.153), suicide attempt in peers (β = 0.068, 95% CI: 0.057; 0.079), and low academic achievement (β = 0.166, 95% CI: 0.156; 0.175). In males, aggregate genetic liability for suicide attempt (β = 0.130, 95% CI: 0.111; 0.148), suicide attempt in parents during adolescence (β = 0.099, 95% CI: 0.074; 0.124), suicide attempt in peers (β = 0.118, 95% CI: 0.108; 0.129), and low academic achievement (β = 0.61, 95% CI: 0.152; 0.171) were related to later suicide attempt. These factors also acted as mediators to explain the association between environmental exposures in childhood and later suicide attempt.ConclusionsThese findings illustrate sex‐specific pathways to suicide attempt by including risk factors that occur during the development. Results highlight the importance of genetic and family environment but also the prominent role of academic achievement.

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Enatescu, V. R., M. Dinescu, R. Kalinovic et G. Vlad. « The level of depressive, anxiety and obsessive-compulsive psychopathological dimensions in symptomatic versus asymptomatic SARS-CoV-2 infected pregnant women ». European Psychiatry 65, S1 (juin 2022) : S537. http://dx.doi.org/10.1192/j.eurpsy.2022.1372.

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Introduction The neurotropic valence of SARS-CoV-2 has been revealed in several studies. Depressive and anxiety symptoms are more frequent in the perinatal period leading to maternal and neonatal negative outcomes. Accordingly, depressive and anxiety symptoms are more frequent in the perinatal period leading to negative consequences in both mothers and their neonates. Objectives To determine the level of depression, anxiety, and obsessive-compulsive symptoms depending on the severity of SARS-CoV-2 infection of pregnant women. Methods Based on the RT-PCR test, thirty-eight pregnant women with SARS-CoV-2 infection, hospitalized in Bega Clinic in Timisoara, were assessed concerning the presence of psychopathology. The severity of infection was dichotomized based on the presence or absence of the symptoms. The Edinburgh Postnatal Depression Scale, State and Trait Anxiety Inventory, and the Obsessive-Compulsive Inventory were administered to all participants. Results Of 38 recruited pregnant women, 12 (31,5%) had symptomatic SARS-CoV-2 infection. Symptomatic SARS-CoV-2 infected pregnant women had a higher average score of depression (p = 0.001) and state and trait anxiety (p = 0.002 and p < 0.001, respectively) compared to their asymptomatic counterparts. There were no differences in obsessive-compulsive symptoms (p > 0.05) in relation to the severity of SARS-CoV-2 infection. Conclusions The SARS-CoV-2 infection significantly interferes with the psychological status, thus jeopardizing the mental health of pregnant women. Therefore, SARS-CoV-2 infection should be considered an additional risk factor for anxiety and affective disorders during pregnancy. Disclosure No significant relationships.

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SÁNCHEZ, M. MAR, CHARLOTTE O. LADD et PAUL M. PLOTSKY. « Early adverse experience as a developmental risk factor for later psychopathology : Evidence from rodent and primate models ». Development and Psychopathology 13, n^o 3 (septembre 2001) : 419–49. http://dx.doi.org/10.1017/s0954579401003029.

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Increasing evidence supports the view that the interaction of perinatal exposure to adversity with individual genetic liabilities may increase an individual's vulnerability to the expression of psycho- and physiopathology throughout life. The early environment appears to program some aspects of neurobiological development and, in turn, behavioral, emotional, cognitive, and physiological development. Several rodent and primate models of early adverse experience have been analyzed in this review, including those that “model” maternal separation or loss, abuse or neglect, and social deprivation. Accumulating evidence shows that these early traumatic experiences are associated with long-term alterations in coping style, emotional and behavioral regulation, neuroendocrine responsiveness to stress, social “fitness,” cognitive function, brain morphology, neurochemistry, and expression levels of central nervous system genes that have been related to anxiety and mood disorders. Studies are underway to identify important aspects of adverse early experience, such as (a) the existence of “sensitive periods” during development associated with alterations in particular output systems, (b) the presence of “windows of opportunity” during which targeted interventions (e.g., nurturant parenting or supportive–enriching environment) may prevent or reverse dysfunction, (c) the identity of gene polymorphisms contributing to the individual's variability in vulnerability, and (d) a means to translate the timing of these developmental “sensitive periods” across species.

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Buhagiar, Rachel, Kristina Bettenzana et Jane Barlow. « The effectiveness of video feedback intervention on mother-infant interactional quality for women with perinatal mental health illnesses : protocol for a pilot randomised control trial ». International Journal of Clinical Trials 11, n^o 3 (25 juillet 2024) : 197–206. http://dx.doi.org/10.18203/2349-3259.ijct20242002.

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Background: The literature strongly suggests that early parent-child relational interventions for at-risk dyads can support healthy infant development and attachment security. Video Feedback (VF) is a widely used attachment-based intervention, but evidence for its effectiveness with mother-baby dyads where there is maternal psychopathology remains limited. Methods: This study constitutes a two-armed pilot randomised controlled trial aimed at evaluating the feasibility, acceptability, and preliminary benefits of Video Interaction Guidance (VIG), a type of VF, on mother-child dyadic interactional quality for postpartum women and their infants in Malta. Participants must be mothers with a baby aged 0-12 months who meet criteria for one or more mental health disorders on diagnostic interview. Exclusions are severe maternal mental illness, active drug dependence, being in receipt of in-patient care or therapy, or inability to speak English or Maltese. Consenting, eligible mothers are randomly allocated (minimised by infant age, relationship and employment status, and number of children at home), to either 3 cycles of one-to-one VIG intervention and treatment-as-usual (TAU), or to TAU only. Outcome assessors are blind to study arm allocation. The primary outcomes are parental sensitivity and dyadic synchrony coded using the CARE-index. Secondary outcomes are maternal depression and anxiety, bonding experience, capacity for reflective functioning, and well-being. Conclusions: This is the first study on the preliminary effectiveness of VIG within perinatal services in Malta. Findings should guide future larger scale, definitive RCTs and subsequently inform health policy and management decisions in perinatal and infant mental health care. Trial registration: Registered 16th March 2023 in ISRCTN registry (Trial ID: ISRCTN26320951).

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Perez, Gabriela R., Sara M. Stasik-O’Brien, Lauren M. Laifer et Rebecca L. Brock. « Psychological and Physical Intimate Partner Aggression Are Associated with Broad and Specific Internalizing Symptoms during Pregnancy ». International Journal of Environmental Research and Public Health 19, n^o 3 (31 janvier 2022) : 1662. http://dx.doi.org/10.3390/ijerph19031662.

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Background: Intimate partner violence (IPV) has serious consequences, particularly during high-risk periods such as pregnancy, which poses a significant risk to maternal mental health. However, it is unclear whether IPV presents a broad risk for psychopathology or is specific to distinct diagnoses or symptom dimensions (e.g., panic, social anxiety). Further, the relative impact of physical versus psychological aggression remains unclear. Methods: One hundred and fifty-nine pregnant couples completed surveys assessing psychological and physical intimate partner aggression unfolding in the couple relationship, as well as a range of internalizing symptoms. Results: Psychological and physical aggression were each associated with broad negative affectivity, which underlies mood and anxiety disorders; however, only psychological aggression demonstrated a unique association. Further, for pregnant women, aggression was uniquely associated with several symptom dimensions characteristic of PTSD. In contrast, men demonstrated a relatively heterogeneous symptom presentation in relation to aggression. Conclusion: The present study identifies unique symptom manifestations associated with IPV for couples navigating pregnancy and suggests psychological aggression can be more detrimental to mental health than physical aggression. To promote maternal perinatal mental health, clinicians should screen for covert forms of psychological aggression during pregnancy (e.g., raised voices, insults), trauma-related distress, and symptom elevations in women and their partners.

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Romano, Graziella, Daniela Patrascu, Priyanka Tharian et William Burbridge-James. « The neurobiology of attachment and the influence of psychotherapy : a literature review ». BJPsych Open 7, S1 (juin 2021) : S285. http://dx.doi.org/10.1192/bjo.2021.759.

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AimsTo review the existing scientific literature on the neurobiology of caregiver-infant attachment and the effects of psychotherapy on neurobiological structures. We hypothesised that the therapeutic relationship is a new attachment relationship that can model and re-map neural networks involved in emotional self-regulation.Understanding attachment is relevant to working with women and families in the perinatal period and has an impact on treatment outcomes. Evolutionary perspectives show that the infant's attachment to the caregiver is important for survival, development of self and relational patterns. Mother's attachment predicts the infant caregiving behaviour in perinatal period and psychotherapeutic interventions at this time have a role in modifying the risk of intergenerational transmission of trauma and further pathological attachment styles.MethodWe performed a MEDLINE search focussing on the past 10 years. Keywords used were attachment, neurobiology and psychotherapy. We included original studies and existing reviews looking at all types of formal psychotherapy used and focussing on human research. Exclusion criteria were non psychotherapeutic interventions and attachment based on couples only.ResultThere has been an increasing focus in the literature on studying the neurobiology of attachment in caregivers and infants both in healthy cases and in psychopathology over the past decade. Existing studies concentrate on care givers, there is growing evidence on the effects of attachment styles on the infant's brain, mostly from animal studies. Some authors looked at the effects of parental childhood trauma on later parenting styles and intergenerational transmission of trauma. A few studies highlighted neurobiological changes as a result of psychotherapeutic interventions in various psychiatric disorders.ConclusionThere is growing evidence on the neurobiology of attachment focussing on specific neurotransmitters and brain pathways. The modulating effect of psychotherapy has also been studied, albeit with more focus on recovery from psychiatric illness. The literature on neurobiological changes with psychotherapy remains scarce and heterogeneous and further research may be needed in the neurobiology of therapeutic relationship itself as there is increasing recognition that this may be the agent of change, with evidence in the role of linking cortical structures to subcortical limbic systems.

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Ríos-Vaquero, M., G. Lorenzo-Chapatte, L. Rojas-Vázquez, A. Monllor-Lazarraga, L. Sobrino-Conde, M. J. Mateos-Sexmero, T. Jimenez-Aparicio et al. « Impulse phobias during pregnancy : a case report of a 37 year-old woman pregnant of her first child ». European Psychiatry 67, S1 (avril 2024) : S801. http://dx.doi.org/10.1192/j.eurpsy.2024.1669.

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IntroductionPregnancy and puerperium are two critical stages for women’s mental health due to the biological stress of pregnancy itself, as well as the emotional stress that surrounds this vital moment. (1) Debut and aggravation of psychiatric symptoms may occur, as well as relapse in women previously diagnosed with Severe Mental Disorder (SMD).Symptoms of the anxious spectrum are the most frequent within the perinatal mental pathology, being impulse phobias an entity that appears in about 25% of women previously diagnosed with OCD and up to 10-15% of women without previous psychopathology (2)ObjectivesExposing the importance of Perinatal Mental Health from the presentation of a clinical case.MethodsReview of the literature available in PubMed. Presentation of the pathobiography and evolution of the patient.ResultsOur case is about a 37-year-old woman, 30 weeks pregnant with her first child and history of having required admission to Psychiatry with subsequent follow-up in Mental Health for anxious-depressive symptoms with the presence of self-injurious ideas who, after two weeks with multiple life stressors, came to the Emergency Department for the presence of impulse phobias focused on pregnancy with significant internal anguish and ideas of death as a resolution to it, which is why it was decided to hospitalize her. During admission, and taking into account the patient’s gestational state, treatment was started with diluted Mirtazapine and Aripiprazole solution at minimal doses, which in this case were sufficient for symptom control.The latest guidelines addressing psychopharmacology during pregnancy and lactation point to sertraline among the antidepressants and Lorazepam among the benzodiazepines as the safest drugs during pregnancy (3).Conclusions-The exacerbation of anxious symptomatology and the presence of gestation-focused impulse phobias are frequent during pregnancy and their intensity increases as the time of delivery approaches.-Sertraline, Lorazepam, Mirtazapine and Aripiprazole are safe drugs during pregnancy.-In these women, a close and multidisciplinary follow-up by Psychiatry and Gynecology is advisable.Disclosure of InterestNone Declared

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Fonseca, Lais, Gabrielle de Oliveira S. V. Navarro, Marcos Leite Santoro, Pedro M. Pan, Rodrigo Bressan et Ary Gadelha. « S24. PATHWAYS LINKING ENVIRONMENTAL RISKS, POLYGENIC RISK SCORE TO SCHIZOPHRENIA AND PSYCHOTIC EXPERIENCES IN A BRAZILIAN COHORT OF CHILDREN AND ADOLESCENTS ». Schizophrenia Bulletin 46, Supplement_1 (avril 2020) : S39—S40. http://dx.doi.org/10.1093/schbul/sbaa031.090.

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Abstract Background Polygenic risk score to schizophrenia (PRS-SZ) provides a liability measure summarizing each genetic risk variant and the polyenviromic risk score (PERS) proposes the same regarding exposure factors to psychosis, yet few studies addressed how both scopes interplay, especially in early developmental stages. Psychotic experiences (PE) rest on the lower range of psychosis spectrum, representing an important asset to study psychotic disorders, ie. schizophrenia. However, investigators failed to find significant associations between PRS-SZ and PE in children. We hypothesize that unspecific psychopathology – also previously linked to PE – can mediate the effects of higher risk load for psychosis during neurodevelopment. Thus, our aim is to test a moderated mediation model in which PERS and general psychopathology in youths can lead to PE, prospectively, through SZ genetic liability. Methods We analyzed data from the Brazilian High-Risk Cohort for Psychiatric Disorders, a youth community sample with 2 time-points: baseline (w0) and 3year follow-up (w1), from São Paulo and Porto Alegre, both urban centers. PRS-SZ was calculated using summary statistics from the PGC and corrected for the 10 principal components of the GWAS. PE were assessed at w0 and w1 with the Community Assessment Psychotic Experiences – CAPE and trained psychologists rated the reliability of students’ answers. The Development and Well-Being Assessment – DAWBA, a structured interview with a transdiagnostic approach, was used to extract a general factor for psychopathology (P-factor) on w0. Latent variables for PE and P-factor were generated through confirmatory factor analysis yielding good model fits. We calculated PERS on w0, as validated, with birth season, urbanicity, cannabis use, paternal age, obstetric/perinatal complications and physical/sexual abuse, neglect or parental loss/separation. Last, we built a moderated mediation diagram based on model 15 of Haye’s PROCESS builder on SPSS: (X) PERS > (M) P-factor > (Y) PE w1, with (V) PRS-SZ as a moderator for PERS > PE and P-factor > PE. Age, sex, site and PE w0 were covariates. Results 2,511 students (6–14 y/o, mean=10.2 ± 1.9, 53% male) completed the w0 assessment and 2,010 the follow-up (mean=13.5 y/o ± 1.9). In our moderated mediation model, P-factor emerged as a full mediator between PERS and PE w1 (B=.324, BootLL–UL CI=.138 to .553). We found PRS-SZ provided a significant moderation effect on the P-factor > PE relation (M*V=.053, R2-chng=.003, p=.037), with the moderator effects of the focal predictor rising considerably according to values of PRS-SZ: p16 (B=.047, p=.192), p50 (B=.099, p=.000) and p84 (B=.153, p=.000). PRS-SZ did not moderate PERS > PE separately (X*V=.016, R2-chng=.001, p=.974). However, conditional indirect coefficients for the complete model were also significant for higher PRS-SZ levels: p16 (B=.143, BootLL–UL CI=-.072 to .389), p50 (B=.304, BootLL–UL CI=.126 to .529) and p84 (B=.470, BootLL–UL CI=.197 to .814). Discussion Our findings suggest environmental risk factors and intermediate phenotypes – namely unspecific non-psychotic psychopathology – can play crucial and intertwined roles in children and adolescents with higher genetic liability to SZ. Moreover, the moderation effects of PRS-SZ imply the existence of thresholds for those relations. The non-clinical nature and age of our sample could explain the low effect sizes. Next steps would include additional phenotypic tracks, such as cognition and social functionality – both previously connected to PRS-SZ as well. We hope our results can help disentangle the genetic and environmental trajectories bonding SZ proneness and PE, and possibly contribute to risk assessment in youths, especially among vulnerable populations.

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Gelabert, E., A. Torres Giménez, S. Andrés-Perpiñá, C. Naranjo, E. Roda, L. Garcia-Esteve et A. Roca Lecumberri. « Mother-Baby Day Hospital (MBDH) : preliminary results of effectiveness of multidisciplinary intensive intervention for women with postpartum affective/anxiety disorder ». European Psychiatry 65, S1 (juin 2022) : S331. http://dx.doi.org/10.1192/j.eurpsy.2022.843.

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Introduction Women experiencing postpartum mental illness have unique needs. Psychiatric Mother Baby Units (MBUs) can provide specialist in-patient care for mothers without separation from their baby. Since 2018, an innovative Mother-Baby Day Hospital (MBDH) have been developed and implemented in a public hospital in Spain, directed at the intensive, integral, and multidisciplinary treatment. Objectives The aim of the present study was to obtain preliminary data regarding its effectiveness in postpartum women with affective and anxiety disorders. Methods Thirty-three mothers and their babies with affective or anxiety disorders attended to MBDH CLINIC-BCN participated in the study. All women were assessed at admission, discharge, and 3 months follow-up. Primary outcomes were depression (EPDS) and anxiety symptoms (STAI-S), mother-infant bonding (PBQ) and functional impairment (HoNOs). Results At discharge, 100% of women no longer met the full criteria for the main diagnosis (PSR≥5). Significant improvements from admission to discharge were achieved in depression and anxiety symptoms, mother infant bonding and functional impairment. Clinical significance was also calculated. After treatment, mothers had greater autonomy for care their babies. Similar results were observed at 3 months follow-up. The MBDH was rated by mothers as an excellent quality program and they would recommend it. Conclusions This study found that multidisciplinary intervention at MBDH for postpartum women with affective or anxiety disorders is effective, not only for maternal psychopathology but also for maternal care and bonding. It is imperative to develop specialized devices that integrate the care of the dyad by professionals specialized in perinatal mental health. Disclosure No significant relationships.

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Chen, Buffy, Prescilla Carrion, Ravneet Grewal, Angela Inglis, Catriona Hippman, Emily Morris, Heather Andrighetti, Arianne Albert et Jehannine Austin. « Short interpregnancy intervals, maternal folate levels, and infants born small for gestational age : a preliminary study in a Canadian supplement-using population ». Applied Physiology, Nutrition, and Metabolism 42, n^o 10 (octobre 2017) : 1092–96. http://dx.doi.org/10.1139/apnm-2017-0292.

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Short interpregnancy intervals (SIPI) have been associated with increased risks for adverse neonatal outcomes including preterm delivery and infants small for gestational age (SGA). It has been suggested that mechanistically, adverse neonatal outcomes after SIPI arise due to insufficient recovery of depleted maternal folate levels prior to the second pregnancy. However, empirical data are lacking regarding physiological folate levels in pregnant women with SIPI and relationships between quantified physiological folate levels and outcomes like SGA. Therefore, we sought to test 2 hypotheses, specifically that compared with controls women with SIPI would: (i) have lower red blood cell folate (RBCF) levels and (ii) be more likely to have SGA infants (defined as <10th percentile). Using data collected in British Columbia, Canada, for a larger study on perinatal psychopathology, we documented supplementation use and compared prenatal RBCF levels and proportion of SGA infants between women with SIPI (second child conceived ≤24 months after previous birth, n = 26) and matched controls (no previous pregnancies, or >24 months between pregnancies, n = 52). There were no significant differences in either mean RBCF levels (Welch’s t test, p = 0.7) or proportion of SGA infants (Fisher’s exact test, p = 0.7) between women with SIPI and matched controls. We report the first data about RBCF levels in the context of SIPI. If confirmed, our finding of no relationship between these variables in this population suggests that continued folic acid supplementation following an initial pregnancy mitigates folate depletion. We found no relationship between SIPI and SGA.

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