Guidelines for the Management of Depression During Pregnancy

Department of Psychiatry, University of Pennsylvania, 3535 Market Street, 2nd Floor, Philadelphia, PA 19104, USA.
Current Psychiatry Reports (Impact Factor: 3.24). 08/2010; 12(4):279-81. DOI: 10.1007/s11920-010-0114-x
Source: PubMed


Guidelines regarding the treatment of depression during pregnancy were recently published by the American Psychiatric Association and the American College of Obstetricians and Gynecologists. We provide a commentary on these guidelines.

11 Reads
  • Source
    • "However, therapeutic gains were not sustained on longitudinal follow-ups and did not generalize to infants' cognitive or behavioral outcomes, with the exception of one study in which extensive and prolonged therapy was implemented (Cicchetti et al., 2000). Current APA and AGOC guidelines recommend psychotherapy as the first-line of treatment for mild to moderate depression, although antidepressant medications are recommended in the presence of moderate to severe depressive symptoms, particularly in women with a history of recurrent depression (Kim et al., 2010; Yonkers et al., 2009). The acceptability of psychotherapy is reported to be high in postpartum women (Chabrol et al., 2004) and psychotherapy is often preferred to antidepressants in this population (Pearlstein et al., 2006; Turner et al., 2008). "
    [Show abstract] [Hide abstract]
    ABSTRACT: The role of oxytocin in the treatment of postpartum depression has been a topic of growing interest. This subject carries important implications, given that postpartum depression can have detrimental effects on both the mother and her infant, with lifelong consequences for infant socioemotional and cognitive development. In recent years, oxytocin has received attention for its potential role in many neuropsychiatric conditions beyond its well-described functions in childbirth and lactation. In the present review, we present available data on the clinical characteristics and neuroendocrine foundations of postpartum depression. We outline current treatment modalities and their limitations, and proceed to evaluate the potential role of oxytocin in the treatment of postpartum depression. The aim of the present review is twofold: a) to bring together evidence from animal and human research concerning the role of oxytocin in postpartum depression, and b) to highlight areas that deserve further research in order to bring a fuller understanding of oxytocin's therapeutic potential.
    Brain research 11/2013; 1580. DOI:10.1016/j.brainres.2013.11.009 · 2.84 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Recent advances in DNA sequencing methodology have facilitated studies of human skin microbes that circumvent difficulties in isolating and characterizing fastidious microbes. Sequence-based approaches have identified a greater diversity of cutaneous bacteria than studies using traditional cultivation techniques. However, improved sequencing technologies and analytical methods are needed to study all skin microbes, including bacteria, archaea, fungi, viruses and mites, and how they interact with each other and their human hosts. This review discusses current skin microbiome research, with a primary focus on bacteria, and the challenges facing investigators striving to understand how skin microorganisms contribute to health and disease.
    Trends in Molecular Medicine 03/2011; 17(6):320-8. DOI:10.1016/j.molmed.2011.01.013 · 9.45 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: This meta-analysis assessed efficacy of pharmacologic and psychological interventions for treatment of perinatal depression. A systematic review identified 27 studies, including open trials (n=9), quasi-randomized trials (n=2), and randomized controlled trials (n=16) assessing change from pretreatment to posttreatment or comparing these interventions to a control group. Uncontrolled and controlled effect sizes were assessed in separate meta-analyses. There was significant improvement in depressive symptoms from pretreatment to posttreatment, with an uncontrolled overall effect size (Hedges' g) of 1.61 after removal of outliers and correction for publication bias. Symptom levels at posttreatment were below cutoff levels indicative of clinically significant symptoms. At posttreatment, intervention groups demonstrated significantly greater reductions in depressive symptoms compared to control groups, with an overall controlled effect size (Hedges' g) of 0.65 after removal of outliers. Individual psychotherapy was superior to group psychotherapy with regard to changes in symptoms from pretreatment to posttreatment. Interventions including an interpersonal therapy component were found to have greater effect sizes, compared to control conditions, than interventions including a cognitive-behavioral component. Implications of the findings for clinical practice and future research are discussed.
    Clinical psychology review 07/2011; 31(5):839-49. DOI:10.1016/j.cpr.2011.03.009 · 7.18 Impact Factor
Show more