Psychiatric Morbidity In Women Research Articles

Psychiatric Morbidity in Women With Previous Gestational Diabetes Mellitus: A Nationwide Register-Based Cohort Study.

To investigate associations between previous gestational diabetes mellitus (GDM) and incident psychiatric morbidity, and to explore the role of subsequent diabetes development in psychiatric morbidity risk. A nationwide register-based cohort study including all women delivering in Denmark from 1997 to 2018 was conducted. GDM exposure was based on diagnosis code, whereas psychiatric morbidity outcome was based on diagnosis code and psychopharmacological medication use. Multiple Cox regression and mediation analyses were performed. In a study population of 660,017 women, previous GDM was associated with increased risk of depression based on diagnosis code and/or medication use (adjusted hazard ratio [aHR] 1.22 [95% CI 1.18-1.27]), any psychiatric diagnosis (aHR 1.20 [95% CI 1.13-1.27]), and any psychopharmacological medication use (aHR 1.21 [95% CI 1.17-1.25]). Moreover, risk of depressive and anxiety disorders, as well as antidepressant and antipsychotic medication use, was increased, with aHRs ranging from 1.14 (95% CI 1.05-1.25) to 1.32 (95% CI 1.22-1.42). No associations were found regarding substance use disorders, psychotic disorders, bipolar disorders, postpartum psychiatric disease, or anxiolytic medication use. Psychiatric morbidity risk was higher in women with versus without subsequent diabetes development. However, GDM history affected risk estimates only in women without subsequent diabetes. Subsequent diabetes mediated 35-42% of the associations between GDM and psychiatric morbidity. GDM was associated with increased psychiatric morbidity risk. Subsequent diabetes development played a significant role in future psychiatric morbidity risk after GDM, although it only partly explained the association.

Women’s Mental Health and Pregnancy Loss: What Should We Be Aware Of?

IntroductionPregnancy 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.ObjectivesTo understand the existence of psychiatric morbidity in women, associated with PL, as well as related risk factors.MethodsNon-systematic review of literature through search on PubMed/MEDLINE for publications up to 2021, following the terms ‘pregnancy loss’, ‘psychiatry disorder’, ‘depression’ and ‘anxiety’.ResultsAfter 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.ConclusionsIn 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.DisclosureNo significant relationships.

The Effect of Brief Supportive Psychotherapy on Prevention of Psychiatric Morbidity in Women with Miscarriage: A Randomized Controlled Trial about the First 24-hours of Hospitalization.

ObjectivesMiscarriage is a common pregnancy complication causing substantial psychiatric complications. This study was designed to investigate whether the administration of brief supportive psychotherapy (BSP) is effective on the management of women with miscarriage when conducted in the first 24 hours of hospitalization in order to prevent symptoms of anxiety, depression, and grief at four-months post-miscarriage.MethodsWe conducted a randomized clinical trial on 79 women with miscarriage hospitalized in Ayatollah Rohani teaching hospital. The women were randomly assigned into two groups (39 in the experimental group and 40 in the control group). All interventions were implemented for two study groups during the first 24 hours of hospitalization in a private room in the hospital. The experimental group received a two-hour BSP. The objective outcomes were assessed using Hospital Anxiety and Depression Scale and Perinatal Grief Scale (PGS), which has three subscales (active grief, difficulty coping, and despair) and were measured before the intervention and at four-months post-miscarriage.ResultsThe results of pre-tests in the follow-up of the trial suggested that the participants who received BSP reported significant reductions in the mean scores of active grief (-34.2±9.7 vs. 28.1±-6.9), difficulty coping (27.1±6.4 vs. 23.3±4.3), despair (28.0±8.4 vs. 22.8±5.2), and total PGS (89.6±23.1 vs. 74.4±15.3), in contrast to participants in the control group who did not report such results. Further, the results of generalized estimating equations models revealed that brief supportive psychotherapy caused a significant decrease in the level of factors including active grief, difficulty coping, despair, total perinatal grief, anxiety symptoms, and depressive symptoms in subjects in the experimental group compared to those in the control group after miscarriage. Also, the frequency of anxiety symptoms (13.5% vs. 60.5%), depressive symptoms (32.4% vs. 71.1%), and grief symptoms (10.8% vs. 65.8%) was found to be significantly lower in the group receiving psychotherapy than in the control group at four-months follow-up.ConclusionsAdministration of BSP session during the first 24 hours of hospitalization for women with miscarriage can be considered a reliable method to prevent anxiety symptoms, depression symptoms, and perinatal grief at four-months follow-up.

Increased psychiatric morbidity in women with complete androgen insensitivity syndrome or complete gonadal dysgenesis

Abstract Objective Knowledge concerning mental health outcomes is important to optimize the health of individuals with disorders or differences of sex development (DSD). Thus, the aim of this study was to estimate if the prevalence of psychiatric morbidity in adult women diagnosed with complete androgen insensitivity syndrome (CAIS) or complete gonadal dysgenesis (46,XY GD and 46,XX GD) differs from that in women with premature ovarian insufficiency (POI) or age-matched population controls. Methods This cross-sectional study was conducted at the Karolinska University Hospital, Stockholm, Sweden, and included 33 women with different DSDs: 20 CAIS, 6 46,XY GD, 7 46,XX GD, 21 women with POI and 61 population-derived controls. Psychiatric morbidity was assessed using the Mini International Neuropsychiatric Interview plus (MINI +). To complement the MINI +, three self-report questions were used to evaluate current and previous psychiatric history. Results are presented as p values and estimated risks (odds ratio [OR], 95% confidence intervals [CI]) of psychiatric conditions among women with CAIS or GD in comparison with women with POI and age-matched population-derived controls. Results Twenty-eight of the 33 women (85%) with CAIS or GD met the criteria for at least one psychiatric disorder according to the MINI +, with depression and anxiety disorders being most common. This was significantly higher compared with population controls (52%) (OR 5.1, 95% CI 1.7–14.9), but not compared to women with POI, who had a high frequency of psychiatric diagnoses (76%). Conclusion The increased psychiatric morbidity in women with CAIS and GD highlights the need for clinical awareness of the psychiatric vulnerability in these patients.

A cross sectional survey on quality of life and psychiatric morbidity in women with polycystic ovary syndrome

A cross sectional survey on quality of life and psychiatric morbidity in women with polycystic ovary syndrome

Increased psychiatric morbidity in women with complete androgen insensitivity syndrome or complete gonadal dysgenesis

ObjectiveKnowledge concerning mental health outcomes is important to optimize the health of individuals with disorders or differences of sex development (DSD). Thus, the aim of this study was to estimate if the prevalence of psychiatric morbidity in adult women diagnosed with complete androgen insensitivity syndrome (CAIS) or complete gonadal dysgenesis (46,XY GD and 46,XX GD) differs from that in women with premature ovarian insufficiency (POI) or age-matched population controls. MethodsThis cross-sectional study was conducted at the Karolinska University Hospital, Stockholm, Sweden, and included 33 women with different DSDs: 20 CAIS, 6 46,XY GD, 7 46,XX GD, 21 women with POI and 61 population-derived controls. Psychiatric morbidity was assessed using the Mini International Neuropsychiatric Interview plus (MINI+). To complement the MINI+, three self-report questions were used to evaluate current and previous psychiatric history. Results are presented as p values and estimated risks (odds ratio [OR], 95% confidence intervals [CI]) of psychiatric conditions among women with CAIS or GD in comparison with women with POI and age-matched population-derived controls. ResultsTwenty-eight of the 33 women (85%) with CAIS or GD met the criteria for at least one psychiatric disorder according to the MINI+, with depression and anxiety disorders being most common. This was significantly higher compared with population controls (52%) (OR 5.1, 95% CI 1.7–14.9), but not compared to women with POI, who had a high frequency of psychiatric diagnoses (76%). ConclusionThe increased psychiatric morbidity in women with CAIS and GD highlights the need for clinical awareness of the psychiatric vulnerability in these patients.

Intimate Partner Violence and Minor Psychiatric Morbidity of Aboriginal Taiwanese Women

Experiences of abuse increase the risk of psychiatric morbidity in women. This study assesses the prevalence of intimate partner violence and minor psychiatric morbidity and analyzes their association among aboriginal women in Taiwan. Using system random sampling, 840 aboriginal women between the ages of 18 and 50 years old were recruited from four townships with aboriginal communities in southern Taiwan. Trained primary care nurses interviewed the participants at home by structured questionnaire. One hundred twenty-six of 840 (15%) of the aboriginal women had experienced physical abuse perpetrated by an intimate partner (her husband or cohabitant) during their lifetime; 10.1% had experienced it during the past 12 months; 4.0% had experienced sexual abuse by the partner; and 6.3% had experienced physical abuse during childhood at the hands of one or both parents. Multiple logistic regression revealed that after adjusting for women's age, alcohol and drug use, religious activity and husband's employment status, the experience of abuse (including partner physical abuse, partner sexual abuse, and childhood physical abuse) was significantly associated with suicidal ideation and depression. Health care professionals need to provide adequate support and health education, develop interventions, and use referrals in primary care in the community in order to reduce and prevent domestic violence against aboriginal women in Taiwan.

Abusive experiences and psychiatric morbidity in women primary care attenders.

Abusive experiences in childhood and adulthood increase risks of psychiatric morbidity in women and independently increase risks of further abuse over the lifetime. It is unclear which experiences are most damaging. To measure lifetime prevalence of abusive experiences and psychiatric morbidity, and to analyse associations in women primary care attenders. A cross-sectional, self-report survey of 1207 women attending 13 surgeries in the London borough of Hackney, UK. Independent associations between demographic measures, abusive experiences and psychiatric outcome were established using logistic regression. Childhood sexual abuse had few associations with adult mental health measures, in contrast to physical abuse. Sexual assault in adulthood was associated with substance misuse; rape with anxiety, depression and post-traumatic stress disorder but not substance misuse. Domestic violence showed strongest associations with most mental health measures, increased for experiences in the past year. Abuse in childhood and adulthood have differential effects on mental health; effects are increased by recency and severity. Women should be routinely questioned about ongoing and recent experiences as well as childhood.

Mood disturbance and neurosteroids in women with breast cancer

AbstractWe studied the prevalence of psychiatric morbidity in breast cancer women and the neurosteroid concentrations in those subjects during cancer treatment to examine whether some biological factors change during psychiatric morbidity. Of the 49 eligible women, four were diagnosed with major depression and 16 with an adjustment disorder. Patients with an adjustment disorder had a significantly lower mean age than those with no psychiatric morbidity. Measurements of plasma dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEAS), estradiol and cortisol did not reveal significant differences among the three groups. We also did not find a significant correlation between any subscale of the Profile of Mood States and concentration of any of the steroids measured. Plasma DHEA, DHEAS, estradiol or cortisol values did not differ among women treated with tamoxifen alone, with chemotherapy alone or with both of these therapies. These results indicate that psychiatric morbidity is very high in women with breast cancer, but do not suggest that plasma neurosteroid levels are associated with psychiatric morbidity or with treatment of breast cancer. It is difficult to predict psychiatric morbidity in women with breast cancer from the viewpoint of biological measurements because the relationship between biological factors and psychiatric factors is complicated in these patients. Copyright © 2003 John Wiley & Sons, Ltd.

Coping strategies and psychiatric morbidity in women attending breast assessment clinics

This study examined the role of coping strategies and personality characteristics in mediating psychiatric morbidity in subjects facing possibly serious breast disease. Participating were 121 women aged 20 to 65 undergoing breast fine needle biopsy for a suspicious lesion on mammography. All subjects received psychosocial assessments including the 12-item General Health Questionnaire (GHQ-12), the Eysenck Personality Inventory (EPI) and the Coping Strategies Inventory. The results show that neuroticism was the only EPI subscore significantly correlated with GHQ-12 score. A habitual method of coping with adversity known as ‘engagement’ has a negative correlation with GHQ-12 score; that is, patients who actively confront their illness and the uncertainty that surrounds it show better psychological health. Stepwise multiple regression reveals that neuroticism and an engagement coping strategy are the most significant predictors towards GHQ-12 score prior to the diagnosis of breast cancer.

Cigarette Smoking during Pregnancy

To determine: 1. the prevalence of regular smoking in the latter half of pregnancy in a sample of Canadian prenatal patients; 2. the psycho-social and demographic characteristics that differentiate smoking from nonsmoking patients; 3. the characteristics that differentiate prenatal patients who smoke more than 10 cigarettes per day from those who smoke 1 to 10 cigarettes per day; and 4. the psychiatric morbidities or psychological attitudes associated with smoking in pregnancy. Consecutive consenting women 20 or more weeks pregnant were given, at a prenatal clinic, the General Health Questionnaire (GHQ), the Fetal Health Locus of Control (FHLC), and a study questionnaire to complete. Five-hundred and forty-five women completed the questionnaires. Eighty-nine (16.3%) women reported regular daily cigarette smoking in the second half of pregnancy, while 43 (7.9%) smoked more than 10 cigarettes per day. Women who smoked were more likely than nonsmokers to be under 21, born in Canada, have only elementary education, be unemployed and unmarried, eat unhealthy diets, drink alcohol, use nonprescription and illicit drugs, have unplanned pregnancies, histories of emotional and physical problems, and have suffered physical abuse before and during pregnancy. Smokers were more likely than nonsmokers to meet case status on the GHQ and on the FHLC to believe "chance" and less likely to believe that "internal control" or "powerful others" affected the health of their fetuses. "Social disorganization", "health risks", and "poor health" factors accounted for 83.1% of the total variance. Women who smoke in pregnancy have a higher rate than nonsmokers of other health risk behaviours, social disadvantage, and emotional disturbance. Psychiatrists can play an important role in identifying and treating emotional and psychiatric morbidity in women of reproductive age to facilitate a reduction in smoking rates in this high-risk population.

A question of choice: results of a prospective 3-year follow-up study of women with breast cancer

The objective of this study was to determine the impact of offering women choice in decision-making about surgery in early breast cancer. We examined how women felt about choosing, which choices they made and the effect that choosing had on psychiatric morbidity over 3 years. 269 women with stage I or II breast cancer were treated by three groups of surgeons, who either favoured mastectomy or breast conserving surgery or who offered patients choice whenever possible. Results revealed that a significant minority of women experienced unremitting psychiatric morbidity, irrespective of surgeon group or actual surgery performed. At 3 years, 19% of women were clinically anxious and 15% were depressed. With 3-year follow-up, the relative risk (95% CI) for psychiatric morbidity was less in women treated by ‘choice’ surgeons, compared to women treated by surgeons favouring mastectomy (p < 0.05). 62 women were eligible to choose their surgery, and of these 8 (13%) were unable to make a decision. Difficulty was experienced by 23 62 (37%) of women. Nevertheless, 26 62 (42%) felt pleased that they had been allowed to choose, although others had some reservations about the process. Only 5 women expressed doubts about their original decision. There was no evidence that choice in itself prevents psychiatric morbidity in women treated for breast cancer.

Cigarette smoking and psychiatric morbidity in women.

A random community survey of psychiatric morbidity in adult New Zealand women, the Otago Women's Health Survey, investigated the association of cigarette smoking with mental health. Of the women interviewed, just over one quarter (26.1%) smoked, with one third of these smokers consuming more than 20 cigarettes per day. Demographic factors associated with smoking were younger age, lower socio-economic status, poor education, caring for preschool children, dissatisfaction with female caring roles and financial strife. Psychiatric morbidity as measured by the short PSE was statistically associated with smoking. The unexpected finding reported here is a higher rate of recovery from their psychiatric morbidity amongst women who smoked. This result fits with previously reported data indicating that women use cigarette smoking to regulate mood and cope with the pressures of relentless child care in the context of strained financial resources. The profile of the woman who smokes differed substantially from that of the woman who drinks alcohol in a hazardous manner. Different preventive strategies are therefore required for these two risky behaviours.

Psychiatric morbidity in women attending a clinic for vulval problems--is there a higher rate in vulvodynia?

A General Health Questionnaire (GHQ) was completed by 55 women attending a clinic for vulval problems in central London. The GHQ-caseness rate was 40% from which the psychiatric morbidity in the sample was estimated to be 32%. The level of psychiatric morbidity in 10 women with a diagnosis of vulvodynia was similar to that of 41 women with other vulval diagnoses.

Psychiatric outcome of termination of pregnancy for foetal abnormality.

Termination of pregnancy for foetal abnormality has become frequent with the increasing sophistication of techniques of antenatal diagnosis. The aim of this study was to obtain quantitative and qualitative information about psychiatric morbidity in women after termination of pregnancy for foetal abnormality. Two samples of women were compared. The first consisted of 71 women who had had a termination of pregnancy for foetal abnormality (FA group). The second consisted of 26 women who had experienced so-called missed abortion (MA group). Both groups had lost a pregnancy in the mid-trimester of pregnancy, but the MA group had no element of choice. Standardized psychiatric and social measures were used to assess both groups on three occasions after the termination. In both groups, 4 weeks after the termination psychiatric morbidity was high (four to five times higher than in the general population of women), and social adjustment was impaired. Six months and 12 months after the abortion, levels of psychiatric morbidity were near normal. Semi-structured interviewing was used to obtain information about the experience of grief after mid-trimester termination. For many women, symptoms of grief persisted throughout the year. These symptoms included typical features of grief as well as grief symptoms specific to pregnancy loss. The findings have implications for the counselling of women after termination for foetal abnormality or after missed abortion.

Psychological outcomes of different treatment policies in women with early breast cancer outside a clinical trial.

To assess outside a clinical trial the psychological outcome of different treatment policies in women with early breast cancer who underwent either mastectomy or breast conservation surgery depending on the surgeon's opinion or the patient's choice. To determine whether the extent of psychiatric morbidity reported in women who underwent breast conservation surgery was associated with their participation in a randomised clinical trial. Prospective, multicentre study capitalising on individual and motivational differences among patients and the different management policies among surgeons for treating patients with early breast cancer. 12 District general hospitals, three London teaching hospitals, and four private hospitals. 269 Women under 75 with a probable diagnosis of stage I or II breast cancer who were referred to 22 different surgeons. Surgery and radiotherapy or adjuvant chemotherapy, or both, depending on the individual surgeon's stated preferences for managing early breast cancer. Anxiety and depression as assessed by standard methods two weeks, three months, and 12 months after surgery. Of the 269 women, 31 were treated by surgeons who favoured mastectomy, 120 by surgeons who favoured breast conservation, and 118 by surgeons who offered a choice of treatment. Sixty two of the women treated by surgeons who offered a choice were eligible to choose their surgery, and 43 of these chose breast conserving surgery. The incidences of anxiety, depression, and sexual dysfunction were high in all treatment groups. There were no significant differences in the incidences of anxiety and depression between women who underwent mastectomy and those who underwent lumpectomy. A significant effect of surgeon type on the incidence of depression was observed, with patients treated by surgeons who offered a choice showing less depression than those treated by other surgeons (p = 0.06). There was no significant difference in psychiatric morbidity between women treated by surgeons who offered a choice who were eligible to choose their treatment and those in the same group who were not able to choose. Most of the women (159/244) gave fear of cancer as their primary fear rather than fear of losing a breast. The overall incidences of psychiatric morbidity in women who underwent mastectomy and those who underwent lumpectomy were similar to those found in the Cancer Research Campaign breast conservation study. At 12 months 28% of women who underwent mastectomy in the present study were anxious compared with 26% in the earlier study, and 27% of women in the present study who underwent lumpectomy were anxious compared with 31% in the earlier study. In both the present and earlier study 21% of women who underwent mastectomy were depressed, and 19% of women who underwent lumpectomy in the present study were depressed compared with 27% in the earlier study.) There is still no evidence that women with early breast cancer who undergo breast conservation surgery have less psychiatric morbidity after treatment than those who undergo mastectomy. Women who surrender autonomy for decision making by agreeing to participate in randomised clinical trials do not experience any different psychological, sexual, or social problems from those women who are treated for breast cancer outside a clinical trial.

Factors associated with psychiatric morbidity in women--a general practice survey.

1517 women between 20 and 59 years of age were screened for current psychiatric disturbance using the General Health Questionnaire, and 382 of the subjects were also interviewed. The women gave information on a variety of family, demographic and reproductive or gynaecological items. Items concerning personal relationships with mother, husband and father were significantly associated with high scores on the GHQ as were demographic items such as marital status, numbers of children and social class and gynaecological items such as sterilization and painful, heavy or irregular periods. The many cross associations between items included in the study need to be considered when interpreting the findings. In particular the highly significant association of relationship and demographic factors with psychiatric morbidity in women must be taken into account when investigating the impact of reproductive physiology and gynaecological procedures on mental health.