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Babies born to mothers who are depressed during pregnancy have higher levels of stress hormones, decreased muscle tone and other neurological and behavioral differences, a new study finds.

“The two possibilities are that [the infants] are either more sensitive to stress and respond more vigorously to it, or that they are less able to shut down their stress response,” lead investigator Dr. Delia M. Vazquez, a professor of psychiatry and pediatrics at the University of Michigan School of Medicine, said in a school news release.

She and her colleagues examined the association between depression in pregnant women and the development of infants’ neuroendocrine system, which controls the body’s stress response, as well as mood and emotions.

The study included 154 pregnant women, over the age of 20, whose depressive symptoms were assessed at 28, 32 and 37 weeks of pregnancy and again when they gave birth. Umbilical cord blood samples were taken at birth to measure stress hormone levels. At two weeks, the infants underwent neurobehavioral tests to assess their motor skills and responses to stimuli and stress.

The findings appear online and in an upcoming print issue of the journal Infant Behavior and Development.

“It’s difficult to say to what extent these differences (in babies born to mothers with depression) are good or bad, or what impact they might have over a longer period of time,” lead author Dr. Sheila Marcus, clinical director of U-M’s Child and Adolescent Psychiatry Section, said in the news release.

“We’re just beginning to look at these differences as part of a whole collection of data points that could be risk markers,” she added. “These in turn would identify women who need attention during pregnancy or mother/infant pairs who might benefit from postpartum programs known to support healthy infant development through mom/baby relationships.” Continue Reading

By Alan Mozes

Even as fewer Americans have sought psychotherapy for their depression, antidepressant prescription rates have continued to climb in recent years, a new survey reveals.

“This is an encouraging trend as it suggests that fewer depressed Americans are going without treatment,” said study author Dr. Mark Olfson, a professor of clinical psychiatry at Columbia University/New York State Psychiatric Institute in New York City. “At the same time, however, the decline in psychotherapy raises the possibility that many depressed patients are not receiving optimal care.”

“While progress is being made in increasing the availability of depression care, a mismatch is opening up between clinical evidence and practice,” Olfson cautioned. “For many depressed adults and youth, a combination of psychotherapy and antidepressants is the most effective approach. Yet, only about one-third of treated patients receive both treatments, and the proportion receiving both treatments is declining over time. Efforts should be made to increase the availability of psychotherapy for depression.”

Olfson and his colleagues report the findings in the December issue of the Archives of General Psychiatry.

The authors noted that previous research indicated that depression treatment rose significantly between 1987 and 1997, from less than 1 percent to nearly 2.5 percent. Antidepressant use among depressed patients rose similarly, from just over 37 percent to more than 74 percent. At the same time, however, the percentage of patients undergoing psychotherapy dropped, from about 71 percent to 60 percent.

Newer medication options (including the introduction of serotonin selective reuptake inhibitors, or SSRIs), streamlined treatment guidelines, and improved screening tools accounted for the bump in overall treatment.

For the study, the researchers analyzed data from two national surveys on depression, one conducted in 1998 and one done in 2007. In that time period, there was a small increase in outpatient treatment rates (from 2.37 per 100 people to 2.88 per 100 people), and only a nominal bump in antidepressant use. Continue Reading

Young women with a menopause-like condition called primary ovarian insufficiency should be evaluated for depression, a new study suggests. Women with the condition, called POI for short, stop producing normal amounts of reproductive hormones, develop hot flashes, typically become infertile and, in addition, face an increased risk for depression. POI can develop as early as the teens or 20s, according to the researchers, from the U.S. National Institutes of Health.

The investigators evaluated 174 women with POI and found that 67 percent either currently had depression or had been clinically depressed at least once in the past. That rate is more than twice the rate found among women in general, the researchers noted.

The finding was released online in advance of publication in an upcoming print issue of the Journal of Clinical Endocrinology and Metabolism.

Just why depression seems more prevalent among women with POI, however, remains unclear. The theory that learning of a POI diagnosis is what triggered depression in most women with the condition was not supported by the study, which found that more than 68 percent of the women became depressed before they were diagnosed.

What doctors should do, however, was made clear by the study, according to one of the study’s senior authors, Dr. Lawrence M. Nelson, head of integrative and reproductive medicine at the U.S. National Institute of Child Health and Human Development.

“Because of the strong association with depression, our results indicate all women diagnosed with POI should be thoroughly evaluated for depression,” Nelson said in an NIH news release.

Continue Reading

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