Pregnancy-related depression linked to eating disorders and abuse histories

ScienceDaily (June 16, 2011) — One in 10 women experience depression during pregnancy or shortly after giving birth. Although the problem has received increased attention in recent years, little is known about the causes or early-warning signs of pregnancy-related depression. In a study published in the June 2011 issue of Journal of Women's Health, researchers at the University of North Carolina at Chapel Hill School of Medicine offer new clues to help doctors identify at-risk patients and refer them to treatment early on.

The researchers surveyed 158 pregnant and postpartum women undergoing treatment for depression at UNC's Perinatal Psychiatry Clinic. One-third of the patients reported a history of eating disorders; in addition, many had a history of physical or sexual abuse. The findings suggest these psychiatric factors may increase a woman's likelihood of developing depression during pregnancy or postpartum.

Mental health screening tools that include questions about eating disorders, abuse and other factors should be incorporated into routine prenatal care, said Samantha Meltzer-Brody, MD, the lead author of the study and director of UNC's Perinatal Psychiatry Program. "Screening by obstetrical providers is really important because they can refer patients for appropriate treatment," she said. "And that can prevent long-lasting problems for mom and baby."

Undiagnosed and treated postpartum depression "causes enormous distress to the family, and it can have long-lasting consequences for the child," said Meltzer-Brody. Children of depressed mothers are more likely to develop mental health problems, and children of mothers with an active eating disorder may also be more likely to develop an eating disorder themselves. Making sure mothers struggling with mental health issues receive adequate assessment and treatment is critical to breaking that cycle, said Meltzer-Brody.

"The message we need to get out is that these things are incredibly common and routine screenings need to occur," said Meltzer-Brody. "The prevalence of abuse and eating disorder histories may be much higher than people appreciate."

Up to 25 percent of women experience physical or sexual abuse during their lifetime, a rate the UNC associate professor of psychiatry called "staggering." An estimated 6-8 percent of women are at some point affected by an eating disorder, with binge eating and bulimia nervosa being the most common, followed by anorexia and other disorders.

"Pregnancy and the postpartum period is a very vulnerable time for women," said Meltzer-Brody. Rapid changes in body shape, weight and hormone levels, combined with major lifestyle changes during the transition to motherhood, can take a toll on women -- especially those with a history of previous psychiatric issues.

Despite these challenges, Meltzer-Brody said pregnancy represents an ideal time for doctors to intervene and help women get mental health treatment if they need it. "[Pregnancy] is a time when people are really motivated to make changes and get treatment, because that can have serious consequences for how you do and for how your children do," she said, adding that by conducting mental health screens during prenatal care, doctors can help curb pregnancy-related depression.

The study's co-authors included Stephanie Zerwas, PhD, Jane Leserman, PhD, Ann Von Holle, Taylor Regis, and Cynthia Bulik, PhD, all from the Department of Psychiatry at the UNC School of Medicine, UNC Center for Women's Mood Disorders and UNC Eating Disorders Program.

Support for the research came from the NIH Building Interdisciplinary Careers in Women's Health (BIRCWH) Award to Dr. Meltzer-Brody.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of North Carolina School of Medicine.

Journal Reference:

Samantha Meltzer-Brody, Stephanie Zerwas, Jane Leserman, Ann Von Holle, Taylor Regis, Cynthia Bulik. Eating Disorders and Trauma History in Women with Perinatal Depression. Journal of Women's Health, 2011; 20 (6): 863 DOI: 10.1089/jwh.2010.2360

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here sciencedaily.com

Pregnancy-related depression linked to eating disorders and abuse histories

ScienceDaily (June 16, 2011) — One in 10 women experience depression during pregnancy or shortly after giving birth. Although the problem has received increased attention in recent years, little is known about the causes or early-warning signs of pregnancy-related depression. In a study published in the June 2011 issue of Journal of Women's Health, researchers at the University of North Carolina at Chapel Hill School of Medicine offer new clues to help doctors identify at-risk patients and refer them to treatment early on.

The researchers surveyed 158 pregnant and postpartum women undergoing treatment for depression at UNC's Perinatal Psychiatry Clinic. One-third of the patients reported a history of eating disorders; in addition, many had a history of physical or sexual abuse. The findings suggest these psychiatric factors may increase a woman's likelihood of developing depression during pregnancy or postpartum.

Mental health screening tools that include questions about eating disorders, abuse and other factors should be incorporated into routine prenatal care, said Samantha Meltzer-Brody, MD, the lead author of the study and director of UNC's Perinatal Psychiatry Program. "Screening by obstetrical providers is really important because they can refer patients for appropriate treatment," she said. "And that can prevent long-lasting problems for mom and baby."

Undiagnosed and treated postpartum depression "causes enormous distress to the family, and it can have long-lasting consequences for the child," said Meltzer-Brody. Children of depressed mothers are more likely to develop mental health problems, and children of mothers with an active eating disorder may also be more likely to develop an eating disorder themselves. Making sure mothers struggling with mental health issues receive adequate assessment and treatment is critical to breaking that cycle, said Meltzer-Brody.

"The message we need to get out is that these things are incredibly common and routine screenings need to occur," said Meltzer-Brody. "The prevalence of abuse and eating disorder histories may be much higher than people appreciate."

Up to 25 percent of women experience physical or sexual abuse during their lifetime, a rate the UNC associate professor of psychiatry called "staggering." An estimated 6-8 percent of women are at some point affected by an eating disorder, with binge eating and bulimia nervosa being the most common, followed by anorexia and other disorders.

"Pregnancy and the postpartum period is a very vulnerable time for women," said Meltzer-Brody. Rapid changes in body shape, weight and hormone levels, combined with major lifestyle changes during the transition to motherhood, can take a toll on women -- especially those with a history of previous psychiatric issues.

Despite these challenges, Meltzer-Brody said pregnancy represents an ideal time for doctors to intervene and help women get mental health treatment if they need it. "[Pregnancy] is a time when people are really motivated to make changes and get treatment, because that can have serious consequences for how you do and for how your children do," she said, adding that by conducting mental health screens during prenatal care, doctors can help curb pregnancy-related depression.

The study's co-authors included Stephanie Zerwas, PhD, Jane Leserman, PhD, Ann Von Holle, Taylor Regis, and Cynthia Bulik, PhD, all from the Department of Psychiatry at the UNC School of Medicine, UNC Center for Women's Mood Disorders and UNC Eating Disorders Program.

Support for the research came from the NIH Building Interdisciplinary Careers in Women's Health (BIRCWH) Award to Dr. Meltzer-Brody.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of North Carolina School of Medicine.

Journal Reference:

Samantha Meltzer-Brody, Stephanie Zerwas, Jane Leserman, Ann Von Holle, Taylor Regis, Cynthia Bulik. Eating Disorders and Trauma History in Women with Perinatal Depression. Journal of Women's Health, 2011; 20 (6): 863 DOI: 10.1089/jwh.2010.2360

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here

Patients with eating disorders have an elevated rate of death

ScienceDaily (July 5, 2011) — Individuals who have eating disorders have an elevated mortality rate, especially those with anorexia nervosa (AN), according to a meta-analysis of previous studies, reported in the July issue of Archives of General Psychiatry, one of the JAMA/Archives journals.

According to background information in the article, the majority of studies of eating disorder-related death rates focus on AN. Some research of bulimia nervosa (BN) implies that death rates are low for this condition. Moreover, there is limited information about the likelihood of death with eating disorders not otherwise specified (EDNOS), disordered eating that does not meet the criteria for AN or BN, say the authors: "Despite EDNOS being a common presentation in eating disorders services, few published data exist regarding mortality rates in patients given this diagnosis." In this study, the investigators sought to determine the death rates (and the factors thereof) for each of these types of eating disorders.

Jon Arcelus, L.M.S., M.Sc., M.R.C.Psych., Ph.D., from Leicester General Hospital in Leicester, England, and colleagues systematically searched, assessed and analyzed studies related to eating disorder death rates. They included English-language, peer reviewed articles published between January 1966 and September 2010 from a variety of scientific-literature databases and collections. The researchers examined 36 studies; almost all included AN, one-third included BN, and one-fifth included EDNOS. The studies included 17,272 different patients with eating disorders and reported a total of 755 deaths.

The total number of person-years represented by the studies was 166,642 for AN; 32,798 for BN; and 22,644 for EDNOS. For each 1,000 person-years, the AN group experienced 5.1 deaths (1.3 of which were from suicide), the BN group experienced 1.7 deaths, and the EDNOS group experienced 3.3 deaths. The standardized mortality ratio (the number of actual deaths compared with the number of expected deaths) was 5.86 for AN, 1.93 for BN and 1.92 for EDNOS. The age at which a patient presented for treatment was found to correlate with AN deaths, with patients in their late teens and 20s having a higher death rate than younger patients or those in their 30s.

The authors acknowledge that some of the deaths included in the studies may be due to factors other than an eating disorder. However, they found that death rates for eating disorders -- especially AN -- are higher than for some other psychiatric disorders, such as schizophrenia and depression. The elevated death rate for BN and EDNOS as well "highlights the seriousness of those conditions," write the authors. They call for more research into what factors might predict death risk in those two conditions in particular.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by JAMA and Archives Journals.

Journal Reference:

Jon Arcelus; Alex J. Mitchell; Jackie Wales; Soren Nielsen. Mortality Rates in Patients With Anorexia Nervosa and Other Eating Disorders: A Meta-analysis of 36 Studies. Archives of General Psychiatry, 2011; 68 (7): 724-731 DOI: 10.1001/archgenpsychiatry.2011.74

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here

Pregnancy-related depression linked to eating disorders and abuse histories

ScienceDaily (June 16, 2011) — One in 10 women experience depression during pregnancy or shortly after giving birth. Although the problem has received increased attention in recent years, little is known about the causes or early-warning signs of pregnancy-related depression. In a study published in the June 2011 issue of Journal of Women's Health, researchers at the University of North Carolina at Chapel Hill School of Medicine offer new clues to help doctors identify at-risk patients and refer them to treatment early on.

The researchers surveyed 158 pregnant and postpartum women undergoing treatment for depression at UNC's Perinatal Psychiatry Clinic. One-third of the patients reported a history of eating disorders; in addition, many had a history of physical or sexual abuse. The findings suggest these psychiatric factors may increase a woman's likelihood of developing depression during pregnancy or postpartum.

Mental health screening tools that include questions about eating disorders, abuse and other factors should be incorporated into routine prenatal care, said Samantha Meltzer-Brody, MD, the lead author of the study and director of UNC's Perinatal Psychiatry Program. "Screening by obstetrical providers is really important because they can refer patients for appropriate treatment," she said. "And that can prevent long-lasting problems for mom and baby."

Undiagnosed and treated postpartum depression "causes enormous distress to the family, and it can have long-lasting consequences for the child," said Meltzer-Brody. Children of depressed mothers are more likely to develop mental health problems, and children of mothers with an active eating disorder may also be more likely to develop an eating disorder themselves. Making sure mothers struggling with mental health issues receive adequate assessment and treatment is critical to breaking that cycle, said Meltzer-Brody.

"The message we need to get out is that these things are incredibly common and routine screenings need to occur," said Meltzer-Brody. "The prevalence of abuse and eating disorder histories may be much higher than people appreciate."

Up to 25 percent of women experience physical or sexual abuse during their lifetime, a rate the UNC associate professor of psychiatry called "staggering." An estimated 6-8 percent of women are at some point affected by an eating disorder, with binge eating and bulimia nervosa being the most common, followed by anorexia and other disorders.

"Pregnancy and the postpartum period is a very vulnerable time for women," said Meltzer-Brody. Rapid changes in body shape, weight and hormone levels, combined with major lifestyle changes during the transition to motherhood, can take a toll on women -- especially those with a history of previous psychiatric issues.

Despite these challenges, Meltzer-Brody said pregnancy represents an ideal time for doctors to intervene and help women get mental health treatment if they need it. "[Pregnancy] is a time when people are really motivated to make changes and get treatment, because that can have serious consequences for how you do and for how your children do," she said, adding that by conducting mental health screens during prenatal care, doctors can help curb pregnancy-related depression.

The study's co-authors included Stephanie Zerwas, PhD, Jane Leserman, PhD, Ann Von Holle, Taylor Regis, and Cynthia Bulik, PhD, all from the Department of Psychiatry at the UNC School of Medicine, UNC Center for Women's Mood Disorders and UNC Eating Disorders Program.

Support for the research came from the NIH Building Interdisciplinary Careers in Women's Health (BIRCWH) Award to Dr. Meltzer-Brody.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of North Carolina School of Medicine.

Journal Reference:

Samantha Meltzer-Brody, Stephanie Zerwas, Jane Leserman, Ann Von Holle, Taylor Regis, Cynthia Bulik. Eating Disorders and Trauma History in Women with Perinatal Depression. Journal of Women's Health, 2011; 20 (6): 863 DOI: 10.1089/jwh.2010.2360

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here