Latest news with #AmericanPsychiatricAssociation
Yahoo
2 days ago
- General
- Yahoo
Still vexed — an overview of anxiety and depression
In 2018, the Deseret News published a series called Generation Vexed, exploring and detailing the then-growing scope of teenage anxiety in the United States. It was already well on the rise even before the pandemic, the land wars that broke out in the Middle East and Europe, and the political schism of the 2020 election. Approximately 1 million teenagers struggled with anxiety, and experts at the time estimated that nearly 1 in 4 had some form of an anxiety disorder, with that ratio going up to nearly 1 in 3 when just girls were considered. Census data from 2015 'estimated more than 17 million (children) had already experienced a diagnosable mental disorder,' the Deseret News reported. That number was 'the equivalent of the entire populations of Utah, Idaho, Arizona and Colorado' combined. That was just teenagers, and just the disorder of anxiety — and that was seven years ago. Anxiety is still rising. From 2018 through the first two years of the pandemic in 2022, anxiety rates for all Americans went up by over 16%, and depression rates by over 15%. In 2023, the American Psychiatric Association said that more than a third of all adults felt more anxious than they did the year before. Then, when it did the same study last year, the number of adults reporting that they felt more anxiety jumped to 43%. For perhaps a brief moment, 2023's number seemed small by comparison. Today, the National Institute of Mental Health reports that some 40 million Americans have anxiety disorders — nearly one-fifth of the total U.S. population — and more than 14 million suffer from depression. That is another mental health disorder that has steadily been rising, with 29% of all Americans experiencing depression, according to Gallup, up from 19% eight years earlier. Now, the NIH research suggests that 21 million people in the U.S. will experience a depressive episode in their lifetimes. Mental Health America, a nonprofit dedicated to mental health and prevention, published a report that says 46% of Americans will at some point confront a mental-health-related disorder. Those numbers, while shocking, are not as surprising to encounter in 2025 as they may have been even a few years ago. That's because, while there are more people experiencing disorders such as anxiety and depression, general awareness of broader mental health issues has risen, too. According to Michele Nealon, a psychologist and president of the Chicago School of Professional Psychology, writing for the United Nations in 2021, the pandemic 'accelerated positive momentum in our communities to raise awareness about these issues and increased accessibility to crucial support and services for those affected.' Talking about mental health — interpersonally, on the news, social media or via the numerous celebrities who often show support (including Michelle Obama, Demi Lovato, Simone Biles, Prince Harry and Dwayne Johnson) — has become so common that the cause and effect of anxiety and depression are beginning to look like the chicken and the egg question to some, too. The BBC reported earlier this year that experts in England are now openly debating if the proliferation of awareness has actually caused more young people to self-diagnose, which results in 'over-pathologising distress.' The argument is that, rather than learning resilience, some are diagnosing what might be the normal discomfort of growing up as anxiety or depression. Regardless of the possible pitfalls, the pandemic had one recognizable silver lining, Nealon wrote: it 'resulted in more open dialogue on, and greater knowledge of, mental health than ever before.' This is not to say that stigma no longer exists; it does. The Centers for Disease Control and Prevention has a webpage that was updated in January of 2025, explaining and contextualizing the ways people with mental health disorders are made to feel stigma — the negative sentiment, shame or disgrace leveled onto an action or behavior. It included structural stigma, where institutions are not prepared to support those with them; public stigma that comes from individuals and groups judgmental toward mental health issues; and even self-stigma, where someone with a mental health issue 'may believe they are flawed or blame themselves for having the condition.' All of which is why experts say it's so important to keep talking about the resources that exist for people who are experiencing anxiety and depression. Not just in order to combat the stigma that individuals, communities, cultures and organizations may have, but also the sheer volume of those who are already experiencing anxiety and depression and need to know how and where to find help for a legitimate and pressing health concern. There are resources that exist, and — as always — much more to learn. It's a topic that's been investigated, it turns out, since the days of ancient Greece and Rome. The first known medical reference to mental health disorders like anxiety or depression is within the texts attributed to Hippocrates from ancient Greece. They describe a subject named Nicanor who's stricken with an irrational fear — a phobia — of the woman who plays the flute at the symposium. Hearing the music played at night, Nicanor would have panic attacks, yet he was unaffected when he encountered the same flutist during the day. Its inclusion by one of modern medicine's founders made clear that mental disorders had long been considered health issues. Ancient Roman thinkers investigated the variations of mental disorders more specifically. It was Cicero, the Roman statesman and stoic philosopher, who carved out the notion of anxiety and depression — separately — and sought to solve them. 'In some there is a continual anxiety, owing to which they are anxious … for all are not anxious who are sometimes vexed, nor are they who are anxious always uneasy in that manner,' he wrote in 45 B.C. According to Marc-Antoine Crocq, a psychiatrist, who wrote 'A history of anxiety: from Hippocrates to DSM' in the scientific journal Dialogues in Clinical Neuroscience, Cicero's arguments come from a book written after his daughter's untimely death and was 'a plea for Stoicism, a branch of philosophy that is one of the pillars of today's cognitive therapy.' Kathleen Evans, of Griffin University in Australia, suggested that Cicero's whole book was indicative of a 'major depressive episode' for the great ancient philosopher. His work may have been a means for him to navigate the struggles of his own life. Another stoic called Seneca, wrote Crocq, 'taught his contemporaries how to achieve freedom from anxiety in his book 'Of Peace of Mind.'' Later, Seneca suggested in another of his treatises that people should stay present in their day-to-day lives, previewing thousands of years ago what is now commonly referred to as 'living in the moment.' Depression was long called by the other name of 'melancholia,' especially so during the period between the late 1700s and the late 1800s. It was defined as 'a disorder of intellect or judgment, a 'partial insanity' often, but not always, associated with sadness,' wrote Kenneth S. Kendler, of Virginia Commonwealth University. He wrote that it was a 'mood disorder.' That name, itself, helps to understand why there is some lasting stigma felt today by folks whose lives and work are disrupted by their depression as if it is a matter of mood, rather than a debilitating health disorder. Not until the German psychiatrist Emil Kraepelin began using the word 'depressive' to describe elements of 'melancholia' in the late 1900s did its name change to what we know today. That definition and symptoms have changed, too. While it is common for people to feel sad or low in the course of their days, depression manifests itself with more pronounced symptoms, some of which include feeling down, empty, pessimistic or hopeless. Those experiencing depression report feeling tired, lacking in pleasure or interest in the things they care about, difficulty concentrating and trouble sleeping, among many others. Though not always, some also report suicidal thoughts. Understandably, these feelings often implicate behaviors and moods — the poor descriptor from the Victorian period raising its ugly head — like anger, restlessness, a tendency to isolate or a struggle to manage responsibilities. The list of symptoms is long, and not everyone who has depression exhibits all of those that are published by the National Institutes of Health, the Mayo Clinic, or any of other national and local agencies. Additionally, age plays a role in which symptoms are more or less pronounced, as does gender. There are a kaleidoscope of different possible symptoms — many of which everyone feels at some point or other in the course of their lives — and it makes it difficult to determine when one is momentary and another a disorder. If someone is feeling any of these symptoms for prolonged periods, they should speak to their regular medical care provider about it or call one of the local or national hotlines published with this article to discuss their specific circumstances. Taking advantage of available resources and learning more is the first step to care. To help someone who may not have recognized these symptoms for themselves, Harvard Health suggests encouraging that person to use the resources or seek help, or a softer touch might be to offer emotional support. The symptoms of anxiety — just like Cicero suggested a couple millennia ago — are not necessarily unique to those who suffer from an anxiety disorder. Most people will feel some version of what we understand anxiety to be at some point in their lives. It could be before starting a new school, prior to a test, a date or a job interview, or even when rent and other bills are due. To a certain extent, anxiety is a regular part of most lives, which makes its disorder also hard to firmly categorize and understand. The Mayo Clinic explains the disorder as an escalation of the common occurrences of anxiety. 'People with anxiety disorders frequently have intense, excessive and persistent worry and fear about everyday situations,' its website reads. Those symptoms show up as constant worry, elevated heart rates, fear, trouble sleeping, feeling a sense of looming issue or problems. There are also many different permutations of anxiety that also exhibit these symptoms. These issues can lead to other health issues or even depression itself. If someone is uncertain, they should also discuss the matter with their regular health care provider or one of the national hotlines. The treatment for both begins with asking questions and seeking help, no matter how certain or uncertain someone might be. Part of that seeking of help, too, can be speaking with your friends, family, clergy or teachers. The ancient Greek and Roman philosophers asked each other these bigger questions about their minds and health at the lyceum in order to reach reasonable conclusions, and it turns out that many of them are still in place. Today, we have doctors, phone and text hotlines, and our respective loved ones to seek out more and better information about anxiety and depression. The more we know, too, the less likely we are to judge or to suffer needlessly from anxiety or depression. Seneca wrote that 'there are more things … likely to frighten us than there are to crush us; we suffer more often in imagination than in reality.' If you need help, please refer to this document for contacts that can speak over the phone or text in either moments of crisis or those who need support. You can always call or text the national Disaster Distress Hotline at 1-800-985-5990 (para Español: Llama o envía un mensaje de texto 1-800-985-5990 presiona '2.'). If you're in Utah, Huntsman Mental Health Institute lists several ways to get help for a mental health crisis: University of Utah community crisis intervention and support services: 801-587-3000. Text or call Suicide & Crisis Lifeline: 988. Utah Crisis Line: 1-800-273-TALK (8255). Walk-in crisis center for adults: 955 W. 3300 South, South Salt Lake. Utah Warm Line: 8 a.m. to 11 p.m. 1-833-773-2588 (SPEAKUT) or 801-587-1055. For parents, teachers and educators: SAFEUT Crisis Chat & Tip Line, download the app or call 833-372-3388. For active National Guard members, their family and civilian personnel: download SafeUTNG app or call 833-372-3364 (SAFENG).
Medscape
6 days ago
- Health
- Medscape
Vitamin D Especially Important for Women's Brain Health
LOS ANGELES — Vitamin D is important for brain health, but this might be particularly true for women but doesn't appear to have this beneficial effect in men, early research suggested. The large study showed an association between greater plasma vitamin D levels in females and better memory and larger subcortical brain structures. 'We found that vitamin D for women was correlated with better cognitive outcomes, but we need to do more research to find out what role vitamin D actually plays at a mechanistic level,' study investigator Meghan Reddy, MD, Psychiatry Resident, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, told Medscape Medical News . The findings were presented here at the American Psychiatric Association (APA) 2025 Annual Meeting. Protective Effects This latest study added to the growing body of literature of research on vitamin D and brain health. Previous studies have shown that vitamin D may influence cognition and brain function in older adults, potentially through its anti-inflammatory, antioxidant, and neuroprotective effects. Research also suggested it may promote brain health by increasing neurotrophic factors and aiding in the clearance of amyloid from the brain. Recent findings published in the American Journal of Clinical Nutrition suggested that vitamin D may also affect biological aging by preserving telomeres — the protective caps at the ends of chromosomes that shorten with age. Other research has also shown telomere length may help protect against brain diseases, including a study previously reported by Medscape Medical News , which linked longer leukocyte telomere length to a lower risk for stroke, dementia, and late-life depression. Meghan Reddy, MD In the current study, Reddy and colleagues used data from the multisite Human Connectome Project to track individuals over time to understand age-related changes in brain structure, function, and connectivity. They are investigating various biomarkers that might correlate with aging, including hemoglobin, creatine, glycated hemoglobin (for blood glucose levels), high-density lipoprotein, and low-density lipoprotein, in addition to vitamin D. The idea, said Reddy, is to track cognitive health using biomarkers in addition to brain imaging and cognitive testing. The study included 1132 individuals, 57% of whom were women and 66% of whom were White. The average age was approximately 62 years, with participants ranging from 36 to 102 years old. Participants underwent neuropsychological testing to assess short-term memory and fluid intelligence — the capacity to reason and solve problems, which is closely linked to comprehension and learning. They also provided blood samples and underwent MRI scans. Researchers divided participants into two age groups: those younger than 65 years and those 65 years or older. The investigators found a significant association between vitamin D levels and memory in women ( P = .04). Sex Differences 'What's interesting is that when we looked specifically at memory, higher vitamin D levels were linked to better memory performance — but only in women, not men,' said Reddy, adding that she found this somewhat surprising. In women, investigators found a significant association between vitamin D levels and the volume of the putamen ( P = .05) and pallidum ( P = .08), with a near-significant trend for the thalamus. In contrast, studies show that in men, higher vitamin D levels were associated with smaller volumes of the thalamus, putamen, and pallidum. There were no differences in the impact of vitamin D by age group. Sex differences in the relationship between vitamin D, cognition, and brain volume warrant further investigation, Reddy said. She also noted that the study is correlational, examining memory, brain volume, and vitamin D levels at a single timepoint, and therefore it can only offer a hypothesis. Future studies will include multiple time points to explore these relationships over time. The results did not determine an ideal vitamin D plasma level to promote brain health in women. Commenting on the research for Medscape Medical News , Badr Ratnakaran, MD, a geriatric psychiatrist in Roanoke, Virginia, and chair of the APA's Council on Geriatric Psychiatry, said the finding that women may get more brain benefits from vitamin D than men is 'key' because dementia is more prevalent among women since they tend to live longer. Other research has shown vitamin D may help manage depression in older women, which makes some sense as dementia and depression 'go hand in hand,' he said. Ratnakaran recommended that women take a vitamin supplement only if they're deficient, as too much vitamin D can lead to kidney stones and other adverse side effects.
Sinar Daily
25-05-2025
- Entertainment
- Sinar Daily
Diana Danielle reflects on living with ADHD in a neurotypical world
One of Diana's most challenging symptoms remains a distorted perception of time—something she describes vividly. By DANIAL HAKIM 25 May 2025 08:00am One of Diana's most challenging symptoms remains a distorted perception of time—something she describes vividly and viscerally. Actress and singer Diana Danielle shares what it's like living with MALAYSIAN actress and singer Diana Danielle is no stranger to performing under pressure, but behind the camera and bright lights lies a lifelong, quiet struggle with a neurodivergent condition - Attention Deficit Hyperactivity Disorder (ADHD) - a condition she recognised in herself long before she even had a name for called 'hyperkinetic reaction of childhood' and only formally recognised by the American Psychiatric Association (APA) as a mental disorder in the 1960s, ADHD is a developmental disorder characterised by an ongoing pattern of one or more of the following types of symptoms like inattention, keeping on task, or staying before an official diagnosis, Diana sensed her mind functioned differently. As a child, she experienced classic ADHD symptoms—chronic forgetfulness, impatience, mental restlessness, and an inability to focus for long periods. 'I was aware of my ADHD symptoms without having a name for it since I was very young.'So I knew that I was not typical in terms of the way I behaved or the way that I was bringing myself amongst people in a social setting,' she then at the age of 13 and with limited information readily available, Diana turned to the early internet for upon a website that described her predicament at the time, she was struck with the realisation that she was not a neurotypical individual."I was very forgetful. My attention span was running between, you know, ten different things. I was always multitasking."I was always impatient, and I was always forgetting to do things that were like deadlines and stuff like that was not very good for me,' she of Diana's most challenging symptoms remains a distorted perception of time—something she describes vividly and viscerally.'I also didn't have a good concept of time, I can't feel 2 hours go as it's almost as if the concept of time isn't something that I could grasp."I was either very early or very late and I was always demotivated until the last minute, where you know you have that sense of urgency," she is not uncommon for individuals with ADHD. Disorders that involve dopamine dysfunction—such as ADHD, Parkinson's, and schizophrenia—are associated with time prefrontal cortex, responsible for executive functions and attention regulation, also plays a major role in time estimation. ADHD medications, often targeting dopaminergic pathways, have been shown to help normalise these cognitive story also sheds light on the emotional and social impact of navigating life with undiagnosed ADHD in a society that predominantly caters to neurotypical she describes it, her most profound struggle, she revealed, wasn't just the symptoms but the pressure to conform and fit in the circle as a square.'You're always on that push and pull and always struggling to fit in and working in the same way as people who are not neurodivergent, who are neurotypical.'That was my biggest struggle. It was pretending or masking as if I was like everybody else and having to function the way that they did while also not knowing how to function the way that I should,' she Malaysia, the estimated prevalence of ADHD ranges from 1.6 per cent to 4.6 per cent, as per the Health is noted that while statistics for ADHD cases are still low, most cases of the disorder go undiagnosed, alluding to much higher numbers unaccounted for those unknowingly suffering from diagnostic services exist, Diana points out that a lack of awareness and social conversation around adult ADHD makes the journey to diagnosis unclear and lonely.'It took me a while only because we're living in a country that although we have access to it, we don't have exposure to it."So there are two different perspectives at play. It's like you know it's there but you just don't know how to get to it,' she candidness about her neurodivergence is helping shift the narrative in Malaysia's entertainment and health spaces—breaking the stigma surrounding adult ADHD and mental health. Her journey shows the importance of self-awareness, education, and access to proper support systems.
Medscape
23-05-2025
- Health
- Medscape
Human vs AI: Who's Better at Cognitive Behavioral Therapy
LOS ANGELES — Artificial intelligence (AI) falls short of human therapists when it comes to empathy and emotional connection in the delivery of cognitive behavioral therapy (CBT), initial results of a new pilot study suggested. However, the results showed that AI performed well in providing a structured therapeutic approach. 'While AI may offer structured CBT components and serve as a supplementary or triage tool, it lacks the nuance and flexibility to serve as a stand-alone therapy,' study investigator Esha Aneja, a fourth-year medical student at California Northstate College of Medicine, Elk Grove, California, told Medscape Medical News . 'Physicians and therapists should view AI as a potential adjunct, not an alternative.' 'Human oversight, ethical safeguards, and empathy remain essential to safe and effective mental health care.' The findings were presented on May 17 at the American Psychiatric Association (APA) 2025 Annual Meeting. Demand for CBT Outstripping Supply Currently, there aren't enough psychiatric professionals in the United States — or globally — to meet the growing demand for CBT. Patients frequently face delays in accessing care, so more are turning to AI tools like ChatGPT to address their mental health needs, said Aneja. However, she noted in her presentation that large language model (LLM)–based AI chatbots for text-based therapy are still largely theoretical in psychiatric literature. While LLMs have been integrated into electronic health records for diagnostic purposes, the ability of AI to execute CBT remains understudied. The goal of the study was to compare the effectiveness of therapy delivered by humans with AI. Experts familiar with CBT principles using the Cognitive Therapy Rating Scale (CTRS) compared a human therapist with an AI model (ChatGPT-3.5) in responding to a third-party patient presenting with a specific mental health concern. CTRS is a gold-standard observational tool for assessing the quality and fidelity of CBT sessions. It evaluates multiple domains, each rated on a 0-6 scale, with higher scores reflecting more skilled therapeutic delivery. Both the human therapist, who conducted the session over Zoom, and the AI therapist, ChatGPT-3.5 (the most current version at the time), interacted with the patient solely via text chat. Reviewers received transcripts of each session but were blinded to whether the responses came from a human or AI. The study surveyed 75 reviewers to compare the quality of human-based and ChatGPT-3.5-based interactions with patients. Participants included medical students, social work students, psychiatric residents, and board-certified psychiatrists. Humans Win the Day The human therapist outperformed ChatGPT-3.5 across all domains. Areas where the differences in mean CTRS scores were statistically significant included feedback (4.48 vs 3.03), collaboration (4.91 vs 3.84), pacing (4.60 vs 3.67), and guided discovery (0.35 vs 3.45), as well as 'focus on key cognitive behaviors' and 'application of CBT techniques' ( P = .001 for all). Areas where the ratings were similar between the two groups included agenda setting, understanding, interpersonal effectiveness, and strategies for change. When it came to therapeutic approach and empathy, respondents disagreed on whether the human therapist demonstrated enough empathy, Aneja reported. 'Some praised their warmth and responsiveness, while others felt the therapist focused too much on technique and missed emotional cues,' she said. 'In contrast, AI was more uniformly described as 'robotic' or 'surface-level' in its empathy, with little variation.' While AI may become 'cognitively empathetic' in the future and therefore able to respond more appropriately, 'emotional or embodied empathy, the kind that comes from shared human experience, is beyond its current capabilities,' said Aneja. And, even in the areas that were more compatible with AI such as structure and agenda, respondents felt AI was 'too wordy' and 'robotic' and included 'a lot of lecturing,' she added. They also noted AI lacked personalized recommendations with respect to patient understanding and tailored approaches. While the researchers suspected AI might fall short, this new study 'quantifies and contextualizes those limitations in a real-world CBT framework,' said Aneja. AI could 'definitely' be used as a screening tool in psychiatry, particularly when patients can't get to see a provider in a timely manner, she said. It could 'look for things like suicidality or situations where urgent attention is important.' However, therapists should keep the tool's limitations in mind, especially the empathy component, she added. Weighing in on these results, Howard Liu, MD, chair of the Department of Psychiatry at the University of Nebraska Medical Center, Omaha, Nebraska, and chair of the APA Council on Communications, Washington, DC, called the study 'fascinating,' especially with the backdrop of psychiatrist shortages across the country. However, he stressed the importance of informing patients when using AI. 'Different health systems have different policies about whether you can, in fact, feed in protected health information into these systems,' he pointed out. Philip R. Muskin, MD, professor of psychiatry at the Columbia University Irving Medical Center, New York City, said he was not surprised by the findings overall or the comments about the 'lecture-like quality' of the AI 'therapist.' 'Human responses vary, even when rigidly following a CBT agenda,' he told Medscape Medical News . 'Reading about therapy, which is essentially what the AI software does, isn't comparable to a therapist who has read training materials but has incorporated the information through human interaction.'
Medscape
22-05-2025
- Health
- Medscape
Postpartum Psychosis Risk Linked to Sister's Medical History
LOS ANGELES — Risk for postpartum psychosis is significantly higher in women who have a sister who has experienced the condition and/or has bipolar disorder (BD), a new study showed. In a population-based cohort study of nearly 1.7 million women, those with a full sister who had had the disorder were 10 times more likely to have postpartum psychosis than those whose sister did not have it. Odds of developing the condition were doubled when a sister had BD and about 14-fold higher if a sister had both BD and postpartum psychosis. Although rare, postpartum psychosis is considered 'one of the most severe psychiatric conditions,' co-investigator Veerle Bergink, MD, PhD, professor in the Department of Psychiatry, Icahn School of Medicine at Mount Sinai, and director of Mount Sinai's Women's Mental Health Center, New York City, and colleagues noted. If not addressed and treated, the condition has been linked to increased risk for suicide and infanticide. But findings such as these can help clinicians identify those at potentially greater risk and make a plan, Bergink told Medscape Medical News. 'You don't have to start medication right away, but we do need to be aware' of the risk, she said. The findings were presented on May 19 at the American Psychiatric Association (APA) 2025 Annual Meeting and were simultaneously published online in the American Journal of Psychiatry. Relative Risks Postpartum psychosis typically occurs in the first 3 months after childbirth, with onset most likely in the first month. It can also occur in women who have no history of psychiatric illness and is the leading cause of maternal deaths, the researchers noted. If a woman shows symptoms of the condition — which include excessive energy, agitation, paranoia, confusion, and sleep problems — it should be addressed as a medical emergency, they added. Although previous research has shown that genetic factors can contribute to increased postpartum psychosis risk, the magnitude of that contribution has been unclear. In the current analysis, Bergink and colleagues examined data from Swedish national registers for 1,648,759 women who gave birth between January 1980 and September 2017. The primary outcome was a diagnosis of postpartum psychosis. Results showed that 2514 of the total participants — only 0.15% — had postpartum psychosis within the first 3 months of the birth of their first child. However, after adjusting for year and age at childbirth, the relative recurrence risk (RRR) was 10.69 for the condition in mothers with a full sister who had experienced the condition compared with mothers with a sister who had not experienced it (95% CI, 6.6-16.3; P < .001). Still, the absolute risk for those with an affected sister was estimated at just 1.6%. In the women diagnosed with postpartum psychosis, 49% had a history of BD, and 24% had a history of other mental health diagnoses. Prevalence of BD was 1.4% for the entire participant population. The odds ratio (OR) for postpartum psychosis when a sister had BD was 2.1 (95% CI, 1.0-4.0; P = .04). In addition, the combined OR was approximately 14.3 when a sister had experienced postpartum psychosis while also having BD. The RRR was also increased when a woman had a full woman cousin with postpartum psychosis, but it was not statistically significant when adjusted for birth year and age at childbirth or when adjusted for those factors plus history of BD. 'Our results provide guidance for clinicians working with pregnant women with personal or family histories of postpartum psychosis,' the investigators wrote. Diagnostic and Statistical Manual of Mental Disorders (DSM) Inclusion? Bergink noted that the condition is not currently listed as a stand-alone disorder in any version of the DSM. However, numerous research groups are collaborating to develop criteria for its inclusion in future iterations of the manual. They propose that criteria should include experiencing at least one of the following within 3 months of childbirth, with a duration of at least 1 week or of any duration if hospitalization is necessary: Mania/mixed state, delusions, hallucinations, disorganized speech or thoughts, and disorganized or confused behavior. Asked during a question-and-answer session if family history screenings are currently being done among women who are pregnant, Bergink answered, 'In general, no, but it should be.' 'Because of the potential negative impacts, sometimes severe, on mother and baby, this disorder needs to be identified and effectively treated,' Ned H. Kalin, MD, editor-in-chief of the American Journal of Psychiatry and professor and chair of the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, said in a press release. The current study is important because it highlighted the increased risk when the condition runs in families, he told Medscape Medical News . 'It also underscores the importance of understanding that risk and of working with your OB-GYN [obstetrician-gynecologist] doctor or psychiatrist to help reduce and mitigate the risk with treatment and close observation,' Kalin said. Bringing 'Stigma Out of the Darkness' Although postpartum psychosis is considered quite rare, tragic aftereffects in some undiagnosed and untreated women have been widely reported in the media. At the press briefing, Bergink shared that a medical colleague with the condition recently shot and killed herself and her baby girl. 'Unfortunately, not all cases are detected in time. At Sinai, we lost a colleague who had no psychiatric history and her baby,' she said. 'That happens. And it can occur in anyone.' Michael F. Myers, MD, chair of the APA meeting's Scientific Program Committee, shared that he was involved with two situations where patients had extreme forms of the condition, including one where a woman psychiatrist killed herself and her child. 'You hear about postpartum depression and postpartum blues. But then there's this subset that is not only dangerous to themselves but also to their baby,' Myers told Medscape Medical News. 'Talking about these situations is how we bring the stigma [about the condition] out of the darkness.' Psychiatric History Not Always a Factor 'There's a theme that having a psychiatric history is the main predictor for postpartum psychosis. But sometimes we miss it,' Misty C. Richards, MD, associate professor at the University of California, Los Angeles, and medical director of perinatal psychiatry for the university's Maternal Outpatient Mental Health Services Clinic, said at the briefing. She added that, as a clinician, 'you do the best that you can to try to catch this early because things can become wildly out of control in the postpartum period. Infanticide should just never happen.' She later told Medscape Medical News that the symptoms of postpartum psychosis differ from those of schizophrenia because they wax and wane and almost present as delirium. 'So you can be lucid one minute and the next be wildly delusional. It's usually in the setting of poor sleep and severe anxiety and becomes an emergency very quickly,' Richards said. She added that this is much more extreme than a normal response to the chaos that often occurs during the first week after delivery. 'People may think, 'Oh, she'll shake it off and be okay.' But no. If you miss it, that's when it can be catastrophic,' she concluded.
