What We're Reading
By Joy Burkhard, MBA
Founder and Executive Director, 2020 Mom
This month, articles about specific risk factors during pregnancy, how using Cognitive Behavioral Therapy to treat insomnia prevents depression, and the effects of Adverse Childhood Experiences (ACEs) are among those that I highlight below. Leave a comment below if any of these articles strike a chord with you.
What Types of Mental Health Apps Actually Work? A Sweeping New Analysis Finds the Data is Sparse
Mental health apps come up short in evidence reviews. A meta-review that focused explicitly on randomized control trials for mental health apps found universal shortcomings in study design, leading the researchers to write that they "failed to find convincing evidence in support of any mobile phone-based intervention on any outcome."
Suicidal Ideation: Prevalence and Risk Factors During Pregnancy
Suicide is the leading cause of maternal death during pregnancy in industrialized countries and the leading cause of maternal mortality in the first 12 months after childbirth. In this multicenter study, the prevalence of suicidal ideation was found to be higher than expected – the results of the study suggest a critical need for screening and designing preventive interventions adapted to pregnant women to decrease the risk of associated suicidal behavior. In protocols carried out by midwives, specific risk factors should be included in health screenings during pregnancy.
Antidepressant Transparency; Intranasal Carbetocin Not OK’d; 2021: Year of Anxiety
Developers of new anti-depressants have increasingly disclosed adverse clinical trial outcomes. "Positive trials have always been reliably published, but negative trials, while common, have long been swept under the rug," said lead author Erick Turner, MD, of Oregon Health & Science University, in a statement.
Using Cognitive Behavioral Therapy to Treat Insomnia Prevents Depression
In new research reported in the Journal of the American Medical Association (JAMA), older adults with insomnia who are treated with cognitive behavior therapy may have a lower risk of depression. There were two significant findings.
Effect of Adverse Childhood Experiences on Hypothalamic-Pituitary-Adrenal (HPA) Axis Function and Antidepressant Efficacy in Untreated First Episode Patients With Major Depressive Disorder
A history of ACEs significantly decreased medication efficacy among 330 Chinese patients with major depression who were treated for the first time with one of 4 anti-depressants. Exposure to ACEs also influenced measurements of the stress hormone system and was associated with more severe symptoms of depression.
Billing for Email Puts a Value on Virtual Care
At the University of California, San Francisco, physicians have had to contend with surging numbers of clinical emails, growing from a few hundred thousand in 2016 to about two million in 2021. The system is fighting back against digital burnout by billing payers for emails that require medical evaluation or more than a few minutes to respond, a shift enabled by pandemic-era policy from CMS that allowed for reimbursement for such "e-Visits."
Podcast: After A Death, Bringing Stillbirth Prevention To The US
A mother whose son was stillborn at thirty-six weeks is importing stillbirth prevention policies from abroad.
Risk Factors For Dual Burden of Severe Maternal Morbidity and Preterm Birth By Insurance Type in California
Among childbearing women, insurance coverage determines the degree of access to preventive and emergency care for maternal and infant health. Risk factors of dual burden were found to have differed by insurance type across sociodemographic and perinatal factors, suggesting that care quality may vary by insurance type. Attention to peripartum care access and care quality provided by insurance type is needed to improve maternal and neonatal health.
As Suicide Attempts Rise in America, Mental Health Care Remains Stagnant
Despite the substantial increase in suicide attempts among U.S. adults over the last decade, these individuals' use of mental health services didn't match that growth, data from the National Surveys on Drug Use and Health (NSDUH) revealed. Young adults, women, and unemployed people were increasing suicide attempts.
Trauma-Informed Care: Recognizing and Resisting Re-Traumatization in Health Care
Although trauma is often viewed as an individual or interpersonal issue, this paper expands the definition to include the impact of collective and structural elements on health and well-being.
Associations of Parental and Perinatal Factors With Subsequent Risk of Stress-Related Disorders
Little is known about the contribution of pregnancy-related parental and perinatal factors to the development of stress-related disorders. Findings suggest that most of the observed associations between parental and perinatal factors and risk of stress-related disorders in the population analysis are driven by shared familial environment or genetics and underscore the importance of family designs in epidemiological studies on the etiology of psychiatric disorders.
Intergenerational Associations between Parents’ and Children's Adverse Childhood Experience Scores
Adverse childhood experiences (ACEs) are stressful childhood events associated with behavioral, mental, and physical illness. Parent experiences of adversity may indicate a child's adversity risk, but little evidence exists on intergenerational links between parents and children's ACEs. Addressing parenting stress, aggravation, and discord may interrupt intergenerational adversity cycles.
Association Between Adverse Childhood Experiences and Adverse Pregnancy Outcomes
One in four individuals referred to a perinatal mental health program who were pregnant or postpartum had a high ACE score. A high ACE score was associated with an increased risk of hypertensive disorders of pregnancy and preterm birth. These results underscore how remote events may reverberate through the life course.
The Depression-Vaccine Misinformation Connection
The study asks whether mental health plays a role in believing COVID vaccine falsehoods.
Barriers and Facilitators of Maternal Healthcare Utilization In the Perinatal Period Among Women With Social Disadvantage
Women with social disadvantage have poorer perinatal outcomes than women in advantaged social positions, which may be linked to more inadequate healthcare utilization. Disadvantaged groups may experience a greater diversity of barriers (i.e., feeling embarrassed about pregnancy, lack of transportation) or barriers judged to be particularly difficult (i,e., embarrassment about pregnancy).
Birth During the Pandemic May Affect Neurodevelopment
In utero COVID exposure does not appear to be a factor.
Neurons Derived From Stem Cells Predict Psychosis and Cognitive Deficits
In a breakthrough that holds significant promise for early diagnosis and better treatment of psychiatric illness, researchers have for the first time used neurons derived from human stem cells to predict the cardinal features of a psychiatric condition, such as psychosis and cognitive deficits in patients with schizophrenia.
Revamped Calif. Medicaid System Gets CMS OK
The CMS has approved the new California Advancing and Innovating Medi-Cal program, which aims to expand services provided to low-income Medi-Cal members to address homelessness and other societal issues. Under the revamped system, Medi-Cal members with managed care plans may be eligible for benefits from a care coordinator who assists with finding and making appointments with providers, obtaining medical transportation, and educating patients about their medications.
Black Youth Face Rising Rates of Depression, Anxiety, Suicide
Nearly everyone has experienced a degree of anxiety or depression due to the pandemic, but for young Black people also confronting persistent racism and ever-widening inequities, the current moment has led to an acute crisis in mental health.
Moms’ Thyroid Hormones Tied to Behaviors in Preschool Boys
The study looked at the effects of TSH and FT4 levels in pregnancy.
Why Therapists Are Worried About Mental Health in America Right Now
The Times recently asked mental health professionals from across the country to share how their patients — and they — are coping with the coronavirus crisis. "I think the lesson is that the therapists are shouldering the entire burden of this mental health crisis. And they're saying: 'We can't keep doing this. We can't carry this alone.'"
Psychosis and the Female/Maternal Brain
Hyper-mentalism/hyper-empathizing correlates with psychosis in normal females.