Seleni Institute Sponsors Researchers in Perinatal Mental Health
Awardees will use grant funds to present cutting-edge research at conference in Chicago
Seleni is thrilled to announce that we will be sponsoring five researchers in perinatal mental health to attend the 2nd Biennial Perinatal Mental Health Conference in Chicago, Illinois from November 4-6, 2015. This year the conference will focus on translating laboratory and clinical research into practical information on diagnosis, health decision-making, therapy, and prevention.
The researchers Seleni is sponsoring are tackling little understood issues, such as opioid dependence and treatment in pregnancy, the new diagnostic criteria for perinatal OCD, and the differences in postpartum depression across cultures. Seleni spoke with the grant winners to find out what excites them in the field of perinatal mental health and what they hope to accomplish at the conference and in their careers.
Leah Susser, MD, resident psychiatrist at New York-Presbyterian Hospital/Weill Cornell Medical Center
What are your career goals, and what will you be presenting at the conference?
I plan to pursue clinical work in reproductive psychiatry and research into obsessive-compulsive disorder (OCD) in the perinatal period. I will be taking part in the symposium, "OCD With Absent Insight: The Implications of the DSM-5 for Postpartum OCD."
The diagnostic criteria for perinatal OCD changed in the newest edition of the Diagnostic and Statistical Manual of Mental Disorders. Now, according to the new criteria, the level of insight a woman has about her condition can vary from completely understanding that the thoughts she is having are unrealistic to being completely sure that they are true. So the symptoms for perinatal OCD now overlap with what used to be considered postpartum psychosis (PPP), and we don't yet know how to manage this new group of people who are being classified as [having] OCD. The symposium seeks to clarify whether women who have symptoms of OCD with accompanying delusions should be treated for OCD or PPP.
What do you hope to accomplish?
It's really important to figure out how to do risk assessment and successful treatment of OCD in the postpartum period for the new group of women who will now be diagnosed with OCD rather than postpartum psychosis. We need to have a better understanding of how to treat this new group of patients.
Shona L. Ray-Griffith, MD, assistant professor in the departments of psychiatry and obstetrics and gynecology at the University of Arkansas for Medical Sciences
Where are your research interests and career goals?
The treatment of pain and opioid use disorders during pregnancy. I am interested in the role of pain management and analgesic use during the perinatal period, the association of psychiatric diagnoses and symptoms with the use of analgesic agents, the course and consequences of neuropathic pain in pregnancy, pain management during labor for women who are undergoing opioid maintenance therapy, and the impact of acetaminophen on early fetal neurodevelopment.
Over the next few years, I am combining my clinical and research interests into a focus on pain management in pregnancy. At the conference, I will be sharing my research at the "Treatment of Childbearing Women" symposium. My presentation will discuss the impact psychiatric diagnoses have on analgesic use in pregnant women.
What areas of perinatal mental health are critical to address with research?
With the emerging opioid abuse/dependence problem in the United States, expanding our knowledge of pain and opioid use disorders in pregnancy is needed. The inclusion of this population and the outcomes associated with analgesics will be an incremental step in advancing our understanding of the potential impact of co-occurring exposures and diagnosis on pregnancy outcomes.
Jessica Coker, MD, resident psychiatrist at the University of Arkansas for Medical Sciences
How did you become interested in perinatal mental health?
During my third year of medical school, I cared for a patient with a drug dependence. It was fascinating to see both the anxiety this created in her provider and the lack of resources and knowledge available to medical professionals.
What are your career goals, and how will you participate in the conference?
I am planning to expand my training in women's mental health following residency to prepare for an academic career as a psychiatrist at an academic institution. I want to incorporate my focus on substance abuse during the prenatal period in both my clinical practice and in my research. At the conference, I will be presenting at the "Treatment of Childbearing Women Symposium" on maternal and neonatal outcomes following longitudinal benzodiazepine exposure.
What areas of perinatal mental health are critical to address in research?
There has been a tremendous amount of research focused on prescription safety profiles during the perinatal period, and that has been crucial to answering important questions regarding the treatment of mental illness during this time period. Looking forward, understanding the addiction process and the risks of substance use – to mothers, fetuses, and infants – is a critical area on which to focus research. Given the various legal jurisdictions across the nation that are criminally penalizing women for substance use during the perinatal period, it is up to researchers and clinicians not only to offer these women care, but also to have a greater understanding of the consequences of addictions during fetal development.
Cara Angelotta, MD, fellow in psychiatry and law at Columbia University Medical Center
What are your research interests and career goals?
I am interested in the intersection between women's mental health and the law. In particular, my current research is on women with opioid use disorders who are charged with child abuse for drug use during pregnancy and the substance use treatment pregnant women receive. I will be presenting that research at the conference. I would like to work at an academic center doing research and practice clinical and forensic psychiatry related to women's mental health.
What do you think are the greatest challenges to the field?
There continues to exist a great deal of stigma about taking medication for mental illness in pregnancy. In my clinical experience, I have found that this seems to be especially true for pregnant women who have substance use disorders. We have medications available that greatly reduce the risk of relapse to substance use, but many pregnant women don't have access to these treatments. Or if they do have access, some feel guilty that they need them to stay sober.
Arianna Di Florio, MD, PhD, psychiatrist and Marie Curie International Fellow at theUNC Center for Women's Mood Disorders
What are your career goals, and how will you participate in the conference?
I am an academic psychiatrist. I hope my work will improve life [for] many families who suffer and empower women with mental disorders who face very difficult decisions during pregnancy and childbirth. I will be giving two presentations at the conference, one on personalized risk predictions of perinatal episodes in women with bipolar disorder and the second on the cross-cultural differences of postpartum depression.
In the first talk, I will argue that the risk of perinatal illness is not the same for all women with bipolar disorder and present an overview of the work I have conducted for the past five years on the relationship between bipolar disorder and childbirth. In the second talk, I will present the results of a large, international study in which we examined a broad definition of culture and used a novel statistical methodology that detects differences in the way depression is expressed and in the relationship between symptoms across cultures.
Where do you think we need to focus perinatal mental health research?
Perinatal mental disorders are complex and require a multidisciplinary, holistic approach. Both research and clinical practice need to tackle them on multiple levels and with scientific rigor. As we recently pointed out in an article published in the journal "Current Psychiatry Report," mental health in general, and perinatal psychiatry in particular, should be based on empirical evidence and clinical utility.
Contemporary medicine is hyperspecialized, so sometimes it is very hard to keep a holistic perspective. Similarly, the pressure to deliver short-term outcomes often obfuscates scientific rigor and hinders the achievement of long-term and more ambitious goals. For example, postpartum depression is likely to be a complex and heterogeneous disease entity with complex disease mechanisms, including psychological, biological, but also social factors. I think it requires personalized treatment strategies as much as adequate social policies to prevent it or at least to minimize its impact on the families affected.