Welcome
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A very warm welcome to you during your visit to
our website home! In 1985, I was a new faculty member in general
and child psychiatry at Western Psychiatric Institute and Clinic
(WPIC) at the University of Pittsburgh, and a post-doctoral student
in psychiatric epidemiology. I had evaluated many women who had
childbearing-related mental health problems. Curiously, I had been
taught in my residency that women who were pregnant did not become
psychiatrically ill, because they were "fulfilled".
At that time, experts in the field of psychiatry were debating whether
an entity called postpartum depression even existed! Patients are
always the best teachers, and the unmet needs of pregnant and breastfeeding
women rapidly became my clinical and research career focus.
Eighteen years later, I am amazed at the progress in research that
has been accomplished! We have data to direct decisions about antidepressant
drug use in pregnancy and breastfeeding. More is known about antidepressants
in pregnancy than almost every other class of medication! We know
that interpersonal psychotherapy (IPT) is effective for postpartum
depression from a well-designed randomized clinical trial. Novel
therapies, such as light therapy and acupuncture, are being evaluated
for efficacy in treating pregnant depressed women. And newly graduated
mental health professionals are very interested in this field, now
often referred to as perinatal psychiatry!
Women are at the highest risk for depression during the childbearing
years. Depression not only exacts a heavy toll from women, but also
yields a legacy of poor outcomes for the offspring. Effective treatments
for depression exist, yet mothers continue to suffer from depression
at an unacceptable rate in our society. As always, knowledge acquisition
is a process, and much remains to be done. We are beyond the time
for justifying waiting for organized intervention due to the need
for "more research". We cannot continue to ignore the
needs for treatment now the mothers of our next generation, who
pay a large toll in terms of psychiatric morbidity.
In March, 2003, we had an invitational conference of experts to
define how to intervene for depression in mothers of young children.
Three work groups addressed these concerns and developed programmatic
models. The next steps are: 1) describe and integrate the three
models that were developed and publish the proceedings to bring
attention to this major public health problem; 2) plan a follow-up
conference; 3) involve the media in disseminating information about
mothers and depression; 4) define collaborative roles with key community
partners; and, 5) develop training for mental health professionals
who will provide treatment and perform clinical research for depressed
mothers. We welcome the challenge on behalf of the mothers of our
next generation.
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