Dear Members, Dear Colleagues, DearFriends
We are at the threshold of the Spring season with its message of hope and new beginnings. The unique and beautiful varieties of cherry blossoms around the world that bloom in March remind us of the miracle of life and nature. March is also the month where we think of ways in which we can address women’s mental health wherever we live and work.
The recent devastating earthquake in Turkey and Syria and its aftermath have reminded us of the importance of disaster preparedness and developing effective ways of supporting those who have faced losses. The gendered nature of the impact of disasters (be it natural or created by humans) and specific factors related to supporting women and girls should be in the forefront of intervention planning.
Gender Based Violence is known to increase when existing support systems are not functional. Many organisations have been working on important aspects that influence women’s physical, reproductive and mental health such as Period Poverty and Menstrual Hygiene Management (MHM) which are often neglected in disaster support.
Embarrassment and anxiety related to menstrual hygiene and cultural aspects of using toilets and water by women in disaster settings have an important role in relief planning that keep in mind the dignity and mental health of women and girls.
The IAWMH will enable a discussion around these matters through webinars and sharing resources over the next quarter.
We request members to write in with their thoughts and suggest other important topics for discussion.
From this issue we start a Journal Article Review Corner by Early Career Professionals. For this newsletter, Nicole Votruba and Akanksha Agarwal review two of the 5 Most Downloaded articles of 2022 from the Archives of Women’s Mental Health. (See below)
Best regards
Prabha S. Chandra MD, FRCPE, FRCPsych, FAMS
IAWMH President
“Gender equality is more than a goal in itself. It is a precondition for meeting the challenge of reducing poverty, promoting sustainable development and building good governance.” Kofi Annan
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Monday 13 March 2023 - WEBINAR - 13.00 - 14.00 CEST
Adventurous and Impulsive,
but Above All Vulnerable - ADHD in Women
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Presenter:
Dr. Patricia Van Wijngaarden-Cremers
Senior Consultant Psychiatrist
Specialized in Gender, Developmental Disorders and Addiction Dimence a large Mental Health Facility in the Province Overijssel
THE NETHERLANDS
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COMING SOON: 15 CME Hours - SELF-LEARNING MODULES
Psychotropic Medications in Pregnancy and Lactation
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In March, IAWMH will open registration for a Self Learning Module on Psychotropic Medications in Pregnancy and Lactation that will earn 15 CME hours upon successful scoring of the knowledge assessment test upon completion of your study.
These extensive modules were developed by Dr Gihan ELNahas, IAWMH Secretary, and
Prof of Psychiatry, Head of Liaison Psychiatry Unit, Head of Women Mental Health Program, Head of Tobacco Control and Cessation Unit, Chair CME Committee, Institute of Psychiatry-Ain Shams Medical School, Cairo, Egypt and Florence Thibaut, M.D., Ph.D., IAWMH Immediate Past President, and Professor of Psychiatry, University Hospital Cochin Paris,, Sorbonne-Paris Cité University, France.
This program has been in the works for over a year and we are excited to debut it in the next few weeks.
IAWMH Members will be Complimentary. Non-Members registration will be $149.
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TOP 5 DOWNLOADED ARTICLES OF 2022 FROM THE
Archives of Women’s Mental Health
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Article Review: Premenstrual symptoms across the lifespan in an international sample: data from a mobile application
(Hantsoo, L et al, 2022)
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Review by Dr. Akanksha Agarwal
Senior Resident in Psychiatry
National Institute of Mental Health and Neurosciences, Bangalore, India
This study by Hantsoo et al from Johns Hopkins University, Baltimore, USA, aimed to examine the prevalence of premenstrual symptoms across 238,114 international users; age group ranging from 18 to 55 years, using a mobile application-based survey. A 17-question survey was administered in 10 international languages to the users of Flo, which is a free and widely available application. It examined physical and affective-cognitive symptoms via frequency-type questions. The commonest symptoms reported were food cravings (85%), mood swings, and fatigue. Mood symptoms did not differ by age and physical symptoms increased with age. Premenstrual symptoms interfered with everyday lives in 28.61% of respondents.
This survey captured a large community sample which is an arduous process via traditional surveys. It leveraged a digital tool to seek information from 140 nations, which enhances the generalizability of the results. Data privacy rules limited the examination of confounding factors. Reporting bias due to a self-report survey cannot be ruled out as well. However, a mobile app is perhaps the most intelligible and accessible tool to examine a non-clinical population, for otherwise tabooed topics.
Flo is a user-friendly application to track menstrual cycles and for women to seek personalized information on reproductive health. Such tools can aid clinicians and provide patient-friendly solutions to traditional prospective charting for patients with a premenstrual dysphoric disorder. This study sets the ball rolling for mental health research using technological advancements.
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Article Review: The association of unplanned pregnancy with perinatal depression: a longitudinal cohort study (Muskens, L. et. al. 2022)
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Review by Dr Nicole Votruba
Nuffield Department of Women's & Reproductive Health, University of Oxford
George Institute for Global Health (UK)
Unplanned pregnancy is a risk factor for women’s mental health, and for depression in particular.
The authors conducted a large cohort study to assess the association of unplanned pregnancy with the longitudinal course of depressive symptoms from the first to third trimester of pregnancy and the first year postpartum, to understand whether depressive symptoms in women developed differently if they had unplanned versus planned pregnancies. The study was conducted in the Netherlands as part of a larger longitudinal cohort study.
Muskens et al. recruited 1928 Dutch speaking women in the first trimester of pregnancy, without a history of chronic physical disease, severe mental illness, HIV, substance use or medication use that might harm the foetus. The study used the Edinburgh Postnatal Depression Scale (EPDS) and a question assessing unplanned pregnancy. Women were included if, out of three online questionnaires during pregnancy and five postpartum, they had completed at least the EPDS baseline questionnaire at 12 weeks of pregnancy and one of the follow-up EPDS questionnaires, and the question on unplanned pregnancy. The results were analysed using mixed linear models.
Of all women included, 111 (5.8%) identified as having an unplanned pregnancy, while 1871 (94.2%) indicated a planned pregnancy. Women with unplanned pregnancy had higher rates of depression throughout the perinatal period, compared to women with planned pregnancies. This was the case, even after adjusting for various confounders, of which lower age, unemployment and a previous experience of depression were also significant in predicting perinatal depression.
Interestingly, the authors also found that women with unplanned pregnancies had higher rates of previous experiences with depression (30.9%) than women with planned pregnancies (14.2%), and a sensitivity analysis did not change the results.
While the low rates of unplanned pregnancy in this study may be surprising compared to many other countries, the authors attribute this to the specifics of the Dutch obstetric care system where abortion is freely accessible and there is liberal school sex-education. It will be important to replicate this study in settings where access to birth control and abortions are less/not available and to see how the study replicates in a low socio-economic background. The authors admit limitations in using self-report for symptoms and history of depression and not assessing the influence of treatment.
Previous studies have assessed depression in unplanned pregnancies in cross-sectional designs. This study adds a larger sample and a longitudinal design. Challenges remain as inconsistent and often interchangeable use of the terms describing unplanned pregnancy require further research.
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The Search from a Gender Perspective
𝗗𝗿𝗮. 𝗝𝘂𝗱𝗶𝘁𝗵 𝗨𝘀𝗮𝗹𝗹 𝗶 𝗥𝗼𝗱𝗶𝗲́, IAWMH President-elect, coordinator of the research group, Etiopathogenesis and treatment of mental disorders MERITT" of the IRSJD and coordinators of the Dona i Salut Mental del PSSJD, ens parla.
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WMH Barcelona - IV European Meeting on Women's Mental Health
Psychosis & Gender
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Looking for news from our members!
As we are preparing IAWMH Newsletters we want to highlight our members'
activities, awards and news. Let us know what's happening that would be of interest to
other IAWMH members. Send your news to Debby Tucker at debra@iawmh.org to be
included in the next newsletter.
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