Perinatal generalized anxiety disorder (GAD) has a high prevalence of 8.5%-10.5% during pregnancy and 4.4%-10.8% postpartum. Despite its attendant dysfunction in the patient, this potentially debilitating mental health condition is often underdiagnosed. This overview will provide guidance for clinicians in making timely diagnosis and managing symptoms appropriately. A significant barrier to the diagnosis of GAD in the perinatal population is difficulty in distinguishing normal versus pathological worry. Because a perinatal-specific screening tool for GAD is nonexistent, early identification, diagnosis and treatment is often compromised. The resultant maternal dysfunction can potentially impact mother-infant bonding and influence neurodevelopmental outcomes in the children. Comorbid occurrence of GAD and major depressive disorder changes the illness course and its treatment outcome. Psychoeducation is a key component in overcoming denial/stigma and facilitating successful intervention. Treatment strategies are contingent upon illness severity. Cognitive behavior therapy (CBT), relaxation, and mindfulness therapy are indicated for mild GAD. Moderate/severe illness requires pharmacotherapy and CBT, individually or in combination. No psychotropic medications are approved by the FDA or Health Canada in pregnancy or the postpartum; off-label pharmacological treatment is instituted only if the benefit of therapy outweighs its risk. SSRIs/SNRIs are the first-line treatment for anxiety disorders due to data supporting their efficacy and overall favorable side effect profile. Benzodiazepines are an option for short-term treatment. While research on atypical antipsychotics is evolving, some can be considered for severe manifestations where the response to antidepressants or benzodiazepines has been insufficient. A case example will illustrate the onset, clinical course, and treatment strategies of GAD through pregnancy and the postpartum.

Two experiments were conducted to identify appropriate experimental and practical diets for bluegill Lepomis macrochirus and hybrid bluegill L. cyanellus × L. macrochirus reared in aquaria. In the first study, four experimental diets and five commercial diets were evaluated in juvenile hybrid bluegill initially weighing 4.8 g/fish. The experimental diets contained casein (CAS), casein + gelatin (CAWGEL), casein + L‐arginine‐HCI (CAS/ARG), or casein + gelatin + crystalline amino acids (CAS/AA) as sources of crude protein. The commercial diets included three diets formulated to meet the nutritional requirements of rainbow trout Oncorhynchus mykiss and two diets formulated to meet the nutritional requirements of channel catfish Ictalurus punctatus. Each diet was fed twice daily at a rate of 4% of body weigh/d to triplicate groups of fish. At the end of the 8‐wk feeding trial, weight gain was significantly higher in fish fed the best commercial rainbow trout diets (205–217%) compared to fish fed diets formulated for channel catfish (87–104%). Weight gain and feed efficiency (FE) of fish fed the experimental diets (5346% and 0.19–0.32, respectively) were significantly lower than those of fish fed the commercial rainbow trout diets (143–217% and 0.49–0.64, respectively). In the second experiment, the same dietary treatments were fed for 8 wk to juvenile bluegill initially weighing 3.7 g/fish. Each diet was fed twice daily at a rate of 4% of body weight/d to triplicate groups of fish. Weight gain was significantly higher in fish fed commercial trout diets (291–402%) compared to fish fed diets formulated for channel catfish (164–191%). Weight gain and FE of fish fed CAS/ARG were significantly higher than those of fish fed the commercial catfish diets, but significantly lower than those of fish fed the best commercial trout diets. Results of this study indicate that commercial rainbow trout diets are preferable to commercial channel catfish diets for culture of bluegill and hybrid bluegill. More research is needed to identify appropriate experimental diets for this group of fishes.

The Dodo Bird Verdict (DBV)-the proposition that all psychotherapies are equally effective-remains bitterly contested by researchers, who have mainly used meta-analyses as the primary tool to adjudicate the disagreements about relative psychotherapy efficacy. However, the meta-analytic literature remains inconclusive and contradictory, due in part to heterogeneity in researchers' methodological and statistical decisions. We undertake a review of a number of recent meta-analyses of psychotherapy outcomes to highlight key methodological issues in the DBV meta-analytic literature. Issues under consideration include the inclusion of direct versus indirect comparisons; the restriction of analyses to bona fide rather than intent-to-fail treatments; the outcomes to be included and distinguished in the analysis (e.g., primary and secondary outcomes, outcomes at termination and at follow-up, intent-to-treat and completer analyses); methods for effect size aggregation; the question of what constitutes a clinically significant effect size; search strategies for locating primary studies; statistical considerations; and possible moderators for use in metaregression analysis, including treatment class, disorder, allegiance, and methodological quality. We conclude with recommendations for ensuring that meta-analytic assessments of the DBV are both accurate and even-handed. Public Significance StatementTo reduce the burden of mental health difficulties and maximize clients' well-being, it is critical to be able to determine which, if any, psychotherapies should be considered first-line treatment options. Meta-analyses undertaken with consistent and accurate methodologies will be key to making such determinations.

No abstract