Presenting with common mental health difficulties, particularly depression and anxiety, there is also preliminary evidence that mindfulness-based interventions (MBIs) including mindfulness-based cognitive therapy (MBCT), mindfulness-based stress reduction (MBSR) and integrated mindfulness yoga practices may also be effective in reducing common mental health difficulties during pregnancy. We systematically reviewed and synthesized the current literature on the effectiveness of MBIs in reducing severity of perinatal anxiety and depression. Databases including PubMed, Cochrane Library, IndMED and PsychoInfo were searched for relevant studies. Manual searches were conducted in relevant articles and Google Scholar. Seventeen cohorts representing 18 studies were included. Pre-post effect sizes were reported for both treatment and control groups. Seven randomized controlled trials (RCTs), two non-randomized controlled trials and nine treatment evaluations were included. Maternal participation in an MBI was associated with reductions in perinatal anxiety of moderate to large magnitude. Results for the effect of MBIs on depression were less consistent, with pre-post treatment reductions of moderate magnitude, but no significant differences in depression scores when MBI was compared with a control group. There was some evidence that MBIs were associated with increased mindfulness. Risk of bias in studies was variable. Our review offers preliminary evidence for the effectiveness of MBIs in reducing perinatal anxiety, with more equivocal findings with regard to perinatal depressive symptoms. Further methodologically rigorous evaluation using RCTs and longer follow-up periods are recommended.

Aims/hypothesis Adult beta cells have a diminished ability to proliferate. Phosphatase and tensin homologue (PTEN) is a lipid phosphatase that antagonises the function of the mitogenic phosphatidylinositol 3-kinase (PI3K) pathway. The objective of this study was to understand the role of PTEN and PI3K signalling in the maintenance of beta cells postnatally. Methods We developed a Ptenlox/lox; Rosa26lacZ; RIP-CreER+ model that permitted us to induce Pten deletion by treatment with tamoxifen in mature animals. We evaluated islet mass and function as well as beta cell proliferation in 3- and 12-month-old mice treated with tamoxifen (Pten deleted) vs mice treated with vehicle (Pten control). Results Deletion of Pten in juvenile (3-month-old) beta cells significantly induced their proliferation and increased islet mass. The expansion of islet mass occurred concomitantly with the enhanced ability of the Pten-deleted mice to maintain euglycaemia in response to streptozotocin treatment. In older mice (>12 months of age), deletion of Pten similarly increased islet mass and beta cell proliferation. This novel finding suggests that PTEN-regulated mechanisms may override the age-onset diminished ability of beta cells to respond to mitogenic stimulation. We also found that proteins regulating G1/S cell-cycle transition, such as cyclin D1, cyclin D2, p27 and p16, were altered when PTEN was lost, suggesting that they may play a role in PTEN/PI3K-regulated beta cell proliferation in adult tissue. Conclusions/interpretation The signals regulated by the PTEN/PI3K pathway are important for postnatal maintenance of beta cells and regulation of their proliferation in adult tissues.

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