Toward a framework for best practices and research guidelines for perinatal depression research

Abstract

This review article highlights the current state of perinatal depression (PND) research including established standards of care and innovative research in progress. PND can have a significant adverse impact on mother, child, and family; however, to date, wide‐scale identification, prevention, and treatment have been limited. PND is heterogenous in presentation with likely multifactorial etiologies for each woman. Challenges in PND research are discussed including a need for universal tools, standardized measures, benchmarks, and best practices. Current examples are reviewed that highlight approaches to novel treatment paradigms and interventions. This includes reviewing epidemiologic studies in PND research, examining the biological underpinnings of PND, and discussing examples from this field and other fields currently developing translational research that spans from bench to bedside. Current and future challenges and opportunities in developing best practices for the treatment of PND are outlined. We also discuss the use of the NIMH Research Domain Criteria approach for PND research and provide recommendations for future directions in PND research collaboration. In conclusion, greater precision in perinatal psychiatry can be possible in the future with the development of guidelines and best practices that build on current work and apply innovative and collaborative approaches of scientists, providers, patients, community members, and government officials.

Depression, Anxiety, Resilience, and Coping: The Experience of Pregnant and New Mothers During the First Few Months of the COVID-19 Pandemic

“…2,3 Previous studies suggest that acute and chronic mental health problems during pregnancy can affect maternal/child attachment and other maternal/child health sequelae. 4 Preliminary studies suggest that, during the pandemic, pregnant and postpartum women have experienced high rates of depressive symptoms and anxiety, accompanied by feelings of loneliness, stress related to uncertainty and lack of social support, and concerns about accuracy of information. 5,6 It is essential to conduct research on maternal mental health during pregnancy and postpartum given findings in the extant literature about the correlation of acute stress, anxiety, and depressive symptoms with poor maternal/child health outcomes (e.g., poor maternal health behaviors, suicide, intrauterine growth restriction, preterm birth, impaired breastfeeding, altered infant temperament and social/emotional development, adult-onset chronic illness in the child) and economic burden to the individual and society (e.g., medical costs, comorbidities).…”

Maternal Mental Health MATTERS

“…The United Kingdom provides a model of a comprehensive approach to perinatal mental health that includes integration of home visiting services along with a network of Mother and Baby Units (providing psychiatric inpatient care) that is supported by standards created by the Quality Network for Perinatal Mental Health Services and the government [16]. This and the MCPAP for Moms program in Massachusetts serve as models for developing comprehensive services by bringing together consumers, providers, researchers, advocates, and government leaders.…”

“…Barriers for patients include access, stigma, symptom heterogeneity, changes in presentation over time, and symptoms impairing communication and motivation [15]. However, evidence-based practices can be utilized to improve identification and treatment [16].…”

Toward improved research on peripartum depression

“…While numerous studies on peripartum depression have been published, Kimmel and colleagues point out that most of the research has dealt with incidence estimates and risk factors, studies are mostly cross-sectional rather than longitudinal and often underpowered for the investigation of multiple risk factors (Kimmel, Bauer, & Meltzer-Brody, 2019). Based on the current literature, risk factors can be grouped into two main categories: biological and psychosocial.…”

“…The downside of this bifurcated literature on PPD is that bio‐psychosocial processes and interactions are neglected, and integrative models remain underdeveloped and untested. An important message of this In Focus issue is, thus, to move the field toward wide‐scale collaborations, as it has, already, been done in other fields in medicine (Kimmel et al., 2019).…”