Cognitive processing of infant stimuli in pregnant women with and without affective disorders and the association to postpartum depression.

Pregnancy and childbirth are among the strongest risk factors for depression but the neurocognitive mechanisms underlying this enhanced risk are unknown. This study investigated emotional and non-emotional cognition in 57 pregnant women with or without an affective disorder during their third trimester, and the association between cognitive biases and subsequent postpartum depression (PPD). Of the pregnant women, 22 had a diagnosis of unipolar disorder (UD) and seven of bipolar disorder (BD) in full or partial remission, while 28 had no history of affective disorder. We included a control group of 29 healthy non-pregnant women. First, participants were interviewed, completed non-emotional and emotional cognitive tests and lastly filled out questionnaires. The participants were assessed two times after birth: at a home visit shortly after birth, and with a telephone interview to assess PPD in the first six months after birth. Healthy pregnant women rated infant cries less negatively than non-pregnant women, possibly reflecting preparation for motherhood. Pregnant women with UD exhibited a negative bias in ratings of infant cries, whereas pregnant women with BD showed a positive bias in ratings of infant happy faces and recognition of adult facial expressions. Across all pregnant women, more negative ratings of infant cries were associated with enhanced risk of PPD. Negatively biased perception of infant cries during pregnancy may thus signal vulnerability toward PPD.

Use of psychotropic drugs during pregnancy and breast-feeding.

OBJECTIVE: To write clinical guidelines for the use of psychotropic drugs during pregnancy and breast-feeding for daily practice in psychiatry, obstetrics and paediatrics. METHOD: As we wanted a guideline with a high degree of consensus among health professionals treating pregnant women with a psychiatric disease, we asked the Danish Psychiatric Society, the Danish Society of Obstetrics and Gynecology, the Danish Paediatric Society and the Danish Society of Clinical Pharmacology to appoint members for the working group. A comprehensive review of the literature was hereafter conducted. RESULTS: Sertraline and citalopram are first-line treatment among selective serotonin reuptake inhibitor for depression. It is recommended to use lithium for bipolar disorders if an overall assessment finds an indication for mood-stabilizing treatment during pregnancy. Lamotrigine can be used. Valproate and carbamazepin are contraindicated. Olanzapine, risperidone, quetiapine and clozapine can be used for bipolar disorders and schizophrenia. CONCLUSION: It is important that health professionals treating fertile women with a psychiatric disease discuss whether psychotropic drugs are needed during pregnancy and how it has to be administered.

Daily electronic self-monitoring in bipolar disorder using smartphones - the MONARCA I trial: a randomized, placebo-controlled, single-blind, parallel group trial.

BACKGROUND: The number of studies on electronic self-monitoring in affective disorder and other psychiatric disorders is increasing and indicates high patient acceptance and adherence. Nevertheless, the effect of electronic self-monitoring in patients with bipolar disorder has never been investigated in a randomized controlled trial (RCT). The objective of this trial was to investigate in a RCT whether the use of daily electronic self-monitoring using smartphones reduces depressive and manic symptoms in patients with bipolar disorder. METHOD: A total of 78 patients with bipolar disorder according to ICD-10 criteria, aged 18-60 years, and with 17-item Hamilton Depression Rating Scale (HAMD-17) and Young Mania Rating Scale (YMRS) scores ≤17 were randomized to the use of a smartphone for daily self-monitoring including a clinical feedback loop (the intervention group) or to the use of a smartphone for normal communicative purposes (the control group) for 6 months. The primary outcomes were differences in depressive and manic symptoms measured using HAMD-17 and YMRS, respectively, between the intervention and control groups. RESULTS: Intention-to-treat analyses using linear mixed models showed no significant effects of daily self-monitoring using smartphones on depressive as well as manic symptoms. There was a tendency towards more sustained depressive symptoms in the intervention group (B = 2.02, 95% confidence interval -0.13 to 4.17, p = 0.066). Sub-group analysis among patients without mixed symptoms and patients with presence of depressive and manic symptoms showed significantly more depressive symptoms and fewer manic symptoms during the trial period in the intervention group. CONCLUSIONS: These results highlight that electronic self-monitoring, although intuitive and appealing, needs critical consideration and further clarification before it is implemented as a clinical tool.

The use of poultry litter as co-substrate and source of inorganic nutrients and microorganisms for the ex situ biodegradation of petroleum compounds.

The purpose of this investigation was to determine the feasibility of utilizing poultry litter as a source of microorganisms, C co-substrate, N, and P to enhance the biodegradation of petroleum compounds in contaminated soil. An initial laboratory-scale study utilized soil contaminated with approximately 3,000 mg/kg (ppm) total petroleum hydrocarbons (TPHC) as diesel fuel. Biotreatment units, each containing 10 L of contaminated soil, were supplemented (0, 1, 10, and 20%, total weight basis) with broiler litter containing 3.65% N and 1.89% P. Petroleum-degrading microorganisms previously enriched from broiler and turkey litter were also inoculated into the litter-treated units. A significant first order rate of TPHC biodegradation was measured for all treatment units containing broiler litter (P < 0.05). Based on these results, a subsequent study was conducted at the site of a commercial facility permitted to treat soil (ex situ) contaminated with hazardous compounds. Soil treatment plots, each containing approximately 1 ton of soil contaminated with approximately 1,200 to 1,600 mg/kg diesel fuel were established. Each plot was replicated four times and the experiment was conducted for 35 d. Treatments were as follows: control, soil only; soil + commercial blend of bioremediation nutrients; soil + commercial fertilizer; soil + poultry litter (1% by volume); soil + poultry litter (10% by volume); soil + pelleted poultry litter (10% by volume). The results showed that the remediation of soil contaminated with petroleum compounds is significantly (P < 0.05) enhanced when supplemented with poultry litter (pelleted or nonpelleted) in concentrations of 10% soil volume. These results demonstrate the potential for a specialized market for the use of poultry litter.