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1.
Asian J Psychiatr ; 84: 103592, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37079987

RESUMO

Our paper describes the process of creating a stakeholder group for service development and research in Postpartum Psychosis (PP) at a Perinatal Psychiatry Service in India. We involved women who have recovered from PP as `experts by experience' in identifying areas that need attention from a research and service perspectives. A total of 13 group meetings were conducted, in which 9 group meetings involved women with lived experiences of PP and 4 group meetings were with the family members involved in the care of women during the PP episode. Of the 58 participants, 23 women and two family members expressed their willingness to participate in future stakeholder meetings. Involvement of women with PP and their caregivers as stakeholders in mental health decision-making appears feasible in a LMIC setting and should be encouraged.


Assuntos
Psiquiatria , Transtornos Psicóticos , Transtornos Puerperais , Gravidez , Humanos , Feminino , Transtornos Psicóticos/terapia , Transtornos Puerperais/terapia , Transtornos Puerperais/psicologia , Saúde Mental , Período Pós-Parto
2.
Am J Psychiatry ; 180(12): 884-895, 2023 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-37849304

RESUMO

OBJECTIVE: Postpartum depression (PPD) is a common subtype of major depressive disorder (MDD) that is more heritable, yet is understudied in psychiatric genetics. The authors conducted meta-analyses of genome-wide association studies (GWASs) to investigate the genetic architecture of PPD. METHOD: Meta-analyses were conducted on 18 cohorts of European ancestry (17,339 PPD cases and 53,426 controls), one cohort of East Asian ancestry (975 cases and 3,780 controls), and one cohort of African ancestry (456 cases and 1,255 controls), totaling 18,770 PPD cases and 58,461 controls. Post-GWAS analyses included 1) single-nucleotide polymorphism (SNP)-based heritability ([Formula: see text]), 2) genetic correlations between PPD and other phenotypes, and 3) enrichment of the PPD GWAS findings in 27 human tissues and 265 cell types from the mouse central and peripheral nervous system. RESULTS: No SNP achieved genome-wide significance in the European or the trans-ancestry meta-analyses. The [Formula: see text] of PPD was 0.14 (SE=0.02). Significant genetic correlations were estimated for PPD with MDD, bipolar disorder, anxiety disorders, posttraumatic stress disorder, insomnia, age at menarche, and polycystic ovary syndrome. Cell-type enrichment analyses implicate inhibitory neurons in the thalamus and cholinergic neurons within septal nuclei of the hypothalamus, a pattern that differs from MDD. CONCLUSIONS: While more samples are needed to reach genome-wide levels of significance, the results presented confirm PPD as a polygenic and heritable phenotype. There is also evidence that despite a high correlation with MDD, PPD may have unique genetic components. Cell enrichment results suggest GABAergic neurons, which converge on a common mechanism with the only medication approved by the U.S. Food and Drug Administration for PPD (brexanolone).


Assuntos
Transtorno Bipolar , Depressão Pós-Parto , Transtorno Depressivo Maior , Feminino , Humanos , Animais , Camundongos , Transtorno Depressivo Maior/genética , Estudo de Associação Genômica Ampla , Depressão Pós-Parto/genética , Predisposição Genética para Doença , Transtorno Bipolar/genética , Polimorfismo de Nucleotídeo Único/genética
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