Biomedical subjects

Deirdre Ryan

Publications and source records attributed to Deirdre Ryan.

3 recordsLinked to original sources

PubMed2006

Internalizing behaviors in 4-year-old children exposed in utero to psychotropic medications.

OBJECTIVE: Internalizing behaviors in children between 4 and 5 years of age who had been prenatally exposed to psychotropic medications were investigated. The authors had previously reported the effects of prenatal medication exposure in this same cohort when they were newborns and infants at 3 and 8 months of age. METHOD: Parental/teacher reports and a clinical measure of mother and child interactions were used to assess levels of internalizing behaviors (e.g., depression, anxiety, withdrawal). Outcomes were compared between children with prenatal selective serotonin reuptake inhibitor (SSRI) exposure (N=22) and nonexposed children of healthy, nondepressed, nonmedicated mothers (N=14). Measures of maternal mood were obtained. Ordered logistic regressions, independent-sample t tests, and univariate ANOVAs were used to compare outcomes between groups. Pearson correlations were used to determine associations between maternal mood and child behaviors. RESULTS: Levels of internalizing behaviors did not differ significantly between children with prenatal psychotropic medication exposure and those not exposed. However, as symptoms of maternal anxiety and depression increased, so did reported internalizing behaviors in their children. CONCLUSIONS: Prenatal exposure to psychotropic medications was not associated with increased reports of internalizing behaviors at 4 years of age, whereas impaired maternal mood did have an identified impact on child behavior. Further study of complex associations between maternal psychiatric disorders, prenatal SSRI exposure, and childhood internalizing behaviors is required to understand if the child outcome is affected by the illness, medications, or a combination of both.

Adult↗

PubMed2005

Depression during pregnancy.

OBJECTIVE: To review existing literature on depression during pregnancy and to provide information for family physicians in order to promote early detection and treatment. QUALITY OF EVIDENCE: MEDLINE was searched from January 1989 through August 2004 using the key words depression, pregnancy, prenatal, and antenatal. Articles focusing on depression during pregnancy were chosen for review; these articles were based on expert opinion (level III evidence) and prospective studies (level II evidence). MAIN MESSAGE: Pregnancy does not safeguard women against depressive illness. The Edinburgh Postnatal Depression Scale is an effective screening tool for identifying women with depressive symptoms during pregnancy. Once diagnosed with major depression, these patients need to be monitored closely for up to a year after delivery. Patients with mild-to-moderate illness should be referred for psychotherapy. More severely ill patients might require additional treatment with antidepressants. The most commonly used antidepressants are selective serotonin reuptake inhibitors and the serotonin and norepinephrine reuptake inhibitor, venlafaxine. For each patient, risk of treatment with an antidepressant needs to be compared with risk of not treating her depressive illness. CONCLUSION: Early detection of depression during pregnancy is critical because depression can adversely affect birth outcomes and neonatal health and, if left untreated, can persist after the birth. Untreated postpartum depression can impair mother-infant attachments and have cognitive, emotional, and behavioural consequences for children.

Antidepressive Agents, Second-Generation↗

PubMed2004

Relation between prenatal maternal mood and anxiety and neonatal health.

OBJECTIVE: To examine the relation between the mood and anxiety of pregnant, psychiatrically treated women and neonatal health outcomes after birth. METHOD: We prospectively assessed 46 women treated with psychotropic medications for anxiety and depression during pregnancy. We compared measures of maternal mental health with infant outcomes, in particular, the outcomes of infants with symptoms of poor neonatal adaptation. RESULTS: The mothers of babies who demonstrated poor neonatal adaptation reported higher levels of anxiety and depression at study entry than did the mothers of healthy babies. This relation was not related to the presence or absence of treatment with clonazepam, an anxiolytic used to treat symptoms of anxiety. Further, increased psychiatric comorbidity in the mother was associated with a greater likelihood of transient symptoms in the newborn. CONCLUSIONS: Despite psychiatric treatment, the intensity and degree of comorbid symptoms appear to be related to poor transient neonatal health outcome. Our data suggest that, in addition to the impact of pharmacologic factors, maternal psychiatric status influences infant outcomes.

Adult↗