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Biomedical subjects

Katherine L Wisner

Publications and source records attributed to Katherine L Wisner.

8 recordsLinked to original sources

Bridging the gap: recruitment of African-American women into mental health research studies.

OBJECTIVE: To develop a strategy for recruiting African-American women into a research study for pregnant women. METHODS: With few exceptions, NIH-funded investigators must include women and minorities in clinical research. The authors used the recommendations provided in the Outreach Notebook for the NIH Guidelines on Inclusion of Women and Minorities as Subjects in Clinical Research as a guide to help them reach out to African-American women in the community. RESULTS AND CONCLUSIONS: The outreach experience led to a conference for African-American women about mental health. On the basis of this experience, the authors formulated a five-pronged approach for recruitment of African-American women into their study. The NIH guidelines were useful for this purpose.

Female↗

Verapamil treatment for women with bipolar disorder.

BACKGROUND: Additional pharmacological treatments are needed for patients with bipolar disorder. We describe our experience with verapamil in an inclusive, sequential series of outpatient women (some pregnant) with bipolar disorder. METHODS: All women who were prescribed verapamil for bipolar disorder (n = 37) were included. We used the criterion of 50% reduction in scores on the Mania Rating Scale or the Hamilton Rating Scale for Depression to define response for women who were treated for an acute episode of bipolar hypomania/mania or depression, respectively. For euthymic women who chose verapamil maintenance treatment, we evaluated whether they met criteria for a recurrent episode during therapy. RESULTS: Treatment for acute episodes was initiated in 28 women. Of women with depression and mania, 39% and 100% responded, respectively. Seven of the nine patients (77%) with mixed states responded: all seven improved to response criterion on the mania scale, and two responded on the depression scales as well. Six of eight patients who received continuation therapy remained well. CONCLUSIONS: These data provide evidence that verapamil is effective for mania. The response rate for mania compares favorably to that for other mood stabilizers. After decades of case reports and underpowered clinical trials, we must definitively study verapamil for efficacy and gender specificity in bipolar disorder.

Anti-Arrhythmia Agents↗

An open trial of morning light therapy for treatment of antepartum depression.

OBJECTIVE: About 5% of pregnant women meet criteria for major depression. No pharmacotherapy is specifically approved for antepartum depression; novel treatment approaches may be welcome. The authors explored the use of morning bright light therapy for antepartum depression. METHOD: An open trial of bright light therapy in an A-B-A design was conducted for 3-5 weeks in 16 pregnant patients with major depression. The Hamilton Depression Rating Scale, Seasonal Affective Disorders Version, was administered to assess changes in mood. A follow-up questionnaire was used to assess outcome after delivery. RESULTS: After 3 weeks of treatment, mean depression ratings improved by 49%. Benefits were seen through 5 weeks of treatment. There was no evidence of adverse effects of light therapy on pregnancy. CONCLUSIONS: These data provide evidence that morning light therapy has an antidepressant effect during pregnancy. A randomized controlled trial is warranted to test this alternative to medication.

Adult↗

Serum bupropion levels in 2 breastfeeding mother-infant pairs.

BACKGROUND: These are the first reported data on bupropion and hydroxybupropion levels in infants whose treated mothers were breastfeeding. The information will assist physicians and parents in the risk-benefit decision-making process for bupropion treatment during breastfeeding. METHOD: Serum samples were obtained by venipuncture from 2 mother-infant pairs. The serum was assayed for levels of bupropion and its most active metabolite, hydroxybupropion. RESULTS: Neither infant had quantifiable serum levels of bupropion or its metabolite at steady state. Neither infant had medical problems during the time of maternal therapy. CONCLUSION: We recommend obtaining and publishing additional serum level findings for breastfeeding mother-infant pairs since data for bupropion are favorable but limited.

Adult↗

Successful recruitment strategies for women in postpartum mental health trials.

Recruiting women into research protocols allows investigators to examine the efficacies of treatments and to study other outcomes among women with mental illnesses. However, achieving recruitment goals has been difficult for researchers. The objective of this study was to examine the success rates of different strategies for recruiting women into clinical trials for the prevention and treatment of postpartum major depression. This is a descriptive study designed to examine which recruitment efforts, over a 4-year period, yielded women who participated in the studies. It was conducted in an outpatient clinic affiliated with a major urban teaching hospital where women of childbearing age sought treatment for affective disorders. All women (n=589) who called about our research studies were systematically screened. The women were either pregnant or in the postpartum period. Our results show that in both studies, obstetricians and other healthcare professionals referred a large number of women. These referrals yielded relatively high rates of participation. However, other methods were differentially successful for the two studies: media appearances and advertising resulted in almost 50% of the screening calls for the prevention study, whereas mass mailings and other promotional materials were more effective for the treatment study. Those materials contributed 44% of screening calls for the treatment study. Our conclusions were that women were most likely to enter the research studies when referred by an obstetrician or other professional.

Antidepressive Agents↗