Studies of traumatic brain injury (TBI) from all causes have found evidence of chronic hypopituitarism, defined by deficient production of one or more pituitary hormones, in 25–50% of cases. Hypopituitarism, particularly growth hormone deficiency (GHD), is associated with symptoms that can be mistaken for PTSD, including fatigue, anxiety, depression, irritability, insomnia, sexual dysfunction, poor concentration and memory, and decreased quality of life.

The objective of this study is to determine the prevalence and consequences of posttraumatic hypopituitarism (PTHP) after blast-related mild TBI (mTBI), an extremely common injury in modern military operations.

Blood samples are analyzed from US military Veterans with blast mTBI and from Veterans with similar experience but without blast exposure to determine the frequency of PTHP and to characterize specific hormonal defects.

Concentrations of 12 hormones are measured with radioimmunoassays or enzyme-linked immunosorbent assays and behavioral and neuropsychological testing is conducted on all subjects.

Eleven of 26, or 42%, of subjects with blast mTBI were found with abnormal hormone levels in one or more pituitary axes. Five individuals with mTBI were found with probable GHD, and three mTBI participants showed evidence of hypogonadism. Veterans without blast exposure had no hormonal abnormalities.

There is a high prevalence of PTHP after blast mTBI, the neuropsychiatric symptoms of which are treatable with hormonal replacement. Screening for PTHP after blast mTBI shows promise for appropriately directing diagnostic and therapeutic decisions that may otherwise remain unconsidered.

Studies support the view that the balance of autonomic nervous system shifts to sympathetic direction and that there is a suppression on the parasympathetic system in Posttraumatic Stres Disorder(PTSD).

Basal and post-traumatic-stimulus measurements were made with HRV (Heart Rate Variability) on soldiers diagnosed with PTSD. The data were compared with control group.

The sample of this study consisted of 27 patients diagnosed with PTSB according to the DSM-IV criteria and 23 healthy control. Holter recording device was installed in all subjects for 2 hours. Then a slide show was shown with a total of 120 pieces of traumatic experience photographes about six minutes in duration. And Holter recording was continued for another 2 hours.

After exposing to the photographes, in control group: RMSSD, NN50 Count and pNN50 parameters of HRV increased as an indicator of parasympathetic activation; SDANN and SDNN decreased as an indicator of dominance of parasympathetic system to sympathetic system. But in patient group after exposing to the photographes; SDNN and SDANN increased as an indicator of sympathetic activation and RMSSD and pNN50 decreased as an indicator of dominance of sympathetic system to parasympathetic system.

Patient group results indicate parasympathetic failure. This was thought to be related to insufficiant prefrontal inhibition. HRV is thought to be used for detection of short-and long-term change of the sympathovagal balance. It is evaluated that the severity of autonomic symptoms may have predictive about the development of the disease and may be a guide for treatment.

In the perinatal period the woman is vulnerable to depression. Major and minor depression presents prevalence rates ranging respectively from 8,5 and 11% during pregnancy and between 6.5% and 12.9% in the first year post-partum. However, only a small percentage of cases are identified and treated, with negative consequences on both the mother and the baby.

To compare two samples of women at the first month postpartum, the first followed since first month of pregnancy and the second evaluated the first time in the first month postpartum, about the symptoms of depression and anxiety.

We compared two groups of women in the first month postpartum: 271 women followed since 1 st month of pregnancy and 130 women evaluated for the first time in the first month postpartum. We administered: the Edinburgh Postnatal Depression Scale (EPDS), the State-Trait Anxiety Inventory (STAI), the Postpartum Depression Predictors Inventory-Revised (PDPI-R) and the Structured Clinical Interview for the Diagnosis of Axis I psychiatric disorders (SCID-I).

In the first month postpartum, women followed since pregnancy have a significantly lower depressive symptoms and anxiety, as demonstrated by lower EPDS scores (t = −6,140, p < .001) and STAI scores (t = −4,800, p < .001).

Early screening can reduce rates of perinatal psychopathology and allow to identify women most at risk, allowing earlier diagnosis and better treatment management.

PostPartum Depression (PPD) is a common problem connected to pregnancy. Related previous data show a prevalence of depressive symptoms between 8% and 51% and a prevalence of Major Depressive Disorder between 10% and 17%.

Find a correlation between Psychosocial Risk Factors and the develop of Mood Disorders during pregnancy and post-delivery.

Develop strategies of prevention and treatment of PPD.

A population of pregnants has been analyzed proposing an anamnestic questionnaire, the Edinburgh Postnatal Depression Scale (EPDS) and the Hypomania checklist Symptoms (HCL), in two times: between the 35th and the 37th week of pregnancy and 2–3 days after the delivery.

We found that at the first survey were depressed (EPDS score >9) 21 women of 149 (14.1%) and hyperthymic (HCL score >14) 59 women of 149 (39.9%).We noticed that risk factors for depression were a complicated pregnancy (p = 0.004), a conflicting relationship with the partner (p = 0.009) and a permanence in Italy < 6 months (p < 0.001). An history of illnesses during pregnancy (p = 0.042) and previous psychological problems (p = 0.049) were correlated to an hyperthymic state.

At the second survey, data were confirmed: the incidence of depression was 17,4% (12/69 women) and that of hyperthymia was 44% (30/69 women).

Our data confirm previous evidences about the incidence of PPD and the contribution of risk factors of the pregnancy in its pathogenesis; moreover, high scores at HCL can express an hyperthymic dimension peculiar of pregnancy, rather than a mood disorder, considering HCL as a dimensional assessment.

A strong link between estradiol and dopamine (DA) neurotransmission, which is regulating cognitive and affective pathways, has been provided by animal studies.

Catechol-O-methyltransferase (COMT) enzyme activity, which degrades DA and Noradrenaline, is influenced by a single nucleotide polymorphism (COMTVal158Met). This variation has been reported to be related to both executive and emotional functions.

To investigate whether the physiologically high estradiol levels during pregnancy affect emotional processing in relation to COMTVal158Met genotype.

To test the hypothesis that the Val/Val genotype, associated with high COMT enzyme activity and therefore decreased DA signalling, shows a different startle response compared to the other COMTVal158Met genotypes, in the presence of an enhancer of DAergic neurotransmission, such as estradiol.

Seventy-eight pregnant women were assessed at gestational week 38 for startle response, measured by eye blink, during control condition, positive and negative anticipation stimuli and pleasant and unpleasant image stimuli. A blood sample was used for measurement of hormonal levels and genetic analyses. Personality traits (SSP), depression (MADRS) and anxiety (STAI) symptoms were also investigated.

COMTVal158Met heterozygote women (N = 29) scored the lowest in overall startle response magnitude (p < 0.05). No difference was observed between homozygous women with regard to the Met (N = 23) and Val alleles (N = 22). No significant difference by genotype was found in affective modulation, depression or anxiety scores.

Enhancement of DA signalling by estradiol might result in a U-shaped response curve, as has been shown with regard to administration of amphetamine, in relation the COMTVal158Met polymorphism.

Giving birth to an infant with very low birth weight (VLBW) is a major life event for a mother. Several studies have shown that mothers of these infants are at greater risk of psychological distress. The aim of this study was to investigate the level of depressive symptoms and to determine the associated factors among mothers who have infants with VLBW.

The sample consisted of 105 subjects; 35 mothers of VLBW infants (< 1500 g), 35 mothers of low birth weight (LBW) infants (1500 – 2500 g), and 35 mothers of healthy term infants (> 2500 g). The Edinburgh Postpartum Depression Scale (EPDS) was used to detect maternal depressive symptoms. Maternal social support was assessed by the Multidimensional Scale of Perceived Social Support (MSPSS).

The mean EPDS score and the number of mothers with high depressive scores (EPDS > 12) were significantly higher in mothers of infants with VLBW than mothers of LBW and term infants. We found that low birth weight (Odds Ratio [OR]: 1.009; p = 0.005; 95% Confidence Interval [CI]: 1.003 – 1.016) and long hospital stay (OR: 1.074; p = 0.01; 95% CI: 1.017 – 1.133) were predictors of PPD.

The birth and subsequent hospitalization of an infant with very low birth weight evokes psychological distress in mothers. Pediatricians should be more careful about depressive symptoms of mothers of infants with VLBW and should refer for counseling when it is necessary.

Substance use in pregnancy is an increasingly common problem and has become an important public health issue. Postpartum depression has a high prevalence (10%) of women in Spanish population.

To study the impact of perinatal tobacco use in postpartum depression.

A cohort study of 1804 puerperal Spanish Caucasian women of general population. Variables collected: socio-demographic, obstetric, personal and family psychiatric history, substance use during pregnancy and 6 months postpartum, depressive symptoms (EPDS) and anxiety traits (STAI) at 2–3 days, 8 weeks and 32 weeks postpartum. Major postpartum depression (MPD) (EPDS>9) were confirmed through a structured interview (DIGS-DSM-IV). The sample was divided in four groups:

1. 1) No smoking,

2. 2) Smoking postpartum,

3. 3) Smoking pregnancy,

4. 4) Smoking pregnancy & postpartum.

The mean (SD) age was 31.8 (4.6), 46% were primiparous, 96.5% were married and 68% had at least secondary school. Thirty-one per cent had family and 17% personal psychiatric history. Twenty one percent reported tobacco use during pregnancy and 28.2% use tobacco in postpartum. Tobacco use in the four groups and MPD at 8 weeks (x2 = 17.872;df = 3;p < 0.001) and at 32 weeks postpartum (x2 = 15.582;df = 3;p = 0.001) were different. Only smoking postpartum group had a risk four times higher of having MPD at 8 weeks postpartum (OR=4.3; 95%CI = 1.91–9.66). Others independent variables: personal psychiatry history (OR = 2.53; 95%CI = 1.55–4.22), family psychiatry history (OR = 1.87; 95%CI = 1.15–3.06) and anxiety traits (OR = 1.12, 95%CI = 1.08–1.16). The results at 32 weeks showed the same risk factors.

The use of tobacco in postpartum had a considerable impact on mother's psychiatric health.

Antenatal mental health problems are well recognised to impact negatively on a woman and her developing fetus, influencing both the pregnancy outcome and quality of life. There is limited information on prevalence and risk factors of antenatal depression in Singaporean women.

To examine the prevalence of depressive disorders in pregnant women attending Singapore's National University Hospital (NUH) and the association between these conditions and socio-demographic factors.

To improve our knowledge and understanding of the epidemiology of antenatal depressive disorders in Singapore.

Pregnant women attending NUH (2009 to 2010) were screened for depressive symptoms using the Edinburgh Postnatal Depression Scale. Patients who screened positive (scores > 13) were clinically assessed by trained clinicians using DSM IV criteria for diagnosis. The cases were then discussed with a core group of 3 psychiatrists to reduce interrater variability.

From 530 screened women, the overall prevalence of antenatal depressive symptoms was 47.8% (EPDS > 13). 12.5% of patients were diagnosed with Major Depressive Disorder, 52.1% with Adjustment Disorder, 4.5% with Anxiety Spectrum illness (Panic Disorder, GAD, OCD, PTSD), 1.1% with Bipolar Disorder and 3.8% with Other diagnoses.

After adjustment with socio-demographic variables, depressive symptoms were significantly associated with single, divorced or separated pregnant women (OR = 4.09, 95% CI = 1.39−12.09, p < 0.05) and those with three or more social relationship problems (OR = 1.68, 95% CI = 1.00–2.84, p < 0.05).

Antenatal depressive symptoms are common in Singaporean women and they are associated with identifiable risk factors such as single status and limited social support.

The birth of a child, specially the first born, is a stage in the family life that brings with it changes both socially and professionally, changing previous balance. The transition to parenthood by the father implies skills to balance stress and difficulties.

To analyse the association of some socio-demographic and obstetrical factors and the functional status of first-time fathers in the six weeks after childbirth.

Cross-sectional study, with a consecutive non probabilistic sample of 204 first-time fathers from a health centre whose partner pregnancies, delivery and postpartum period without complications, and had a childbirth of a term newborn. The data were gathered in the six weeks postpartum from a self-administered questionnaire with socio-demographic and obstetrics questions and the Portuguese version of the Inventory of functional Status - fathers (IFS-F) after the approval of the ethic committee.

The first-time fathers showed better functional status in terms of professional activities, community, social activities and housekeeping. It appears that the first-time fathers showed poorer functional status at the level of educational training, care of newborn and personal care activities. The older first-time fathers tend to show better functional status at the level of household activities.

This study concludes that functional status of first-time fathers isn’t affected by educational level, residence, marital status or by the pregnancy vigilance place but partially influenced by the father's age and employment situation. This study provides information's to adequate care strategy to promote better functional status of first-time fathers in the postpartum period.

Postpartum period is a time of transition, of adjustments to the parental role. This transition calls for changes in role relationships, especially in the first- time parents.

Identify difficulties and needs of the first time parents related to the interaction with the newborn and to the adjustment to the parental role.

Qualitative study using the descriptive phenomenological approach. Inform consent was obtained during the hospitalization after childbirth. Saturation of data was obtained with a group of 25 first-time fathers, using unstructured interviews in the parent's home place.

Two essentials structures emerged from the meaning units of the experiences of the first-time parents adjustment to the postpartum, the first described a positive experience and the second one a negative experience. From the positive key constituents we highlighted: getting to know the baby; the sense of responsibility to the parental role; the sense of family; the greater cooperation and union of the couple. As negative key constituents: insecurity in baby care; experiencing parenthood with emotional vulnerability that is labelled as a period of lack of time to take care of oneself; less time for the couple and less social activity.

This phenomenological study provides a deep understanding of the needs of first-time parents with the essentials structures of the process of paternal adjustment in the period of the post-partum, and generates implications to improve it, specially the postpartum home visit, support groups in the Health Centres, and a maternity postpartum phone line as suggested by the participants.

Approximately 10 to 15% of women experience a clinically significant major depressive episode during pregnancy or the early postpartum period.

The hypothesis of study is that feelings of anxiety or depression and lack of social support would be an interference issue in the development of maternal antenatal attachment.

The aims of this thesis were: to assess the specific role of antenatal attachment as risk factor for depression,as anxiety symptoms, during pregnancy.

Symptoms of maternal depression were assessed using the 10-item Edinburgh Postnatal Depression Scale. The Post-partum Depression Predictors Inventory-Revised (PDPI-R) was used to identify the risk factors for PPD. Prenatal maternal attachment were assessed using the Maternal Antenatal Attachment Scale (MAAS). Maternal and paternal antenatal attachment scales. Anxiety symptoms were assessed using STAI-Y.

Our sample is composed by 456 women: the average of the MAAS total scores at T2 was 76.95 ± 6.3, while at T3, the average is 78.54 ± 6.29. Considering the Quality of Attachment subscale MAAS, at T2, the average is 47.2 ± 3.29, while the T3 is 47.71 ± 2.98.

Further studies are needed to replicate our findings and to clarify the role of pre/post natal attachment during pregnancy and its link with Post-Partum Depression in order to identify a specific subgroup of women.

Cox, J.L., 1987. Detection of postnatal depression: development of the 10-item EPDS. Br J Psychiatry Condon, J. T, (1997). The correlates of antenatal attachment in pregnant women arranting special attention.

For most women in the postpartum period, six to 52 weeks after childbirth, participation in exercise is very limited. More information is needed to fully understand the specific barriers and enablers to exercise during this period.

Explore the daily experience of physical activity in postpartum women. Investigate the key barriers and enablers to physical activity in the postpartum period

A qualitative approach in the form of a semi-structured interview with thematic analysis was used

This study used a multi-method approach.Postpartum women recruited from child health clinics were sent a package of standardized questionnaires to investigate the barriers that affected their exercise participation. In addition, 14 postpartum women who participated in the survey were contacted for an interview in order to further discuss exercise barriers and enablers.

For the 150 women who responded to the survey lack of confidence and lack of time had the greatest impact on participation in sport and exercise. When daily physical activity participation was assessed lack of information, lack of confidence, lack of knowledge were statistically significant. The qualitative data showed that mothers may be able to participate more in exercise if they had greater social support, particularly partner support. The participants suggested that environmental factors like increased knowledge and access to appropriate exercise programs, either in the home or outside, could potentially enable increased exercise.

New mothers require substantial social support and specifically tailored exercise programs to enable them to access the physiological and psychological benefits of exercise.

Various nanoparticles are produced with development of nanotechnology; however, the safety is not confirmed precisely at present. Influence on brain of offspring that exposed to various nanoparticles (titanium dioxide; TiO2, carbon black, carbon nanotube, fullerene; C60 and nanoparticles from diesel engine; DEP) in fetal period was examined pathologically.

Brains from ICR mice born from each nanoparticle-exposed and normal mothers were examined under light and electron microscope. To detect apoptosis, immunohistochemical staining for caspase-3 was performed, and to detect metal particle (TiO2) transferred from mother to the fetus, brains of offspring were observed by energy-dispersive X-ray spectroscopy (EDS). The storage of abnormal structures (amyloid β and phosphorylayed tau), which are characteristic of neurodegenerative diseases, was detected with immunohistochemical staining.

All mice with nanoparticles exposure showed swelling of astrocytes' endfoot, apoptosis of endothelial cells. In brain of TiO2-exposed groups, EDS detected TiO2. Many apoptosis and storage of abnormal structures were showed in characteristic parts of brain. Some capillaries were stenosis and the neighboring parenchyma had degenerative changes.

These findings indicate that nanoparticles transferred from pregnant mice has a severe impact on fetal brain, carries the multiple infarctions and atrophy, a great risk of dementia in offspring. Moreover, appearance of apoptosis and abnormal structures may relate to some mental neurological disorders. Our result should be a grave warning that nonparticles exposure is one of risk factors on neurological diseases, in which various psychic symptoms occur.

The prevalence of obesity has become a health problem worldwide. Amidst this epidemic, obesity among pregnant women has risen dramatically. Bariatric surgery (BS) has become an important alternative for obese women planning pregnancy and should be considered in the pre-conception management of morbidly obese women. Psychological aspects related to this field are still unknown.

To understand psychological meanings of pregnancy following BS.

Qualitative study conducted with an intentional sample of women seen in an outpatient service.

Pregnancy following BS has specific emotional characteristics. There is a greater concern derived from fantasies of causing harm to the baby. There is an evident conflict between desire of eating to feed the fetus and desire of staying thin by eating little. The surprise these women experience when they learn they are pregnant relates to the ambivalence between desire of getting pregnant and fear of losing what was gained after the surgery, as well as to the perception of deviation of the eating compulsion and the inability to postpone pregnancy for the recommended period. Weight loss following BS reduces the worry with obesity during pregnancy, opening affective space for maternity.

Pregnancy following BS imposes on women intense experiences related to fears about the baby's integrity, especially about its weight; risk of losing what was gained after surgery; and ambivalent emotions towards the fetus. Surgeons and obstetricians should be prepared to deal with the complex web of affects related to this specific clinical condition marked by intense emotional reactions.

Post partum depression (PPD) is a serious complication of childbearing, affecting 1 in 8 women worldwide. It is an under-diagnosed condition and has consequences on the mother-infant bond and the social and emotional development of the child.

To present the risk factors that can lead to post partum depression and explore the various treatment options.

Review of the current literature.

Risk factors that contribute to the genesis of postnatal depression can be categorized into five categories:

1. 1) individual characteristics,

2. 2) characteristics of the partner,

3. 3) pregnancy related,

4. 4) infant related and

5. 5) others, such as culture, financial difficulties and lack of social support. Diagnosis is based on the DSM-IV criteria for major depressive episodes and the Edinburgh Postpartum Depression Scale. Treatment options include pharmacological treatment with antidepressants or hormone therapy, psychological and psychosocial treatments, electroconvulsive therapy (ECT), bright light therapy and alternative methods such as acupuncture. Guidelines suggest non pharmacological treatment as first choice for mild-to-moderate PPD and pharmacological treatment and ECT for severe and resistant cases.

All the mentioned treatments are effective in reducing depression symptoms, however the use of antidepressants causes side effects from the infant via breastfeeding, and hormone therapy with estrogen has well-known long-term perils. Psychotherapy methods are usually preferred. High risk women must be detected early by primary health care professionals using screening tools.

Women suffering from Premenstrual syndrome (PMS) tend to have negative attitudes towards their own psychological changes. Negative attitudes and inappropriate adaptive reactions may bring about physiological consequences.

This study aimed to investigate the effectiveness of counseling with cognitive - behavioural approach on reducing PMS depression and psychological-physiological symptoms.

The research method was quasi experimental with pre test-post test design and control group. A sample of 34 women was selected by available sampling method as the statistical sample and was randomly assigned into two groups named control and intervention. Hypothesises were tested by co-variance analysis.

Results indicated that the post-test values have been affected by the independent variable (F = 113.24, P < 0.05).

The results of study showed that cognitive-behavioural therapy had positive effects on PMS depression and psychological-physiological symptoms of female staff of Science and Industry University reducing their complications.

To evaluate the effects of Omega-3 on PMS.

A randomized double blind controlled trial was performed on 184 eligible women. 124 women finally finished the study.

In the case group (n = 70), Omega-3 and in the control group (n = 69) placebo was prescribed.

There were no significant differences between the two groups according to age, BMI, level of education, and the severity and duration of primary symptoms.

45 days after commencing Omega-3, the mean severity of depression (1.85 ± 0.73 vs 3.72 ± 0.65, P = 0.03), anxiety (1.53 ± 1.04 vs 4.07 ± 0.91, P = 0.02), lack of concentration (2. 49 ± 1.26 vs 5.73 ± 1.34 P = 0.03) and bloating (0.95 ± 0.15 vs 2.31 ± 0.19 P = 0.02) in the case group, were all significantly lower than in the control group.

The duration of depression (4.25 ± 1.02 vs 7.21 ± 1.32 days, P = 0.04) and bloating (5.53 ± 2.27 vs 8.33 ± 1.04 days, P = 0.031) in the case group were less than in the control group.

90 days after commencing the treatment, the mean severity of depression (0.95 ± 0.75 vs 3.43 ± 0.65, P = 0.007), anxiety (0.79 ± 1.04 vs 3.89 ± 0.91, P = 0.004), lack of concentration (1.48 ± 1.26 vs 5.63 ± 1.34, P = 0.009), bloating (0.74 ± 0.15 vs 2.14 ± 0.19, P = 0.004), nervousness (2.15 ± 0.93 vs 6.09 ± 0.86, P = 0.01) and the duration of depression (2.12 ± 0.25 vs 7.46 ± 0.02, P = 0.01), nervousness (2.04 ± 0.39 vs 6.33 ± 1.45, P = 0.02), anxiety (4.45 ± 1.02 vs 8.23 ± 1.94, P = 0.03), lack of concentration (2.16 ± 0.26 vs 5.55 ± 1.02, P = 0.02), bloating (3.32 ± 1.01 vs 8.38 ± 2.32, P = 0.004), headache (2.12 ± 0.94 vs 4.28 ± 1.58, P = 0.04) and breast tenderness (4.35 ± 1.31 vs 7.85 ± 2.08, P = 0.02) were lower in the case group.

Omega-3 fatty acids reduces the symptoms of PMS.