Postpartum depression in adolescent mothers.

BACKGROUND: Postpartum depression has been extensively studied in adults but is less understood in adolescent mothers, despite a prevalence that is double that observed in adult mothers. The purpose of this review was to describe the epidemiology, risk factors, treatment and prognosis for adolescents with postpartum depression. We also sought to identify limitations of the available literature and propose areas for future study targeting postpartum depression in this vulnerable population. METHODS: A Medline literature search was conducted for articles published between 1996 and 2015. We identified relevant studies by combining the indexed search terms 'pregnancy in adolescence or teenage pregnancy' and 'depression or postpartum depression'. Additional studies were identified from references of selected articles. We limited our search results to adolescents (18 years or younger) and English language publications. Case studies/series and editorials were excluded. RESULTS: The Medline database search identified 134 articles of which 57 met inclusion criteria. Ten additional articles were identified from reference lists yielding a total of n = 67 articles for review. Among the articles selected, 10 described epidemiology, 27 identified risk factors, nine measured long-term outcome and 21 proposed treatment strategies for postpartum depression in adolescent mothers. CONCLUSIONS: There is limited literature addressing adolescent postpartum depression, but there has been a significant growth of interest in recent years. There is a need for more randomized control trials to establish gold standards for assessing postpartum depression in adolescent mothers and standards for treatment in these patients.

Prevalence, course, and risk factors for executive impairment in patients hospitalized on a general medicine service.

The purpose of this study was to determine the prevalence, course, and risk factors for executive impairment in patients hospitalized on a general medicine service. One hundred patients were administered the Executive Interview (EXIT25), the Executive Clock Drawing Task (CLOX), and the Mini-Mental State Examination at admission and discharge. Fifty-two percent of the patients at admission and 56% at discharge had scores indicating impairment on at least one measure of executive function. Median scores on every measure improved during hospitalization. Older patients and those with a cardiac or gastrointestinal disorder were more likely to have executive impairment. The prevalence of executive impairment on general medicine services is high. Although improvement in executive function occurs during hospitalization, many patients remained impaired.

Laboratory findings in emergently medicated psychiatry patients.

OBJECTIVE: To determine routine laboratory differences between patients with severe psychomotor agitation who require emergency intramuscular (IM-medicated patients) medication and those who do not (non-IM-medicated patients). METHOD: A retrospective chart review of patients 18 years or older who went to a psychiatry emergency service over a 30-day period was performed. Demographic and laboratory variables were compared between IM- and non-IM-medicated patients. RESULTS: Emergently medicated patients (n=35) were older than non-IM-medicated patients (n=179) (42.6 vs 34.3 years, P<.001). Patients receiving emergency IM medications had higher leukocyte (WBC) count (P=.04), blood urea nitrogen (P=.001), creatinine (P=.01), glucose (P=.009), aspartate aminotransferase (P<.001), alanine aminotransferase (P=.01), and electrocardiogram QTc interval (P=.03). They were also more likely to have abnormal levels of potassium (P<.05), glucose (P<.05), aspartate aminotransferase (P<.001), and alanine aminotransferase (P<.05). CONCLUSIONS: Emergently medicated patients in this psychiatry emergency service were more likely to be older and more likely to have abnormal laboratories vs other adult patients.