Postpartum Depression: The Clinical Disorder and Application of Pet Imaging Research Methods

Although postpartum depression (PPD) is a disorder with devastating effects on women, children, and families, it is generally a highly treatable illness once recognized. Increased clinical research of PPD has yielded a wide armamentarium of available treatments during lactation that was not available one decade ago. Study of birth outcomes after in utero selective serotonin-reuptake inhibitor exposure has broadened the understanding of risks and benefits of available treatments in perinatal depression. The perinatal period is replete with intrapsychic, interpersonal, and biological adjustments that render many women vulnerable to mental illness onset and episode recurrence. Increased dissemination of information regarding these illnesses stands to improve recognition and treatment. Ongoing research efforts are needed to fine-tune the risk-benefit decision-making process for the use of psychotropics perinatally. In the absence of the ideal information database, sound clinical evaluation to select an efficacious drug (based on patient history and the literature) and a thorough risk-benefit discussion with patients is the mainstays of good perinatal psychiatric management. The nature of human maternal neuroplasticity and whether such neuroplasticity is possible in perinatal women with mental illness or susceptibility to mental illness) is an important area for future investigation. Because healthy maternal adaptation confers benefits to offspring at the level of emotional, cognitive, and physical development, insights into mental illness-related aberrant maternal brain changes will facilitate the development of treatments to foster healthier adaptation to the maternal role. © 2008