Psychiatric Disorders in Women: Diagnostic and Treatment Considerations Across the Female Lifespan (Community Behavioral Health)
This course will focus on the diagnosis and treatment of psychiatric disorders in women across the reproductive lifespan. Specialized knowledge is necessary to tailor treatments to reproductive events such as pregnancy and pregnancy planning, the postpartum, breastfeeding, the menopausal transition, and menstrual cycle related mood dysregulation. Exposure to psychotropic medications and the consequence of untreated psychiatric disorders must be considered when treating pregnant women, those who may become pregnant during treatment, and those who are breastfeeding. Up to date and comprehensive knowledge is required to help patients make collaborative and individualized treatment decisions. Focused material will also be presented regarding the treatment of premenstrual dysphoric disorder and premenstrual mood exacerbation, as well as treatment considerations for the menopausal transition. Learning in this course will be facilitated by didactic materials delivered by the faculty from the MGH Center for Women’s Mental Health. Faculty will also facilitate a discussion board to answer participant questions. Readings to accompany course materials will also be provided.
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This program is intended for:
- Primary care physicians
- Nurse practitioners
- Social workers
By the end of this program, participants will be able to:
Week 1: Major Depressive Disorder in Pregnancy and the Postpartum
• Describe critical research findings in reproductive psychiatry that inform clinical care
• Recognize the current knowledge gaps in reproductive neuroscience with respect to perinatal depression
• Receive an update regarding reproductive safety of psychiatric medication during pregnancy and management strategies for screening and treatment of postpartum depression
Week 2: Bipolar Disorder: Considerations Across the Reproductive Lifespan
• Frame the treatment of reproductive aged women with bipolar disorder from the standpoint of reproductive safety
• Discuss the relative safety of pharmacologic treatments used in bipolar disorder in consideration of pregnancy
• Consider multiple and patient-centered variables in treatment selection for pregnant and reproductive-aged women with bipolar disorder
Week 3: Premenstrual Dysphoric Disorder (PMDD)
• Identify evidenced based treatments for PMDD, including psychotropic, hormonal and lifestyle modification options
• Describe the pathophysiology of PMDD
• Recognize the diagnostic criteria for PMDD outlined in DSM-5
Week 4: The Menopausal Transition and Depression
• Distinguish normal physical, hormonal and emotional changes at menopause from pathophysiologic conditions occurring during the menopausal transition
• Discuss the pathophysiology of and the role of hormonal changes in psychiatric illness emerging during the menopausal transition
• Identify appropriate treatment options for mood and anxiety disorders in midlife women
Week 5: Substance Use Disorders and Posttraumatic Stress Disorder in Women of Reproductive Age
• Identify the etiology of co-occurring PTSD and SUD in women
• Discuss screening for and diagnosis of co-occurring PTSD and SUD in women
• Describe best treatment modalities for co-occurring PTSD and SUD in women
Week 6: ADHD in Women
• Discuss general risks of stimulant use during pregnancy and lactation with their patients with ADHD
• Create a tailored risk/risk analysis of stimulant use vs. risk of stopping treatment for their patient with ADHD
• Describe the non-pharmacologic treatment options available to their patients with ADHD
- 13.75 AMA PRA Category 1 Credit™
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of McLean Hospital and Massachusetts General Hospital. McLean Hospital is accredited by the ACCME to provide continuing medical education for physicians.
McLean Hospital designates this Enduring activity for a maximum of 13.75 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
- 13.75 Nursing Contact Hours
Massachusetts General Laws, Chapter 13, sections 13, 14, 14A, 15 and 15D and Chapter 112, sections 74 through 81C authorize the Board of Registration in Nursing to regulate nursing practice and education.
This program meets the requirements of the Massachusetts Board of Registration in Nursing (244 CMR 5.00) for 13.75 contact hours of nursing continuing education credit. Advance practice nurses, please note: Educational activities which meet the requirements of the ACCME (such as this activity) count towards 50% of the nursing requirement for ANCC accreditation.
- 13.75 Social Workers
The Collaborative of NASW, Boston College, and Simmons College Schools of Social Work authorizes social work continuing education credits for courses, workshops, and educational programs that meet the criteria outlined in 258 CMR of the Massachusetts Board of Registration of Social Workers
This program has been approved for 13.75 Social Work Continuing Education hours for relicensure, in accordance with 258 CMR. Collaborative of NASW and the Boston College and Simmons Schools of Social Work Authorization Number
- 13.75 Participation
This course allows other providers to claim a Participation Certificate upon successful completion of this course.
Participation Certificates will specify the title, location, type of activity, date of activity, and number of AMA PRA Category 1 Credit™ associated with the activity. Providers should check with their regulatory agencies to determine ways in which AMA PRA Category 1 Credit™ may or may not fulfill continuing education requirements. Providers should also consider saving copies of brochures, agenda, and other supporting documents.
- 13.75 Psychologists CE Credit
The Massachusetts General Hospital Department of Psychiatry is approved by the American Psychological Association to sponsor continuing education for psychologists. The Massachusetts General Hospital Department of Psychiatry maintains responsibility for this program and its content.
This offering meets the criteria for 13.75 Continuing Education (CE) credits per presentation for psychologists.
Release Date: November 4, 2019
Expiration Date: March 23, 2024
Review Date: March 23, 2021 by Robert Althoff, MD, PhD
David H. Rubin, MD, reviewer
Jane Pimental, MPH
Susan E. Sprich, PhD, psychologist reviewer
Marlene Freeman, MD
Lee Cohen, MD
In accord with the disclosure policy of McLean Hospital as well as guidelines set forth by the Accreditation Council on Continuing Medical Education, all people in control of educational content, including speakers, course directors, planners, and reviewers, have been asked to disclose all relevant financial relationships with commercial interests of both themselves and their spouses/partners over the past 12 months, as defined below:
The ACCME defines a “commercial interest” as any entity producing, marketing, re-selling, or distributing health care goods or services, used on, or consumed by, patients. The ACCME does not consider providers of clinical service directly to patients to be commercial interests. For more information, visit www.accme.org.
Financial relationships are those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and other activities from which remuneration is received, or expected. ACCME considers relationships of the person involved in the CME activity to include financial relationships of a spouse or partner.
Relevant financial relationships
ACCME focuses on financial relationships with commercial interests in the 12-month period preceding the time that the individual is being asked to assume a role controlling content of the CME activity. ACCME has not set a minimal dollar amount for relationships to be significant. Inherent in any amount is the incentive to maintain or increase the value of the relationship. The ACCME defines “’relevant’ financial relationships” as financial relationships in any amount occurring within the past 12 months that create a conflict of interest.
Conflict of Interest
Circumstances create a conflict of interest when an individual has an opportunity to affect CME content about products or services of a commercial interest with which he/she has a financial relationship.
The following planners, speakers, and content reviewers, on behalf of themselves and their spouse or partner, have reported financial relationships with an entity producing, marketing, re-selling, or distributing health care goods or services (relevant to the content of this activity) consumed by, or used on, patients:
Lee S. Cohen, PhD
Research Support: National Pregnancy Registry for Atypical Antipsychotics, Alkermes Biopharmaceuticals; Forest/Actavis Pharmaceuticals; Otsuka Pharmaceuticals; Sunovion Pharmaceuticals, Inc.; Teva Pharmaceuticals
Other Research Support: Brain & Behavior Research Foundation; JayMac Pharmaceuticals; National Institute on Aging; National Institutes of Health; SAGE Therapeutics
Advisory/Consulting (through MGH Clinical Trials Network Initiative): Alkermes Biopharmaceuticals; Praxis Precision Medicines, Inc.
Marlene P. Freeman, MD
Investigator Initiated Trials (Research): JayMac, Sage
Advisory Board: Otsuka, Alkermes, Sunovion Pharmaceuticals
Independent Data Safety and Monitoring Committee (Honoraria): Janssen (Johnson& Johnson)
Dr. Freeman is an employee of Massachusetts General Hospital, and works with the MGH National Pregnancy Registry [Current Registry Sponsors]: Teva, Alkermes, Inc., Otsuka America Pharmaceutical, Inc., Forest/Actavis, Sunovion Pharmaceuticals, Inc.
Steering Committee for Educational Activities: Medscape
Susan Sprich, PhD (Psychologist Reviewer)
Royalties (Co-Author): Oxford University Press
Royalties (Co-Edited Book): Springer
Honoraria (Associate Editors): Association for Behavioral and Cognitive Therapies (ABCT)
All other individuals including course directors, planners, reviewers, faculty, staff, etc., who are in a position to control the content of this educational activity have, on behalf of themselves and their spouse or partner, reported no financial relationships related to the content of this activity.
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