On-Demand: Psychiatric Disorders in Women: Diagnostic and Treatment Considerations Across the Female Lifespan
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 question and answer and case-based discussion sessions for course participants. Readings to accompany course materials will also be provided.
Physicians and Doctoral-level Professionals: $95.00
Other Professionals: $75.00
Restriction on Use of Materials
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A $10.00 administrative fee will be applied.
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
Release Date: November 4, 2019
Expiration Date: March 23, 2024
Review Date: March 23, 2021 by Robert Althoff, MD, PhD
Lee Cohen, MD
Marlene Freeman, MD
David H. Rubin, MD, reviewer
Jane Pimental, MPH
Susan E. Sprich, PhD, psychologist reviewer, moderator
Lee Cohen, MD
Marlene Freeman, 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:
Susan Sprich, PhD
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.
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 financial relationships with ineligible companies for the past 24 months, as defined below:
The ACCME defines an “Ineligible company” as “those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.” For more information, visit
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.
Mitigation of Financial Relationships
All financial relationships are reviewed to determine which ones are relevant, and then measures are taken to mitigate all relevant financial relationships and ensure that they do not insert commercial bias into the content of the education.
The following planners, speakers, content reviewers, and others in control of educational content have reported financial relationships with ineligible companies over the past 24 months. Measures have been taken to mitigate the impact of these financial relationships on the educational content and ensure that they do not insert commercial bias into the content of this education.
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
Lee S. Cohen, PhD
Research Support: National Pregnancy Registry for Psychiatric medications, Alkermes Biopharmaceuticals ; Aurobindo Pharma; Auromedics Pharma LLC; Janssen Pharmaceutica; Otsuka Pharmaceuticals, Inc; Supernus 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.
All other individuals in a position to control the content of this educational activity have reported no financial relationships with ineligible companies.
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Windows PC:500-MHz Pentium II; Windows XP or higher; 128 MB RAM; Video Card at least 64MB of video memory; Sound Card at least 16-bit; Macromedia Flash Player 10 or higher, audio playback with speakers for programs with video content; Firefox 1.1+, Internet Explorer 7.0+, Safari 1.0+, Google Chrome, or Opera
Macintosh: Mac OS X 10.3 or higher with latest updates installed; 1.83MHz Intel Core Duo or faster; RAM: 128MB or more; Video Card: at least 64MB of video memory; Sound Card: at least 16-bit