Consider the endocrine system when addressing mental health
Hormonal changes are one of many issues that can affect women’s psychiatry and medical conditions, and recognizing the big picture can have a significant impact on the treatment of these patients. , C. Neill Epperson, MD told the 2022 attendees. Saiki TimesTMs The World CME Conference will be held in San Diego this week.1
Epperson, professor and chief of the Department of Psychiatry at the University of Colorado in Aurora, Colorado, discussed the interplay between the endocrine system, the effects of early childhood, the brain, and the nervous system at the conference.
Epperson noted that it is important for psychiatrists to consider the endocrine system when treating patients, especially when it concerns women. Differences in how hormone treatments affect women begin at puberty, with young girls twice as likely to be prescribed steroids than their male counterparts and often It is related to dealing with unprotected intercourse during sexual debut.
“Always think about the types of steroids/contraceptives they’re using because they can seriously affect your endocrine system,” explained Epperson. Hormones have been shown to influence executive functioning, sexuality, cardiovascular disease, and mental health issues, including major depressive disorder, in women in transition. Postpartum, oxytocin has been shown to play an important role in hypolactation and uterine contractions, greatly influencing maternal parenting.
“I’m not saying hormones are everything, but I’m saying that if you don’t think about it, you’re overlooking a big piece of the puzzle,” Epperson said.
Shifting gears to another “puzzle piece,” Epperson remarked on how childhood experiences affect hormones, which in turn affect patients’ mental health. He described the work of Dr. Ida Haahr-Pedersen of the Trinity Center for Global Health in Dublin and colleagues. This study examined 1839 US household survey participants and assessed self-report rates of adverse childhood experiences (ACEs). The researchers found that a woman was twice as likely as a man to report her ACE and social and emotional problems during childhood. 2
According to Epperson, among peri-menopausal women, the most common ACEs associated with female 4+ status include emotional abuse, domestic violence, emotional neglect, and physical neglect, suggesting that women in this age group belong to the 4+ ACE group. And because the effects of ACE vary greatly depending on where a woman lives, it’s also important to take that into account when considering interactions with patients, especially female patients, she said.
In addition to a thorough initial assessment to assess past trauma, a holistic view of the patient, including any medications they may be taking, addresses any mental health issues that may exist. Epperson concluded that it helps to
1. Epperson N. Practical psychoneuroendocrinology: how the brain, nervous system, and endocrine system interact. Presented at: 2022 Annual Psychiatric TimesTM World CME Conference. August 11-13, 2022, San Diego.
2. Haahr-Pedersen I, Perera C, Hyland P, et al. Women have a more complex pattern of childhood adversity: its impact on the mental, social, and emotional outcomes of childhood. Euro J trauma2020; 11(1):1708618.