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Chapter 39. Treatment of Women

Vivien K. Burt, M.D., Ph.D.; Kira Stein, M.D.
DOI: 10.1176/appi.books.9781585623402.317165

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Although overall men and women are at equal risk for developing a psychiatric disorder over their lifetime, there are gender-specific differences in the prevalence and clinical course of a number of specific mental disorders. These differences stem from a variety of factors, including biological and experiential differences between the sexes. Probably due in part to genetically primed alterations in the risk of depression in response to changing hormones during the menstrual cycle, pregnancy, and the postpartum, the heritability of major depression appears to be higher in women than in men (Kendler et al. 2006). These female-specific hormonal and physiological differences not only predispose women to certain psychiatric illnesses but also often inform treatment decisions.

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Premenstrual dysphoric disorder (PMDD) is a common clinical problem that is often quite responsive to psychiatric treatment. Which of the following statements regarding PMDD is false?
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Although definitive data on birth defects and selective serotonin reuptake inhibitors (SSRIs) are lacking, a range of transient perinatal symptoms (which may require admission to special care nurseries) have been reported. These perinatal symptoms include all of the following except
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Treatment of bipolar disorder during pregnancy is associated with particularly vexing challenges, because of the potential teratogenicity and other effects of mood-stabilizing medication on the newborn. Potential consequences to the neonate from maternal lithium use in pregnancy include all of the following except
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