A Reproductive Subtype of Depression: Conceptualizing Models and Moving Toward Etiology

Overview

Journal Harv Rev Psychiatry

Specialty Psychiatry

Date 2009 Apr 18

PMID 19373617

Citations 47

Authors

Jennifer L Payne

Jennifer Teitelbaum Palmer

Hadine Joffe

Affiliations

Soon will be listed here.

Abstract

The lifetime risk for major depression in women is well known to be twice the risk in men and is especially high during the reproductive years between menarche and menopause. A subset of reproductive-age women experience depressive episodes that are triggered by hormonal fluctuations. Such "reproductive depressions" involve episodes of depression that occur specifically during the premenstrual, postpartum, and perimenopausal phases in women. These reproductive subtypes of depression can be conceptualized as a specific biological response to the effects of hormonal fluctuations in the brain. The different types of reproductive depressions are associated with each other, have unique risk factors that are distinct from nonreproductive depression episodes, and respond to both hormonal and nonhormonal interventions. This review uses a PubMed search of relevant literature to discuss clinical, animal, and genetic evidence for reproductive depression as a specific subtype of major depression. Unique treatment options, such as hormonal interventions, are also discussed, and hypotheses regarding the underlying biology of reproductive depression-including interactions between the serotonergic system and estrogen, as well as specific effects on neurosteroids-are explored. This review will provide evidence supporting reproductive depression as a distinct clinical entity with specific treatment approaches and a unique biology that is separate from nonreproductive depression.

Citing Articles

Neuroactive steroid biosynthesis during pregnancy predicts future postpartum depression: a role for the 3α and/or 3β-HSD neurosteroidogenic enzymes?.

Osborne L, Etyemez S, Pinna G, Alemani R, Standeven L, Wang X Neuropsychopharmacology. 2025; .

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Brain fingerprint and subjective mood state across the menstrual cycle.

Cipriano L, Liparoti M, Troisi Lopez E, Romano A, Sarno L, Mazzara C Front Neurosci. 2024; 18:1432218.

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Estradiol and progesterone from pregnancy to postpartum: a longitudinal latent class analysis.

Dukic J, Johann A, Henninger M, Ehlert U Front Glob Womens Health. 2024; 5:1428494.

PMID: 39444825 PMC: 11496150. DOI: 10.3389/fgwh.2024.1428494.

Symptoms of premenstrual dysphoric disorder and cycle phase are associated with enhanced facial emotion detection: An online cross-sectional study.

Boboc B, Oinonen K Womens Health (Lond). 2024; 20:17455057241259176.

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