The RLS program at Women’s College Hospital is actively involved in a variety of research initiatives at our institution and through partnerships with other hospitals. We aim to conduct research that improves the health of women with mental health issues and their families across the reproductive life cycle, inclxuding across the menstrual cycle, pregnancy, postpartum and in the menopausal transition. Show
Current Studies Recruiting ParticipantsWe have several clinical research studies underway that are actively recruiting participants: Reproductive Mental Health of Ontario Virtual Intervention Network (rMOVIN)Study funded by: Women’s College Hospital Foundation Principal Investigators: Dr. Simone Vigod, Dr. Ariel Dalfen Many people who experience depression or anxiety during pregnancy and postpartum have a hard time accessing the appropriate care. The online rMOVIN platform was created to help pregnant and postpartum people with depression and anxiety find suitable virtual treatment options. The platform includes many resources, access to a “care coordinator” to help people determine the best treatment option for them, link them to online mental health therapy interventions, and when needed arrange virtual e-consults to family doctors or direct patient video-consultation with the rMOVIN reproductive mental health psychiatrist. If you are pregnant or postpartum and experiencing symptoms of depression and/or anxiety, you may be eligible to participate in a study to determine if MOVIN can help to reduce your symptoms. For more information and to access the pre-screening questionnaire, please visit MOVIN at the Women’s Research Institute An Electronic Patient Decision Aid for Antidepressant Use in PregnancyStudy funded by: The Canadian Institutes for Health Research (CIHR) Principal Investigator(s): Dr. Simone Vigod Deciding to start or continue an antidepressant medication during pregnancy can be a difficult and complex decision. If you are pregnant or planning a pregnancy, deciding whether you should start or continue an antidepressant medication for the treatment of depression, and are conflicted about what to do, you may be eligible to participate in a study examining whether or not an interactive website is a helpful tool for women who are making this decision. For more information and to access the pre-screening questionnaire, please visit the PDA Study page. Technology-enabled (Electronic) Measurement Based Care (eMBC) for Perinatal Depression and Anxiety: A Pilot Randomized Controlled TrialStudy funded by: Women’s College Hospital Academic and Medical Services Group (WCHAMSG) Alternate Funding Program (AFP) Physician Innovation Fund Principal Investigators: Dr. Renu Gupta and Dr. Simone Vigod Tracking symptoms of depression and anxiety during pregnancy and postpartum through self-report scales in the electronic hospital chart has the potential to tailor decisions about antidepressant medication to individual patients. Talk to your psychiatrist if you are interested in learning more about this study. Decisional Conflict of Lithium Use in Breastfeeding in Women with Bipolar DisorderPI: Dr. Simone Vigod The postpartum period is a time of high risk for the onset and recurrence of bipolar disorder. The onset of symptoms is often rapid and may occur in late pregnancy or within the first few days to weeks after delivery. There is a higher postpartum relapse rate in women with bipolar disorder who were medication free during pregnancy than those who were maintained on medication. Lithium is a gold standard pharmacological treatment for bipolar disorder because it is effective in both the acute and maintenance phases of manic and depressive episodes. There is also growing evidence of its effectiveness for the prevention and treatment of postpartum psychosis. For some women, lithium may be the only effective treatment or maintenance medication. However, the use of lithium in the postpartum presents a major dilemma for women with BD as it pertains to the issue of breastfeeding because lithium is excreted into breastmilk. There are significant benefits of breastfeeding, so the risk of breastfeeding must be balanced against the risk of exposing the baby to lithium. The purpose of this study is to examine the decision-making around lithium use and breastfeeding among women with bipolar disorder. You may be eligible to participate if you are pregnant or planning to become pregnant. For more information, contact Maria Michalowska at 416-351-3732 ext. 2302 or Using virtual care to reduce barriers to mental health care in postpartum women and full-time workersStudy funded by: MOHLTC AFP Innovation Fund Principal Investigator(s): Dr. Jennifer Hensel We are currently recruiting for a study where women can take advantage of personal computer videoconferencing as part of the therapy offered in the RLS program. Completed StudiesBelow are results from some of our recently completed studies: Postpartum Depression: Action Towards Causes and Treatment (PPD ACT) CanadaStudy funded by: Women’s Mental Health Program, Women’s College Hospital Co-investigators: Dr. James Kennedy, Dr. Valerie Taylor, Dr. Cindy-Lee Dennis, Dr. Sophie Grigoriadis, Dr. Tim Oberlander, Dr. Benicio Frey, and Dr. Ryan Van Lieshout Postpartum mental health problems are common and cause enormous human suffering and costs to society. As yet, we do not have a complete understanding of the causes of postpartum mental health problems, including postpartum depression and postpartum psychosis. So, we cannot accurately predict who will develop them. We now know that postpartum mental health problems have a genetic basis. Understanding the genetic basis of postpartum depression and other postpartum mental health problems is an important goal that could lead to the development of preventive strategies and targeted treatments that could dramatically decrease suffering for women and their families. This research study used an iOS app to identify Canadian women who have ever experienced postpartum depression or other postpartum mental health problems, and collect genetic information from them. Results from the genetic analysis were included in the first large genome-wide association study of postpartum depression which hopes to identify the genetic cause of postpartum depression. Related publications by our team: Pouget et al. (2021). Preliminary insights into the genetic architecture of postpartum depressive symptom severity using polygenic risk scores. Transcranial Direct Current Stimulation (tDCS) for Depression During PregnancyStudy funded by: SickKids Foundation and the Canadian Institutes for Health Research (CIHR) Principal Investigator(s): Dr. Simone Vigod and Dr. Daniel Blumberger Results: Vigod et al. 2019). Transcranial direct current stimulation (tDCS) for depression in pregnancy: A pilot randomized controlled trial. Stay tuned for our CIHR-funded randomized controlled trial (Expected July 2021)! Virtual Psychiatric Care for Perinatal Depression (Virtual-PND): A Pilot Randomized Controlled TrialStudy funded by: Department of Psychiatry, University of Toronto 2016-2017 Excellence Funds Principal Investigator(s): Dr. Lori Wasserman (WCH), Dr. Simone Vigod (WCH, acting PI), Dr. Ariel Dalfen (Sinai Health System) This study assessed the feasibility of virtual psychiatric care for pregnant and or postpartum women with depression. The study was conducted at both Women’s College Hospital (WCH) as well as at Sinai Health System (SHS). The results of this pilot study showed that virtual care is acceptable to clients and psychiatrists, and that virtual care may be just as effective as in-person care. These results informed the development of the MOVIN study, as well as the shift to virtual care during the pandemic. Results: Dalfen et al. (2021). Virtual psychiatric care for perinatal depression (Virtual-PND): A pilot randomized controlled trial. Mother Matters: A Pilot Randomized Controlled Trial of Mother Matters, a Therapist-facilitated Online Group Psychotherapy Intervention for Postpartum DepressionStudy funded by: Ministry of Health and Long-Term Care Alternate Funding Plan Physician Innovation Fund Principal Investigator(s): Dr. Simone Vigod Advances in technology, such as secure, online platforms provide opportunities to make treatment for mental illness more accessible and efficient. Mother Matters is a 10-week, therapist-facilitated, online asynchronous psychotherapy group for postpartum depression (PPD). This pilot randomized controlled trial randomized mothers with Edinburgh Postnatal Depression Scale (EPDS) scores > 9 to Mother Matters or usual care. There was a high level of engagement in the group, and high group cohesiveness. Treatment effect was significant in women with moderate to severe symptoms at enrolment. Learn more about Mother Matters and how to enroll. Results: Vigod et al. (2021). Mother Matters: Pilot randomized wait-list controlled trial of an online therapist-facilitated discussion board and support group for postpartum depression symptoms. Other Ongoing Research StudiesIn addition to the clinical research studies described above, our staff are engaged in high-quality research activities of relevance to women during their reproductive life cycle. Some examples: Schizophrenia Understood in the Perinatal Period: Psychiatric Outcomes and Reproductive Trajectories (SUPPORT) III PACT Canada: Predictive Analytic Models of PPD Risk Which clinical manifestations would the nurse observe in an older client with major depressive disorder?Assessing depression in older persons. feelings of sadness, hopelessness, or discouragement.. appetite changes with significant weight loss.. sleep disturbances (commonly insomnia). psychomotor changes, such as agitation or slowing down.. decreased energy or fatigue.. poor concentration or decision making.. How does drugs affect mental health?Stimulant drugs can make you feel depressed, anxious and paranoid. Cocaine – a type of stimulant – can make previous mental health problems recur and trigger psychosis and schizophrenia. Ecstasy users can experience memory problems. Hallucinogenic drugs such as magic mushrooms can make any mental health issues worse.
What is mental health awareness and why does it matter?Mental health awareness is the ongoing effort to reduce the stigma around mental illness and mental health conditions by sharing our personal experiences. Often, because of misconceptions about mental health and mental fitness, people often suffer in silence and their conditions go untreated.
How often would a student have to show specific symptoms to be diagnosed with clinical depression?To be diagnosed with depression, an individual must have five depression symptoms every day, nearly all day, for at least 2 weeks. One of the symptoms must be a depressed mood or a loss of interest or pleasure in almost all activities. Children and adolescents may be irritable rather than sad.
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