Women's Mental Health
The Women’s Mental Health research stream is based within the Health Service and Population Research Department, Institute of Psychiatry at the Section of Women’s Mental Health led by Professor Louise Howard. We focus on perinatal mental health, domestic violence, gender sensitive mental health services and gender differences in mental health.
Perinatal mental health has a major impact on women and their families, including maternal morbidity and mortality, obstetric complications, neonatal and infant death, and adverse outcomes for both mother, child and the family. We use mixed methods, including epidemiological and qualitative research, systematic reviews, development and evaluation of therapies, development of clinical management guidelines to improve outcomes for pregnant women and their children, analysis of the biological correlates of perinatal mental disorders, and investigation into the impact on parenting skills and long-term offspring development.
In addition we are carrying out a number of research projects on violence against women, including examining the response of mental health services to domestic violence (LARA), the impact of migration and violence on women’s mental health, carrying out systematic reviews on the prevalence of domestic violence experienced by mental health service users (PROVIDE), a programme of research on the health needs of trafficked people (starting June 2012) and epidemiological research investigating the impact of antenatal domestic violence on women’s mental health antenatally and postnatally and the impact this has on child development using the ), a programme of research on the health needs of trafficked people (starting June 2012) and epidemiological research investigating the impact of antenatal domestic violence on women’s mental health antenatally and postnatally and the impact this has on child development using the ALSPAC cohort.
We evaluate complex interventions for women with mental health problems including women’s crisis houses (CHOICES), mother and baby units (ALTERNATIVES study; ESMI pilot study) and health visitor delivered non-directive counselling (RESPOND). We are investigating the impact of stigma on women’s mental health (SAPPHIRE), how to help women make decisions about medication in pregnancy and how to help women with mental health problems stop smoking in pregnancy. We also are collaborating with Professor Lucilla Poston in a series of studies on obesity and mental health in pregnancy.
Current studies include
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barriers and facilitators to smoking cessation in pregnant women with mental disorders
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pregnancy decision making of women with bipolar disorder
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the effectiveness and cost-effectiveness of perinatal psychiatric services (ESMI study)
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epidemiological and biological research into foetal, infant and child outcomes including neonatal deaths, sudden infant death syndrome and childhood behaviour
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a multi-centre RCT comparing the effectiveness of antidepressants compared with a health visitor delivered psychosocial intervention for postnatal depression
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national surveys of existing perinatal mental health services
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systematic reviews of treatments for perinatal psychiatric disorders
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violence, migration and mental disorders in women
Recent Publications
Khalifeh H, Birdthistle I, Howard LM, Hargreaves J. Intimate partner violence and socioeconomic deprivation in England: findings from a national cross-sectional survey. American Journal of Public Health. In Press
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Page L, Hajat R, Kovats S, Howard LM. Temperature-related Deaths in People with Severe Mental Illness. British Journal of Psychiatry In Press
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Howard LM, Flach C, Mehay A, Sharp D, Tylee A. The prevalence of suicidal ideation identified by the Edinburgh Postnatal Depression Scale in postpartum women in primary care: findings from the RESPOND trial. BMC Pregnancy and Childbirth 2011, 11:57 doi:10.1186/1471-2393-11-57
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Flach C, Leese M, Heron J, Evans J, Feder G, Sharp D, Howard LM. Antenatal Domestic Violence, maternal mental health and Subsequent Child Behaviour. BJOG 2011; Volume 118, Issue 11, pages 1383–1391.
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Collins C, Zimmerman C, Howard LM. Refugee, asylum seeker, immigrant women and postnatal depression: rates and risk factors. Archives of Women’s Mental Health 2011 14:3–11
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Rose D, Trevillion K, Woodall A, Morgan C, Feder G, Howard LM. Barriers and Facilitators of Disclosures of Domestic Violence by mental health service users: a qualitative study. British Journal of Psychiatry 2011 198:189-94.
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Howard LM, Trevillion K, Agnew-Davies R. Domestic violence and mental health. International Review of Psychiatry October 2010; 22(5): 525–534
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Sharp DJ, Chew-Graham CA, Tylee A, Lewis G, Mulligan J, Howard LM, Anderson I, Abel K, Turner KM, Tallon D, McCarthy A, Peters TJ. A pragmatic randomised controlled trial to compare antidepressants with a community based psychosocial intervention for the treatment of women with moderate postnatal depression: The RESPOND trial. Health Technol Assess 2010;14(43).
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Howard LM, Flach C, Leese M, Byford S, Killaspy H, Cole L, Lawlor C, Betts J, Cutting P, McNicholas S, Sharac J, Johnson S. The effectiveness and cost effectiveness of admissions to women’s crisis houses compared with traditional psychiatric wards – a pilot patient preference randomized controlled trial. Br J Psychiatry August 2010 197: s32-s40. doi: 10.1192/bjp.bp.110.081083
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Howard LM, Barley E, Rigg A, Davies E, Lempp H, Rose D, Taylor D, Thornicroft G. Cancer diagnosis in people with severe mental illness: practical and ethical issues raised. The Lancet Oncology 2010 11, 8, August, 797-804 doi:10.1016/S1470-2045(10)70085-1
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Bick D, Howard LM. When should women be screened for postnatal depression? Expert Review of Neurotherapeutics 2010 10(2); 151-154.
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Howard LM, Trevillion K, Khalifeh H, Woodall A, Agnew-Davies R, Feder G. Domestic violence and severe psychiatric disorders: prevalence and interventions. Psychological Medicine June 2010 40, 881–893. doi:10.1017/S0033291709991589.
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Elkin A, Gilburt H, Slade M, Lloyd-Evans B, Gregoire A, Johnson S, Howard LM. A national survey of psychiatric mother and baby units in England. Psychiatr Serv 2009 May;60(5):629-33.
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Anderson IM, Baldwin RC, Cowen PJ, Ferrier IN, Howard LM et al. Evidence-based guidelines for treating depressive disorders with antidepressants: a revision of the 2000 British Association for Psychopharmacology guidelines (On Behalf of the Consensus Meeting; endorsed by the British Association for Psychopharmacology). Journal of Psychopharmacology Jun 2008; 22:343-396.
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Howard LM, Kirkwood G, Latinovic R. Sudden Infant Death Syndrome and Maternal Depression. Journal of Clinical Psychiatry. 2007: 68;8:1279-83.
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Howard LM, Hunt K, Slade M, O’Keane V, Seneviratne T, Thornicroft G. Assessing the needs of pregnant women and mothers with severe mental illness: the psychometric properties of the Camberwell Assessment of Need – Mothers (CAN-M). International Journal of Methods in Psychiatric Research. 2007; 16(4): 177-185.