Mood disorders in women: focus on reproductive psychiatry in the 21st century--Motherisk update 2008.

The burden of mental illness in general, and depression in particular, has long been underestimated. One in 6 persons in the United States will, at some point, suffer from major depression. Depression is second only to heart disease as a leading cause of medical disability in the U.S. Women are vulnerable to mood instability at times of life-cycle related hormonal challenge (e.g., including the premenstruum, pregnancy, post-miscarriage, postpartum and perimenopause). Neurobiological, genetic, and psychosocial substrates underlie the increased vulnerability for depression in women. The significant negative impact of maternal depression on maternal and child health and psychological well-being and other possible consequences of chronic depression will be reviewed. The enormous burden of female depression on women, their children and their families has been well-documented over the past two decades. What remains is the need for serious, rigorously conducted research into effective and safe treatments for depression in women, particularly at times of reproductive transition.