Morning Keynote Address: Women's Mental Health Across the Life Course

Presented at: ORWH's 30th Anniversary Virtual Meeting Series: Advancing the Health of Women Through Science

Speaker

Pauline M Maki, Ph.D.

Professor of Psychiatry, Psychology, and Obstetrics & Gynecology Director, Women's Mental Health Research Program, University of Illinois at Chicago
BIOGRAPHY

Abstract

The lifetime prevalence of mental health disorders differs by sex, with a higher prevalence of mood and anxiety disorders in females and a higher prevalence of impulse control disorders and substance use disorders in males. These sex differences emerge at puberty and are heightened in the perinatal and perimenopausal periods, underscoring the important role of hormonal factors in women’s mental health. NIH-supported research studies have greatly enhanced our understanding of the biological factors that contribute to mental health disorders in women across the lifespan. Such work led to the recent development and FDA approval of brexanolone, a novel allopregnanolone formulation that rapidly improves postpartum depression. This recent success in drug development underscores the clinical significance of sex difference research. Focusing on biology is important but insufficient in addressing mental health concerns in women, as environmental exposures also play a key role in their development and life course. One in four females are sexually abused as children, and females experience a higher cumulative exposure to adverse childhood events. Rates of mental health disorders are increasing more in college-aged women than men. Rates of perinatal mental health disorders are also increasing while rates of diagnosis and treatment remain low, particularly for women of color. Advances in perinatal mental health screening and treatment, such as computerized adaptive testing and on-line cognitive behavioral therapy, hold promise in addressing some of those health disparities. Gender differences in caregiving for children can contribute to disproportionate mental health burden in women, a difference that is particularly evident during the COVID-19 pandemic. In adulthood, domestic abuse, sexual harassment and discrimination are key determinants of mental and physical health in women. At midlife, the menopause transition is window of vulnerability for the exacerbation of many mental disorders in women. Finally, gender differences in caregiving for spouses or father’s with Alzheimer’s disease and other chronic diseases, adds to the burden of mental health disorders in older women. The NIH now expects that sex as a biological variable will be factored into research designs, analyses, and reporting in vertebrate animal and human studies. That effort, as well as continued targeted funding for sex- and gender-based research, are key to addressing the biological and environmental risk factors for mental health disorders that women face across the lifespan.

Morning Keynote Address: Women's Mental Health Across the Life Course

Pauline M Maki, Ph.D.