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The article presents the discussion on frequency of pregnancy recognition across the gestational spectrum and the consequences in the US. Topics include retrospective studies of people carrying a pregnancy to term, studies of pregnant people presenting for abortion care, and postpartum studies of people; and interpreting signs and symptoms, seeking confirmation where pregnancy acknowledged as a socially constructed phenomenon as well as a biological reality.

Background: Major depressive disorder (MDD) is a common complication of pregnancy. Once the diagnosis of MDD is made, the physician must assist the pregnant woman in developing a treatment plan. Methods: In considering antidepressants, the benefit of medication treatment for maternal disease control must be balanced against the risk of the drug to the developing embryo-fetus. This is an individualized decision depending on the disease characteristics, likelihood of maternal depression response, probability of adverse fetal effects, and patient characteristics and values. Results: There is no “zero risk” solution in caring for the pregnant woman with MDD; both the disorder and the medication present risks to the mother and the embryofetus. If the decision to use antidepressant medication during pregnancy is made, the justification is that the disease is associated with greater risk than the treatment. The goal should be remission of symptoms to maximally reduce disease risk to the mother and developing fetus. Conclusion: Optimization of selective serotonin reuptake inhibitor dosing during pregnancy dictates several treatment goals: (1) the drug must be at the optimal dose for the woman; that is, the dose that produces the best response with tolerable side effects; (2) a continuous measure of symptoms must be repeated and adjustments to maintain optimal antidepressant efficacy may be required, due to pharmacokinetic changes during pregnancy; and (3) the resolution of pregnancy at birth also requires dose adjustment in accord with the woman’s transition to the nonpregnant, breastfeeding state. [ABSTRACT FROM AUTHOR]

"Chemical endangerment" laws in the United States mark an increasingly growing trend to punish women with substance use disorder. These measures are counterproductive. They create barriers to substance use treatment and prenatal care, disproportionately affecting minority and low-income women. Contingency management programs and expansion of social services would be more effective in protecting children and women and improving the problem more generally. [ABSTRACT FROM AUTHOR]

Nonsuicidal self-injury (NSSI) is a newly proposed diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Some contemporary historiography dismisses NSSI as a fiction of modern psychiatry. Although the exact definition and psychological meaning attributed to self-harm has not been static over history, there is a clear thread that connects Western asylum psychiatrists' thinking about self-harm to the current stand-alone diagnostic category of NSSI. Nineteenth-century psychiatrists identified a clinically meaningful difference between self-harm with and without the intent to die, between self-injurers who were psychotic and those who were not, and between self-injurers who made a single, serious mutilation and those who repetitively self-injured without causing permanent bodily damage. These same distinctions are apparent in the definition of NSSI. Thus, NSSI is a formalization of long-held observations about a category of people who repetitively self-injure without suicidal intent. [ABSTRACT FROM AUTHOR]

The article focuses on methods by which the impact of the COVID-19 pandemic can be mitigated among incarcerated populations. It states inmates are suffering from increased levels of posttraumic stress syndrome symptoms, anxiety, distress, and depression. It comments mental illness rates in incarcerated populations is greater than the general public. It mentions how the U.S. Constitution's Eighth Amendment provision on cruel and unusual punishment requires prisons to provide basic medical care.