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Thanks again to Cynthia Beall for covering this session for the Evmedreview.


The session on behavior and vulnerability to disease covered anxiety, post-partum depression, post-traumatic stress disorder, and the ‘fourth trimester’ of pregnancy. The methods ranged from mathematical modeling to prospective cohort studies and intensive interviewing of small samples.

Frazer Meacham presented a model of normal anxiety and anxiety-associated diseases. The elements included good or bad environments modeled as dangerous or not, the frequency of danger and the easy of detecting danger. The model suggested two ways to become anxious: one is to encounter danger as in the case of PTSD, and the other is to encounter cues of danger as in the case of OCD.

Molly Fox presented the results of a prospective study of 300 women post-partum and nine months later. She made the surprising observations that post-partum depression is not recognized by the DMS or by the WHO as a diagnostic category! This was the first symptom-based characterization of PPD.

Levent Sipahi presented interesting data on PTSD and epigenetics. Interestingly, he found that pre-trauma levels of methylation contribute to the severity of symptoms after trauma. He concluded that PTSD is a biologically functional and appropriate response to trauma exposure.

Kristin Tully reported on the fourth trimester of pregnancy using a group of 20 intensively studied women participating in patient centered research. The project idenfitied a need for policies and service to bring together patients, clinicians, researchers and other stakeholders to define patient-centered priorities in the first 12 weeks after birth. Key, interrelated health themes are (1) maternal mood; (2) infant feeding; (3) sleep and fatigue; (4) sexuality, contraception, and birth spacing; (5) substances, medications, and environmental exposures; and (6) physical recovery from childbirth.