Tag: perinatal

Reading of the Week: Task-sharing & Perinatal Health – the New Lancet Obs Study; Also, Regulations & AI and Dr. Saddawi-Konefka on Bravery

October 29, 2026 / / 0 Comments

From the Editor

Last year, Daisy Singla (of the University of Toronto) and her co-authors published an important paper on perinatal care. The SUMMIT trial borrowed a page from experiments in low-income countries where – with few providers – non-specialists have been trained up for some psychotherapies. There may be a great distance between rural India and the urban North American centres participating in SUMMIT, but Singla et al. showed impressive results at three months for those with perinatal depression. 

But do the benefits continue after those first months? In this week’s first selection, a new paper from The Lancet Obstetrics, Gynaecology, & Women’s Health, Singla et al. attempt to answer that question with a secondary analysis. “Behavioural activation for perinatal depression produced sustained improvements over the 12 months since randomisation when delivered by non-specialist providers… with similar clinical outcomes and favourable economic value relative to specialist delivery.” We consider the paper and its implications.

In the second selection, Dr. William Smith (of the University of North Carolina at Chapel Hill) and his co-authors look at AI and regulations in a new Viewpoint published in JAMA Psychiatry. As AI’s role in mental health grows, they review current US state and federal government regulations. “Emerging federal and state regulatory approaches remain vague and are sometimes conflicting.”

Finally, in the third selection, Dr. Daniel Saddawi-Konefka (of Harvard University) writes about depression and stigma. The JAMA paper is personal – he describes his own experiences. He also notes that disclosing mental illness is often considered brave. “My wish is duller still, a world where getting help for your mind is as ordinary as filling your car’s gas tank.”

DG

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Reading of the Week: Task-sharing in Therapy for Perinatal Depression – the New Nature Med Study; Also, Yoga, and Donelle on Grief After Her Daughter’s Suicide

March 27, 2025 /

From the Editor

She was so excited about the pregnancy; in our sessions, she expressed joy. But, as with some women after childbirth, her mood declined. She couldn’t properly care for her son, which she reported with shame and guilt. Perinatal depression is common – and yet many women in Canada and other high-income countries don’t receive care.

What can be done to help them? Could nonspecialist providers – like nurses, midwives, and doulas – be trained up to deliver psychotherapy effectively? Can telemedicine be used? In a new paper for Nature Medicine, Daisy Singla (of the University of Toronto) and her co-authors attempt to answer these questions. In their study, SUMMIT, they conducted a pragmatic, noninferiority trial comparing specialist and nonspecialist providers, delivering care in person or through telemedicine. Participants received eight treatment sessions of behavioural activation. They found noninferiority with both providers and modality of treatment. “This trial suggests compelling evidence for task-sharing and telemedicine to improve access to psychotherapies for perinatal depressive and anxiety symptoms.” We discuss the paper and its implications.

Daisy Singla

Alternative treatments – think mindfulness, acupuncture, yoga – have been historically popular with patients but generally lacking in evidence. Times have changed: mindfulness as a psychotherapy, for instance, is included in the CANMAT depression guidelines. What about yoga? Does depression care include the downward dog? In the second selection, a new episode of Quick Takes, I speak with Dr. Vanika Chawla (of Stanford University) who is part of that university’s lifestyle medicine team and a registered yoga teacher. “I think yoga is a wonderful way to expand providers’ toolbox of existing treatments.”

And in the third selection, Caroline Donelle writes about the suicide of her daughter. In a deeply personal essay for The Globe and Mail, she notes the loss, her decision to move across the country, and her slow healing. “I’m not the person I was when she died and never will be again. I’ve evolved and grown in unexpected ways.”

DG


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