Mental health
Study finds concerning decline in mental health among US mothers

A new study has revealed a concerning decline in self-reported mental health among mothers in the United States between 2016 and 2023, as well as modest but measurable declines in self-reported physical health during the same period.
The large-scale analysis examined data from 198,417 mothers who participated in the National Survey of Children’s Health (NSCH), a nationally representative annual survey of households with children aged 0 to 17. Most participating mothers were over age 30, and over half had a privately insured or a non-Hispanic white child.
“Although high rates of maternal morbidity and mortality have been well documented, national data on the health status of mothers beyond pregnancy and the first year postpartum is lacking.” said Jamie Daw, assistant professor of Health Policy and Management at Columbia Mailman School.
The findings show that the percentage of mothers reporting excellent mental health dropped sharply from 38 per cent in 2016 to 26 per cent in 2023. Similarly, the proportion reporting excellent physical health declined from 28 per cent to 24 per cent.
Most notably, the percentage of mothers rating their mental health as fair or poor rose by 3.5 percentage points over the 8 year-period, representing a 63.6 per cent increase from the baseline prevalence of 5.5 per cent in 2016. Declines in maternal mental health originated prior to the Covid-19 pandemic and were observed in nearly every socioeconomic subgroup examined.
Among fathers, the percentage reporting excellent physical health declined as well – from 30 per cent to 26.4 per cent; the changes in mental health were less pronounced. However, fathers reported substantially better mental and physical health than mothers in all years of the study.
The authors also examined disparities in maternal mental and physical health and found that the prevalence of fair and poor mental and physical health was considerably higher among mothers of lower educational attainment, single mothers, and those whose children have Medicaid or are uninsured.
Daw and colleagues emphasise the intergenerational consequences of poor parental mental health, including increased risks for adverse birth outcomes, developmental delays, and mental health issues in children.
“Maternal mood disorders, in particular, can have long-term effects on children, directly by affecting development, and indirectly, by increasing the chance of exposure to co-occurring risks such as parental substance use and lower household resources,” Daw said.
“Our results highlight the rising tide of worsening mental health among parenting women as a key target for efforts to improve maternal and child health in the US.
“We found consistently worse health outcomes for mothers compared to fathers, suggesting that mothers may need additional consideration and attention in policies aimed at supporting parental health and especially mental health.
In all cases, our study underscores the need for more comprehensive research on the health and well-being of U.S. parents more broadly, and we urge support for more interventions that support prevention, diagnosis and treatment of mental health outcomes.”
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Menopause
CBT shows promise for menopause insomnia and hot flashes

Cognitive behavioural therapy (CBT) may offer short-term relief for menopause insomnia and night-time hot flushes, a pilot study suggests.
CBT is a structured, short-term talking treatment that helps people change thoughts and behaviours that can worsen sleep problems.
Researchers found the intervention was linked to meaningful short-term improvements in insomnia severity, hot flush interference, sleep self-efficacy, or confidence around sleep, and depressive symptoms.
The Menopause Society said insomnia affects an estimated 20 to 60 per cent of perimenopausal and postmenopausal women in the US.
Ongoing research is focusing on effective treatments because insomnia can have serious physical and psychological effects.
Dr Monica Christmas, associate medical director for The Menopause Society, said: “Nocturnal hot flushes (night sweats) and sleep disruption can have a significant effect on the quality of life with many women claiming extreme impairment due to symptoms that often start in early perimenopause and last 10 or more years.”
“Sleep disturbances can persist even in those using pharmacological therapy to manage hot flushes.
“The study’s findings highlight the utility of cognitive-behavioural therapy as a standalone treatment for insomnia and hot flushes, offering women an alternative or adjunct to pharmacological treatments.”
Insomnia is defined as disturbed sleep associated with distress or impaired daily functioning and is one of the most common complaints in perimenopause and postmenopause.
It can reduce quality of life and is linked to higher healthcare use and costs, disability, depression and cardiovascular disease.
Hot flushes occur in 60 to 80 per cent of women during the menopause transition and can persist for four to five years on average.
Night-time hot flushes are linked to sleep disruption, and women may respond by napping or spending longer in bed, which can help keep insomnia going.
Previous studies have shown that cognitive behavioural therapy is an effective treatment for insomnia and may also help women cope with hot flushes and other menopause symptoms.
However, few trials have looked at both insomnia and hot flushes together.
Insomnia during and after the menopause transition is complex and can have many causes, including ageing, hormone fluctuation, hot flushes, other sleep disorders, psychiatric and medical conditions and psychosocial stressors.
Because women with acute and sustained insomnia can experience greater negative health effects, effective treatment is important.
The pilot study concluded that CBT was feasible and may be a promising approach for menopause-related insomnia and nocturnal hot flushes, although the benefits appeared to lessen after three months.
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