Anxiety Disorders; Health Care Quality, Access, and Evaluation; Mood Disorders; Substance-Related Disorders; Sexual and Gender Disorders
Psychiatry: Center for Wellbeing of Women and Mothers | Psychological Medicine Service | Psychotherapy Development Center | Women's Behavioral Health Research, Division of | Yale Mood Disorders Research Program
Through research, I am committed to servicing women who suffer from mood and anxiety disorders. My specific interests have included sex differences in these conditions as well as the relationship and treatment of mood, anxiety and substance use disorder occurring during the premenstrual phase of the menstrual cycle and during pregnancy and parturition. My research foci are several and include determining the efficacy and effectiveness of pharmacological treatments of perinatal mood disorders substance use disorders and PMDD, determine the degree of health care utilization among women with PMDD and perinatal depression and investigating the impact of perinatal depressive, anxiety and substance use disorders on birth outcomes.
Extensive Research Description
My longstanding interest has been investigations into the clinical course, etiopathology and treatment of psychiatric disorders as they occur in women. A major component of this work includes investigations into the occurrence and treatment of illnesses in pregnancy and the postpartum period, and across the menstrual cycle. This area, by its nature, cuts across disciplines and requires psychiatric expertise, as well as knowledge in neuroscience and reproductive biology.
Reciprocally, I have been involved in the assessment of the effects that psychiatric illnesses and their treatments, have on perinatal outcomes. In a cohort study funded by NICHD, we recruited approximately 2800 women and interviewed them three times during pregnancy. We are assessing whether depression is a risk factor for preterm delivery, independent of antidepressant treatment. This large prospective cohort study includes information on maternal psychiatric illness, antidepressant treatment and other obstetrical risk factors.
Ongoing NIDA studies are assessing the comorbidity, course, consequences and treatment of hazardous substance use in pregnancy and the immediate postpartum time. This study entails following a large cohort of pregnant women who used drugs or alcohol in pregnancy and testing a behavioral treatment for drug and alcohol use. This rich, longitudinal data set also provides information on the clinical course of substance use disorders in pregnancy and after delivery.
- Symptom onset study for premenstrual dysphoric disorder
- Screening and referral for women with substance misuse
- Progesterone as a treatment for postpartum cocaine use
- Implementation of motivational interviewing in the general hospital setting
- Hartlage SA, Freels SA, Gotman N, Yonkers KA. Criteria for Premenstrual Dysphoric Disorder (PMDD): Secondary Analyses of Relevant Data Sets. Archives of General Psychiatry. 2012;69(3):300-305. PMC3370334
- Yonkers KA, Forray A, Howell HB, Gotman N, Kershaw T, Rounsaville BJ, Carroll KM. Motivational Enhancement Therapy Coupled with Cognitive Behavioral Therapy versus Brief Advice; A Randomized Trial for Treatment of Hazardous Substance Use in Pregnancy and After Delivery. General Hospital Psychiatry. 2012: 34 (5): 439-449.
- Yonkers KA, Norwitz ER, Smith MV , Lockwood CJ, Gotman N, Lin H, Luchansky E, Belanger K. Major depressive disorder and serotonin reuptake inhibitor treatment as risk factors for preterm birth. Epidemiology, 2012: Vol 23 (5): 677-685. PMCID: 3415566
- Epperson CN, Steiner M, Hartlage SA, Eriksson E, Schmidt PE, Jones I, Yonkers KA. Premenstrual Dysphoric Disorder: Evidence for a New Category for the DSM-5. American Journal of Psychiatry, 2012: 169(5); 465-475.
- Yonkers KA, Gotman N, Smith MV , Forray A, Belanger K, Brunetto W, Lin H, Burkman RT, Zelop CM, Lockwood CJ. Does Antidepressant Use Attenuate The Risk Of A Major Depressive Episode In Pregnancy? Epidemiology, 2011:22; 848-854.
- Spoozak L, Gotman N, Smith MV, Belanger K, Yonkers KA (Sep 2008) Evaluation of a social support measure that may indicate risk of depression during pregnancy., Journal of Affective Disorders
- Yonkers KA, Lin H, Howell HB, Heath AC, Cohen LS (Apr 2008) Pharmacologic treatment of postpartum women with new-onset major depressive disorder: a randomized controlled trial with paroxetine., The Journal of clinical psychiatry, 69(4)659-65
- Yonkers KA, O'Brien PM, Eriksson E (Apr 2008) Premenstrual syndrome., Lancet, 371(9619)1200-10
- Yonkers KA, Smith MV, Gotman N, Belanger K. Typical somatic symptoms of pregnancy and their impact on a diagnosis of major depressive disorder General Hospital Psychiatry, 2009; 31(4); 327-333.
- Yonkers KA, Howell H, Allen A, Ball S, Pantalon M, Rounsaville B. A treatment for substance abusing pregnant women. Archives of Women's Mental Health 2009; 4(12): 221-225.
- Yonkers KA, Smith MV, Lin H, Howell HB, Shao L, Rosenheck RA. Depression screening of perinatal women: evaluation of the Healthy Start Depression Initiative. Psychiatric Services, 2009,60(3):322-328.
- Smith MV, Shao L, Howell HB, Wang H, Poschman K, Yonkers KA, Success of mental health referral among pregnant and postpartum women with psychiatric distress. General Hospital Psychiatry. 31 (2): 155-162.