I am a Professor in the Departments of Psychiatry, Obstetrics, Gynecology and Reproductive Sciences and in the School of Public Health . My clinical position is Chief for the Yale New Haven Health Division of Psychological Medicine. This Division provides inpatient and outpatient consultations to providers and patients in the other medical and surgical divisions of Yale New Haven Health. Our services are provided at both the York Street and St. Raphael campuses.
My research hats include and being Director of Research for the Yale New Haven Hospital Division of the Department of Psychiatry and Director of the Center for Women and Mothers, a research unit in the Department of Psychiatry. My group investigates the clinical course, etiopathology and treatment of psychiatric and substance use disorders as they occur in women. A major component of this work is 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. Contributions to the literature include evaluations of the impact of psychiatric conditions and treatments on various birth outcomes. My group published pivotal work in postpartum depression including the fact that 50% of instances of postpartum depression began antenatally and that standard antidepressant treatment is effective for postpartum onset of major depressive episodes. My work on premenstrual dysphoric disorder, the severe form of premenstrual syndrome, established the efficacy of serotonin reuptake inhibitors as first line treatments. Moreover, my work showed that treatment with these agents could commence either halfway through the menstrual cycle or at symptom onset. My recent work has explored the impact and treatment of substance use disorders on pregnancy and pregnancy outcomes. We devised a screening measure for substance use in pregnancy, the Substance Use Risk Profile-Pregnancy, which is an efficient measure to help identify and assist pregnant women with substance misuse. Additional work in this arena includes finding a therapeutic effect on abstinence of progesterone for women who have postpartum cocaine use, and showing the efficacy of a computerized brief interview, based upon motivational principles, in reducing substance misuse in pregnant and non-pregnant women.
I led the DSM 5 Study Group for Race, Gender and Ethnicity. This group assessed psychiatric conditions to determine possible bias in race, gender and ethnicity and incorporated relative text about race, gender and ethnicity into the DSM 5 text. I currently lead the Gender Study Group that is reviewing and conducting text revisions for the DSM 5 Text Revision.
I am the inaugural Editor in Chief for a new American Psychiatric Association on-line journal, Psychiatric Research and Clinical Practice. This journal seeks to publish clinical and translational research as well as timely reviews in psychiatry.