Academic Center for Perinatal Psychiatry and Soma & Psyche

Last updated: 365 days ago.

The Center for Perinatal Psychiatry has the ambition to sustain a leading multidisciplinary center in improving perinatal mental health and offspring development by scientific research excellence and best clinical care in populations with neurobiological and severe psychosocial risk factors.

Research and care focuses on diagnosis, early intervention and prevention. This focus on perinatal psychiatry is embedded in research and care in somatically ill patients with comorbid psychological and psychiatric conditions.

Academic Center of Excellence

Research Activities

Within the past 10 year our multidisciplinary research group became world-leading in clinical and population based studies of perinatal mental disorders – in particular postpartum psychosis - and their influence on offspring development. We use a range of approaches, including epidemiology (Generation R, Consortium South-West NL), genetic, neurobiology, immunology and clinical Randomized Control Trials (RCTs).

We founded the National Knowledge Centre of Perinatal Psychiatry (Landelijk Kenniscentrum Psychiatrie en Zwangerschap; www.lkpz.nl), which includes more than 200 health care professionals and 35 centers treating women with psychopathology during pregnancy.

Existing international collaborations between international centres of excellence for perinatal mental health: National Center for Register-Based Research, Aarhus, Institute of Psychiatry London, Imperial College London, Oxford University, Cardiff University, Munster University, Leuven University, Barcelona University, Perth University, University of Sydney, and University of North Carolina.

The ACE conducts fundamental and multidimensionality research in measuring health related quality of life, in the international context of the international leading EuroQoL Group, and is leading at a national level in the investigation of the (cost-)effectiveness of 'Medical Psychiatric Units'. The ACE wants to be an international recognizable ACE in measuring health related quality of life and Medical Psychiatric Units.

Type of

Collaborations

Existing international collaborations between international centres of excellence for perinatal mental health: National Center for Register-Based Research, Aarhus, Institute of Psychiatry London, Imperial College London, Oxford University, Cardiff University, Munster University, Leuven University, Barcelona University, Perth University, University of Sydney, and University of North Carolina. The ACE conducts fundamental and multidimensionality research in measuring health related quality of life, in the international context of the international leading EuroQoL Group, and is leading at a national level in the investigation of the (cost-)effectiveness of ‘Medical Psychiatric Units’. The ACE wants to be an international recognizable ACE in measuring health related quality of life and Medical Psychiatric Units.

Educational

Contributions

The ACE provides education for Ba, MSc, Research Master, PhD, Medical Specialist Education. The Ba and MSc psychiatry program is evaluated annually, on the basis of (digital) evaluation by students.

The ACE education program is part of this evaluation and is not evaluated separately. The ACE is responsible for the communication, attitude and cooperation education of the medical bachelors and master education, which is a substantial program (> €1.0M). This program is evaluated positively by the communication section of the NVMO.

The ACE wants to introduce more 'evidence based education' into this educational program, and more emphasis on the effectiveness of the communication, attitude and cooperation. The ACE is responsible for several courses in the NIHES PhD education program. There are 8 national and 3 international PhD students. The ACE is responsible post-doctoral education of psychologists at Erasmus MC (GZ-psychologist).

Patient

Care Activities

The Erasmus Center for Perinatal Psychiatry has a 50-year national leading academic position in treating women with severe perinatal mental disorders (e.g. postpartum psychosis, postpartum depression and pregnancy related anxiety disorders). We have outpatient facilities, daycare facilities and a clinical mother baby unit.

Furthermore we have narrow collaboration with the department of Obstetrics & Gynaecology, Neonatology, Pharmacology and Child and Adolescent Psychiatry/Psychology and various partners outside Erasmus MC (addiction and public healthcare services) with weekly multidisciplinary meetings (MDO-POPP).

Clinical expertise is fully integrated with the research and education focus, such that new knowledge acquired through research is rapidly implemented into clinical care and education, and analogously that identified clinical issues can be rapidly advanced as research questions.

As a national center of expertise, we are a major referral center for the country, which substantially increases the international visibility of the ACE, and strengthens the clinical, research and educational expertise. The centre "Soma & Psyche" collaborates with all the somatic departments within the Erasmus MC and we provide shared care (diagnostic and treatment) on vast time points with the department of Neurology, Dermatology, Obstetrics & Gynaecology and Oncology. We have clinical facilities for combined care of complex patients with psychiatric and somatic problems (medical psychiatric unit). The ACE participates in the national mandatory mental PROMs (ROM) data collection.

The ambitions is to use the logistics already in place for the Erasmus MC 'Value Based Health Care' program. Members of the ACE are involved in the expert group of 'Value Based Health Care', given their expertise in quality of life measurement, PROMs and Routine Outcome Monitoring (ROM). The ACE wants to be home base for the psychologist and social workers at the Erasmus MC in terms of the education, inter- and super vision. In that way she will be responsible for the psychological and behavioral care given at the Erasmus MC.

Societal Relevance to Research, Education and Patient Care

The ACE has officially registered postpartum psychosis in the list of rare diseases curated by Orphanet, the reference portal for information on rare diseases (www.orpha.net).

This is the first adult psychiatric disease registered in Orphanet ever. Our clinical research was named in 2012 and 2015 by the publishing group of the NEJM as one of the 10 most important clinical studies in the entire field of Psychiatry. Our findings have generated significant public interest and media attention in leading national magazines and journals (e.g. NRC, Volkskrant, Trouw, Telegraaf) and radio/television (RTL4 nieuws, VPRO).

Our work was named as example in the "maatschappelijke impact brochure of the Erasmus MC. The ACE developed guidelines for antidepressant use during pregnancy and measuring health related quality of life in a health economic context, we are the main editors of the first 'Handboek Psychiatrie en Zwangerschap' and we are currently writing standard of care guidelines for evidence-based clinical practice for perinatal mental health.

The ACE has been actively involved in helping to establish the first patient support group in the Netherlands for postpartum psychosis and depression (www.memam.nl). The ACE is leading at a national level in the research related to Medical Psychiatric Units.

Viability of Research, Education and Patient Care

Within the ACE, talent identification, monitoring and review is applied by yearly interviews with all participants, using both qualitative and quantitative reviews. The ACE is involves in educating PhD students and clinical training.

The ACE is the home base for 3 international PhD research projects (China, Spain and Indonesia).

Key and relevant publications of the last five years

  • Wesseloo R, Kamperman A, Munk-Olsen T, Pop V, Kushner SA, Bergink V. Postpartum episodes in women at high risk, a systemic review and meta-analysis. American Journal of Psychiatry. 2016;173(2):117-27. Impact factor 14.721.
  • Bergink V*, Burgerhout K*, Koorengevel KM, Kemperman A, Hoogendijk WJ, Lambregtse-van den Berg MP, Kushner SA (* shared first authorship). Treatment of psychosis and mania during the postpartum period. American Journal of Psychiatry. 2015 Feb 1;172(2):115-23
  • Bergink V, Bouvy PF, Vervoort JS, Koorengevel KM, Steegers EAP, Kushner SA. Prevention of postpartum psychosis in women at high risk. American Journal of Psychiatry. 2012, 169(6): 609-15
  • Bergink V, Burgerhout K, Weigelt K, Pop V, de Wit H, Drexhage RC, Kushner SA, Drexhage HA. Immune system dysregulation in first onset postpartum psychosis. Biological Psychiatry. 2012, 73(10): 1000-7.
  • Van Hout B et al. Interim scoring for the EQ-5D-5L: Mapping the EQ-5D-5L to EQ-5D-3L value sets. Value in Health 2012 Jul;15(5):708-15
  • Janssen et al. Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L across eight patient groups: a multi-country study. Qual Life Res. 2013 Sep;22(7):1717-27
  • Visser et al. The Cost-Effectiveness of Cognitive-Behavioral Group Training for Patients with Unexplained Physical Symptoms. Value Health. 2015 Jul;18(5):570-7.
  • Psychiatric genome-wide association study analyses implicate neuronal, immune and histone pathways. Network and Pathway Analysis Subgroup of Psychiatric Genomics Consortium. Nat Neurosci. 2015 Feb;18(2):199-209. doi: 10.1038/nn.3922. Epub 2015 Jan 19. Erratum in: Nat Neurosci. 2015 Jun;18(6):926. Nat Neurosci. 2015 Dec;18(12):1861
  • Bergink V, Armangue T, Titulaer M.J., Markx S, Dalmau, J, Kushner SA. Autoimmune encephalitis in postpartum psychosis. American Journal of Psychiatry. 2015 Sep 1;172(9):901-8
  • Cents RA, Kok R, Tiemeier H, Lucassen N, Székely E, Bakermans-Kranenburg MJ, Hofman A, Jaddoe VW, van IJzendoorn MH, Verhulst FC, Lambregtse-van den Berg MP. Variations in maternal 5-HTTLPR affect observed sensitive parenting. J Child Psychol Psychiatry. 2014 Sep;55(9):1025-32

PhD theses of the last five years

  • Burgerhout K, 2016. Follow-up of postpartum psychosis
  • Cents R. 2016 The effect of maternal and child genetic variations on the child’s
  • Lotte Timmerman 2/12/2015 Exploring the Mental Health of Living Kidney Donors
  • Jessica Voerman 23/9/2015 Psychosocial Assessment and Self-Management of Chronic Pain
  • C. Quispel C 9/9/2014, Psychosocial Problems and Substance Use During Pregnancy Care
  • Sohal Ismail 10/6/2014 Home-based Education Increases Knowledge, Communication and Living Donor Kidney Transplantations
  • Lucassen N (01/12/213), Does the father matter? Causes and consequences of parental sensitivity
  • Osse RJ 06-11-2013 Delirium after cardiac surgery in older patients
  • Bergink V, 31/10/2012 First onset postpartum psychosis
  • P. van Bokhoven 27/10/2011 Molecular and cellular neuroplasticity in animal models of depression

Non-scientific publications related to the ACE

Principal coordinator(s)