Focus on women's mental health.

wo of the articles in this issue's Focus on Women's Mental Health section provide data on phenomenology and risk of psychiatric disorders in women, while 2 articles report findings from treatment trial results. The perimenopause has been identified as a high-risk time for major depressive disorder in women, as reviewed by Steinberg et al. in the introduction section of their article. The authors generously provide an accompanying editorial following this introduction , in which they put their results into a historical and clinical context. Better understanding of perimenopausal depression will allow for a stronger foundation for its identification, treatment, and prevention. As the authors discuss in their article, " Many assumptions are made about the cause and characteristics of depression occurring during the menopause transition, but little is actually known. " The investigators conducted a cross-sectional study of 116 women between 40 and 55 years of age in the perimenopausal transition who presented to a mood disorders clinic. The authors found that first-onset depression did not present with a different clinical picture than recurrent episodes during perimenopause, and depression that was accompanied by hot flushes did not appear distinct from depressive disorders without hot flushes. Hot flushes were not found to be a predictable determinant of new-onset perimenopausal depression. Also, postpartum depression did not predict perimenopausal depression, although premenstrual dysphoria was common in the sample. Importantly, the investigators documented a high prevalence of depres-sive symptoms with significant impairment and clustering in the later perimeno-pausal transition. These factors may suggest future research directions. Gender, childhood abuse, and comorbidity are important topics regarding the manifestation of psychiatric disorders and treatment response. Richardson et al. present a study in which the serotonin transporter promoter polymorphism 5-HTTLPR is assessed with regard to bulimia-spectrum eating disorders, psychiatric comorbidity, and histories of abuse. Eighty-nine women participated in the study, which included diagnostic assessments, interviews, and genotyping. The complex interplay between genetic predisposition, environmental impact, and expression of psychiatric disorders deserves sophisticated consideration. Richardson et al. found that greater psychiatric comorbidity in an eating-disordered population was associated with the S allele and exposure to abuse. The impact of a more sophisticated understanding of genetic influences on the expression and course of psychiatric disorders remains unclear and full of potential. In this article, the investigators add to the literature that demonstrates the important interactions between environment and biology. These types of studies are exciting overall for psychiatry and …