UIC Department of Psychiatry

Fellowship in Women's Mental Health
Department of Psychiatry
University of Illinois at Chicago

PROGRAM DESCRIPTION

Program Name:

Fellowship in Women’s Mental Health

Sponsoring Department:

Psychiatry

Program Director:

Vesna Pirec M.D. , Ph.D
Assistant Professor
Director, Women’s Mental Health Program
Department of Psychiatry
College of Medicine
University of Illinois at Chicago

Program Length:

One year (12 calendar months)

Locations:

Neuropsychiatric Institute, University of Illinois at Chicago
Outpatient Care Center, University of Illinois at Chicago
University of Illinois Hospital, Inpatient unit
Haymarket Maternal Addiction Center

Participants:

Trainees who have completed their PGY-3 year of a psychiatry residency

Program Purpose:

The female reproductive cycle, along with sociocultural gender roles, can exert a major influence on the course, expression and treatment of psychiatric disorders. The aim of this fellowship is to develop a cadre of experts in the psychiatric care of women, and in the assessment and treatment of psychiatric symptoms linked with female reproductive cycle transitions. Fellows acquire expertise in treating psychiatric disorders associated with the menstrual cycle, pregnancy, the postpartum period, and perimenopause. They come to understand the treatment implications of sex and gender differences in the expression of major psychiatric illnesses. They develop an in-depth appreciation of the influence of sociocultural gender roles on psychopathology.

This is primarily a clinical fellowship, but each fellow also would have an option to participate in research or scholarly project, the nature and scope of which depends on the fellow’s interests. These projects can range from conducting an independent research project and publishing the results, to collaborating on an ongoing research project, to co-authoring a journal article or book chapter, to peer-reviewing others’ research or publishing a book review.

The University of Illinois at Chicago is a nationally recognized leader in the field of women’s health and women’s mental health. It is a federally funded Center of Excellence for Women’s Health. The Women’s Mental Health Program is a winner of the American Psychiatric Association’s Gold Award for innovative mental health services, and the American College of Psychiatrists’ Award for Creativity in Psychiatric Education.

Goals and Major Objectives

1. Knowledge
   1. Sex and gender differences
      1. To understand empirical gender differences in prevalence and expressions of psychopathology.
      2. To understand biological influences on gender differences in both normal and pathological states, including sexual dimorphism in the brain and in brain development.
      3. To understand sociocultural influences on gender differences in both normal and pathological states.
      4. To understand gender differences in pharmacotherapy, including pharmacokinetics, pharmacodynamics, treatment response, side effect profiles, interactions with endogenous and exogenous hormones, psychological reactions to pharmacotherapy, and adherence to treatment.
   2. Reproductive cycle effects
      1. To understand the influence of the female reproductive cycle on psychiatric disorders, including biological and psychological effects of puberty, the menstrual cycle, pregnancy, the postpartum period, and perimenopause.
      2. To understand both normal and psychopathological reactions to reproductive-related interventions, such as hysterectomy, treatment for gynecologic cancers, and infertility interventions.
   3. Effects of gender-influenced trauma
      1. To understand the spectrum of responses to childhood physical and sexual abuse.
      2. To recognize the signs of, and understand the dilemmas faced by, women subjected to current domestic violence, rape, and sexual harassment.
2. Skills
   1. Interviewing skills
      1. To demonstrate competence in interviewing patients with sensitivity to gender-specific communication styles.
      2. To demonstrate competence in eliciting sexual and reproductive histories.
      3. To develop interview techniques which elicit information about past and current traumatic events, such as sexual abuse, physical abuse, and domestic violence, without overly suggestive comments or "leading" questions.
   2. Diagnostic and assessment skills
      1. To incorporate an understanding of biological and cultural gender differences into diagnostic assessment of women patients.
      2. To incorporate assessment of central issues such as family context, parenting capability, family planning needs, and primary women’s health care needs into psychiatric assessments.
      3. To conduct physical examinations that include aspects of screening that are particularly important for women -- e.g. pelvic examinations, skin examinations for bruises.
   3. Treatment skills
      1. To demonstrate an ability to modify pharmacotherapy based on pregnancy, lactation, the menstrual cycle, menopause, exogenous hormones, and gender differences in pharmacokinetics.
      2. To incorporate knowledge of normal and pathological psychological reactions to reproductive events (e.g. pregnancy, menopause) into psychotherapeutic interventions.
      3. To learn how to modify electroconvulsive therapy techniques during pregnancy and lactation.
      4. To recognize gender-specific issues in psychotherapy.
      5. To learn psychotherapeutic techniques effective for treating short and long term sequelae of trauma, including sexual abuse, sexual assault, physical abuse, domestic violence, and perinatal loss.
      6. To learn the indications for various types of psychosocial rehabilitation pertinent to women with major mental illness, including parenting rehabilitation strategies and sexuality education.
3. Attitudes
   1. To demonstrate sensitivity to gender role stereotypes and their influences on diagnosis and treatment.
   2. To recognize one’s own values regarding gender roles, including any beliefs that may interfere with one’s ability to respect and empathize with patients' choices.
   3. To develop a collaborative approach to mental health problems in women, working with patients, family members, other health professionals, child welfare staff and significant others to collectively improve problems.
   4. To develop an appreciation and keen awareness of social, cultural, logistical and economic barriers to mental health care access for women.

Description of Teaching/Learning Activities

Clinical training experiences: