As a young woman, Alkistis Skalkidou spent the last two years of high school in Cambridge, Massachusetts. She then returned to Greece, where she had grown up, to pursue medical studies at the Athens University Medical School, which she completed in 2000. Fresh out of medical school she did 15 months of mandatory work as a country physician, then continued with a year of training in the surgical department of Elpis hospital before two more years of gynecology specialist training in the Agios Savvas hospital in Athens. After that she moved to Uppsala, Sweden, and completed her specialist training in obstetrics and gynecology at the Uppsala Akademiska hospital in 2010.
What is it that you like most about your job as a gynecologist/obstetrician?
I love this specialty because it is so broad. It encompasses everything from maternity primary care to specialized oncologic surgery. I like working with women, and sometimes I even get to work with children. It is very rewarding.
How did you become interested in perinatal mental health?
I think my interest in the field came through ordinary and frequent discussions with my husband, who is a psychiatrist. Perinatal mental health is a field we have a shared interest in. For me it has been very interesting to discuss different aspects with him through the years.
Being pregnant and giving birth to three children myself, I have of course gained personal experience regarding the challenges of the perinatal period. I also know how women often are underdiagnosed and undertreated.
Perinatal mental health fascinates me, and I had the opportunity to do my post-doc in this field when I first came to Uppsala University. Even though funding in this interdisciplinary field is very hard to obtain, it has become very important to me to contribute to an area where the needs in both research and clinical care are substantial. More interest (and funding) is needed!
What can gynecologists/obstetricians do to support women when it comes to mental health?
Their role would be very important in reducing the stigma that still exists. Working together with midwives and psychologists to screen and monitor women, especially those at high risk, is also of great importance.
You are now the president of the Nordic Marcé Society and have been with the board for some time. Can you tell the readers about the organization and what made you engage in this work?
The Nordic Marcé Society is the Nordic branch of The International Marcé Society for Perinatal Mental Health. The Society has been very active in dissemination of knowledge and new research and findings in the field, as well as in practically supporting providers world-wide through an email discussion forum, where everyone could send their questions and get answers and comments.
I find colleagues in the Society to be very open-minded and willing to work together with the common goal of promoting women’s mental health in the perinatal period. This is what really got me involved in the Society. I think it is amazing to be in such engaged groups, regionally and internationally. Our members, besides the e-mail discussion forum, have the possibility to attend our conferences at a reduced rate. We are also planning a common seminar series and courses with the UK-Ireland branch soon.
As a gynecologist/obstetrician, how do you look upon the support of families regarding mental health during the perinatal period in Sweden where you work?
I think there are many good intentions, such as national guidelines for postpartum screening, and regional guidelines for screening during pregnancy. But there are many obstacles of a more practical nature that makes the number of women undergoing screening lower than it should. timely help and support are not always optimal in my experience. There are also regional differences, which we are working to correct, and we hope to improve several aspects of care.
Skilled and dedicated colleagues from different professions working together makes me very hopeful that family centered support in the perinatal period will become better.
I think we need to also look at models used in other countries, such as the establishment of multi-disciplinary clinical teams and mother-baby units, as well as the implementation of preventive interventions for high-risk groups.
Why could psychiatrists be interested in perinatal mental health?
I think that the perinatal period is pivotal in many ways. Pregnancy and childbirth are like a stress-test for body and mind and can give valuable information of future risks. For many young women, this period is when they experience their first depressive episode. Such episodes coming directly postpartum have been shown to be an indication for bipolar disorder. Also, the mood and wellbeing of pregnant women have important implications for the future health of their offspring, so we have a huge preventive potential by seeing to it: and of course, psychiatrists, along with other colleagues, have the possibility to make a big difference there! □
Read more about the Nordic Marcé Society: https://nordicmarce.org/