About

C. Neill Epperson, M.D., is a faculty member in the Department of Psychiatry at the Perelman School of Medicine at the University of Pennsylvania. She has over 20 years of experience in the treatment of mood and behavioral disorders across the female reproductive life cycle, with expertise in premenstrual dysphoric disorder, premenstrual worsening of depression and bipolar disorder, perinatal psychiatric disorders, mood disorders due to hormonal treatments, and perimenopausal mood disturbances. Dr. Epperson also treats women with adjustment difficulties and post-traumatic stress related to pregnancy complications or loss, and consults with peri- and early post-menopausal women with cognitive complaints. She is the director of the Penn Center for Women's Behavioral Wellness, which includes psychologists and psychiatrists specializing in women's mental health.

Research topics

• Social Science
• Political Science
• Computer Science
• Medicine
• Sociology
• Pharmacology
• Demography
• Public relations
• Engineering ethics
• Engineering
• Nursing
• Management science
• Family medicine

Selected publications

• Sperm sncRNA networks are synchronized by a coordination between adverse childhood experiences (ACE) and current stress

  Scientific Reports · 2026-04-17

  articleOpen access

  While stress in the environment alters sperm function and fertility, the underlying biology is not understood. Our prior studies showed that current stress could significantly change the composition and levels of sperm small noncoding (sncRNA) and impact sperm motility in men. However, the additional influence of adversity experienced earlier in life, designated as adverse childhood experiences (ACE), on sperm sncRNA dynamics remains unclear. To expand our understanding of the important relationship between ACE and stress, we recruited a longitudinal human cohort and modeled differential sncRNA and co-expression networks associated with perceived stress and ACE. Utilizing a repeated measures design, we were able to identify significant time-dependent interactions between ACE and perceived stress that resulted in differential sncRNA expression. Furthermore, network analyses revealed ACE and perceived stress coordinated sncRNA across subtypes, including miRNA that target genes important for offspring development. As these changes were identified widely across sncRNA subtypes, our findings reflect a novel and exciting synchronization strategy by which current and past experiences can impact the next generation. Evolutionarily, this coordination would preserve sncRNA modules essential for species survival while allowing refinement around developmental pathways important for intergenerational fitness.

  PublisherOA PDFDOI

• Modifiable cardiovascular risk factors in people with polycystic ovarian syndrome (PCOS): Findings from the endocrine and mental health study

  American Journal of Preventive Cardiology · 2026-03-01

  articleOpen access

  Polycystic ovarian syndrome (PCOS) is a chronic multi-system condition, affecting up to 5 million reproductive aged females in the United States. Research points to significant cardiovascular (CV) risk burden among people with PCOS, even after controlling for body composition. This study sought to evaluate modifiable CV risk factors for a community sample of non-treatment seeking females with and without PCOS. Participants completed validated surveys measuring depression, anxiety, sleep (insomnia, sleepiness, obstructive sleep apnea risk), and physical activity. PCOS status and body mass index (BMI) were self-reported. Data were summarized with descriptive statistics; linear regressions were used to assess differences between groups stratified by PCOS status and BMI category (above or below 25). Among 1,574 participants (95% identified as female, 72.7% White, 7% Black/African American, 7% Asian, mean age 30.6), 24% of participants with PCOS (N = 881) had a BMI < 25, while 51% of non-PCOS participants’ BMI was normal or underweight. Independent of BMI, participants with self-reported PCOS indicated greater depression, anxiety, insomnia, and worse quality of life, compared to participants without PCOS. While PCOS status in those with BMI > 25 was associated with higher sleep apnea risk, most PCOSxBMI interactions were nonsignificant, indicating no difference between BMI groups in the effect of PCOS on outcomes. Regardless of BMI, people with PCOS report greater rates of modifiable psychosocial and behavioral CV risk factors. Given the multifactorial risk of PCOS for CV diseases, screening and treatment is essential for CV prevention in people with PCOS.

  PublisherDOI

• Considerations and practical recommendations for identifying perimenopause in longitudinal research

  Psychoneuroendocrinology · 2026-01-15

  article
  PublisherDOI

• Research Literacy in Residency: Development, Implementation, and Outcomes for the Psychiatry Research Methods and Scholarship (PReMS) Curriculum

  Academic Psychiatry · 2026-03-18

  articleOpen accessSenior author

  OBJECTIVE: Development, implementation, and outcomes are described for the Psychiatry Research Methods and Scholarship (PReMS) curriculum targeting research literacy and scholarship during second year post graduate (PGY-2) residency training. METHODS: PReMS development at the University of Colorado Department of Psychiatry (UC-DOP) incorporated expertise from residency leadership, pedagogy, and biostatistics and was fine-tuned during 5 years of implementation. Content addressed Accreditation Council for Graduate Medical Education core competencies in research literacy and scholarship. Faculty-authored publications from UC-DOP highlighted research aspects including different study designs, methods, populations, sources of bias, and statistical analyses. Residents chose a paper and led its discussion; lecture materials supported the concepts addressed. Faculty authors were invited to sessions when their papers were presented to meet residents, answer questions, and stimulate discussion. The course director developed an assessment for administration before and after PReMS. RESULTS: Across five resident cohorts (n = 66), an increasing number and proportion of invited faculty authors attended sessions discussing their papers (93% overall). After PReMS, residents' research literacy scores improved significantly (p < 0.0001) by 17% on average after accounting for cohort; ratings of the importance of research to psychiatrists were unchanged. CONCLUSIONS: Preliminary results suggest PReMS is an effective curriculum to improve research literacy in residency and thereby advance proficiency in critical evaluation of the medical literature, a crucial skill for all physicians to become life-long learners. PReMS innovatively uses resident-led discussions of faculty-authored publications to make pedantic methodological material more interesting and to provide exposure to the implementing program's researchers, potentially enhancing scholarship mentoring opportunities.

  PublisherDOI

• Ovarian hormones, hormonal contraceptives and reward processing

  BJPsych Advances · 2026-03-23

  articleOpen accessSenior author

  SUMMARY Research on ovarian hormones increasingly reveals their important role in brain function. This includes reward processing, the umbrella phrase for functions that promote motivation for, response to and learning about rewards. This article seeks to provide a concise overview of how ovarian hormones influence reward function, with a specific focus on the ovarian hormone derivatives found in hormonal contraceptives. Despite the complexity of findings, the research suggests a general pattern in which oestradiol may promote multiple reward functions and progesterone often appears to play an inhibitory role. Allopregnanolone’s effects on reward functions appear to be concentration dependent and follow an inverted-U pattern. Limited research on hormonal contraceptives suggests that these agents may interfere with reward neurobiology, potentially contributing to deficits in sexual desire and positive mood, although some individuals may be more susceptible than others. Effects of ovarian hormones and their derivatives on reward processing have multiple clinical implications. These are discussed in relation to hormonal therapy in menopause, avoiding side-effects with hormonal contraceptives, and ongoing research on the use of progesterone in substance use disorders.

  PublisherOA PDFDOI

• Invisible Scars: Residual Consequences of Childhood Maltreatment Even in Adults Classified as Resilient

  Child Maltreatment · 2025-10-27

  articleSenior author

  People exposed to childhood maltreatment (CM) are thought to emerge as "resilient" or "non-resilient" in adulthood, with the implication that resilient adults eluded the negative consequences of CM. However, adults with CM who are classified as "resilient" may still face negative outcomes in areas of life not captured by resilience criteria. To test this hypothesis, the present study examined whether higher levels of CM were associated with worse psychological, social, and physical health outcomes even in "resilient" adults. Using data at all three survey waves spanning two decades from the Midlife in the United States (MIDUS) longitudinal study, resilience was defined as healthy functioning across seven domains: psychiatric disorders, substance use, education, employment, homelessness, crime, and social isolation. Results showed that in both the "resilient" and "non-resilient" groups, higher CM exposure was significantly associated with worse outcomes on measures of stress reactivity, perceived stress, number of chronic conditions, self-esteem, life satisfaction, relationship quality with friends and family, and positive relations with others (measured at wave 3; all p-values <.033). These findings suggest that CM has enduring and overlooked psychological, social, and physical health consequences not captured by comprehensive resilience criteria, highlighting the need for intervention even in seemingly resilient adults.

  PublisherDOI

• Psychiatric symptoms on the ovarian hormone roller-coaster

  The British Journal of Psychiatry · 2025-06-01 · 2 citations

  editorialOpen access

  This themed issue examines the impact of ovarian hormone fluctuations on women's mental health across the lifespan, including puberty, the menstrual cycle, pregnancy, postpartum and menopause. It highlights critical gaps and calls for sex-specific approaches in reproductive psychiatry and hormone-informed mental care.

  PublisherOA PDFDOI

• The Trifecta of Industry, Academic, and Health System Partnership to Improve Mental Health Care Through Smartphone-Based Remote Patient Monitoring: Development and Usability Study

  JMIR Formative Research · 2025-01-07 · 1 citations

  articleOpen access1st authorCorresponding

  BACKGROUND: Mental health treatment is hindered by the limited number of mental health care providers and the infrequency of care. Digital mental health technology can help supplement treatment by remotely monitoring patient symptoms and predicting mental health crises in between clinical visits. However, the feasibility of digital mental health technologies has not yet been sufficiently explored. Rhythms, from the company Health Rhythms, is a smartphone platform that uses passively acquired smartphone data with artificial intelligence and predictive analytics to alert patients and providers to an emerging mental health crisis. OBJECTIVE: The objective of this study was to test the feasibility and acceptability of Rhythms among patients attending an academic psychiatric outpatient clinic. METHODS: Our group embedded Rhythms into the electronic health record of a large health system. Patients with a diagnosis of major depressive disorder, bipolar disorder, or other mood disorder were contacted online and enrolled for a 6-week trial of Rhythms. Participants provided data by completing electronic surveys as well as by active and passive use of Rhythms. Emergent and urgent alerts were monitored and managed according to passively collected data and patient self-ratings. A purposively sampled group of participants also participated in qualitative interviews about their experience with Rhythms at the end of the study. RESULTS: Of the 104 participants, 89 (85.6%) completed 6 weeks of monitoring. The majority of the participants were women (72/104, 69.2%), White (84/104, 80.8%), and non-Hispanic (100/104, 96.2%) and had a diagnosis of major depressive disorder (71/104, 68.3%). Two emergent alerts and 19 urgent alerts were received and managed according to protocol over 16 weeks. More than two-thirds (63/87, 72%) of those participating continued to use Rhythms after study completion. Comments from participants indicated appreciation for greater self-awareness and provider connection, while providers reported that Rhythms provided a more nuanced understanding of patient experience between clinical visits. CONCLUSIONS: Rhythms is a user-friendly, electronic health record-adaptable, smartphone-based tool that provides patients and providers with a greater understanding of patient mental health status. Integration of Rhythms into health systems has the potential to facilitate mental health care and improve the experience of both patients and providers.

  PublisherDOI

• Refugee and asylum seeker child and adolescent mental health: A systematic review of racial, ethnic, and contextual disparities.

  American Journal of Orthopsychiatry · 2025-06-12 · 1 citations

  reviewOpen accessSenior author

  Recent research indicates that sociostructural factors affect mental health and care across racial and ethnic groups differently. The mental health and care access of refugee and asylum-seeking youth has been studied in various populations and host countries. Yet, despite the increasing numbers of such children, their poor outcomes, and underuse of care, little is known about racial, ethnic, and context-based disparities in these outcomes. To our knowledge, this is the first systematic review to identify the progress and shortcomings in the research of such disparities among refugee and asylee youth, emphasizing ecological dimensions affecting health and care. Using rigorous search and inclusion criteria across the MEDLINE, APA PsycInfo, CINAHL, and Web of Science databases and following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, we evaluated the findings and limitations of 63 included studies. These studies compared children or adolescents of distinct racial or ethnic refugee or asylum-seeking populations to each other or to other populations across 30 countries, investigating child and adolescent mental health outcomes (including disorders, symptoms, and mental health care access-related outcomes). We identify specific disparities in outcomes based on racial, ethnic, and contextual differences, with results organized by ecological systems theory dimensions and timescales. Our review highlights that generally, Middle Eastern youth may experience worse outcomes across contexts, that there is a gap in research inclusive of youth from the Americas, and that the mechanisms of sex differences, acculturative stress, and intergenerational transmission may vary by population. We propose actionable steps for research on disparities and interventions in migrant child and adolescent populations. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

  PublisherDOI

• Neonatal Outcomes with the Use of Lamotrigine for Bipolar Disease in Pregnancy and Breastfeeding: A Case Series and Review of the Literature

  Psychopharmacology Bulletin · 2025-08-12

  article

  The treatment of bipolar disorder in pregnant women and the postpartum period is a complex clinical issue requiring careful consideration of the risks involved in using psychotropic medications versus the benefits of successfully managing this chronic illness. We present three cases of women exposed to lamotrigine during pregnancy and breastfeeding, with follow up of their infants until 15–18 months of development. Psychopharmacology Bulletin. 2009;42(3):91–98.

  PublisherDOI

Recent grants

• NIH Grant R01AG030641

  NIH · $994k · 2012

• Multi-Modal Imaging of Psychostimulant Effects on Executive Function Post-RRSO

  NIH · $2.6M · 2017–2023

• NIH Grant K24DA030301

  NIH · $954k · 2015

• NIH Grant K02MH073090

  NIH · $614k · 2009

• NIH Grant P50MH099910

  NIH · $13.0M · 2019

Frequent coauthors

• Thomas Steckler

  4935 shared

• Jos Prickaerts

  Maastricht University

  4230 shared

• Robert L. Balster

  2856 shared

• Carlo Ferrarese

  University of Milano-Bicocca

  2808 shared

• Linda P. Spear

  Binghamton University

  2796 shared

• Sharon Walsh

  University of Cincinnati

  2736 shared

• Gessica Sala

  University of Milano-Bicocca

  2700 shared

• Christine A. Franco

  2194 shared

Labs

• Epperson LaboratoryPI

Awards & honors

• Building Interdisciplinary Research Careers in Women's Healt…
• P50 from the Office of Research on Women's Health and the Na…