Problems of Perinatal Mental Health Care in Tokyo, Japan

Dusunen Adam: The Journal of Psychiatry and Neurological Sciences, 2015

Sociodemographic features and treatments of pregnant psychiatric inpatients in an university hospital: a retrospective chart review Objective: In this study, the sociodemographic characteristics of and treatment methods applied to pregnant inpatients were investigated. Method: Fourty three inpatients, have been included to the study. The sociodemographic data, diagnoses and applied treatments as well as the individual treatment response information were extracted, sorted out and analysed. Results: Diagnosis for nearly half of the women was psychotic disorder (44.2%;19/43). Patients with the diagnosis of a psychotic disorder had been hospitalized longer than the patients with a diagnosis of anxiety and somatoform disorder were. Thirty four of 43 patients (79%) have had psychiatric disorders before pregnancy. Haloperidol was the most frequently used psychotropic drug for the treatment of psychotic disorders and bipolar manic episodes. In 26% of patients, delivery was carried out through cesarean section during hospitalization. Conclusions: In conclusion, it was found that a significant portion of pregnant inpatients have been suffering from a psychiatric disorder before conception. The remarkable ratio of deliveries, which happened during the hospitalization in psychiatry clinics and lack of medically complicated babies, show that the psychiatry services, beyond treatment of psychiatric illnesses, could serve as a secure place for expected mothers and babies prenatally.

Neurologic Clinics

This review, although not exhaustive, provides information on the potential impact of psychiatric illness on obstetric outcome. There is clear evidence that psychiatric illness poses a risk to pregnancy outcome. There productive safety data on many of the available treatments fail to demonstrate a clear risk from treatment. The medications with clear teratogenic, neonatal, and developmental risks are, not surprisingly, those used to treat some of the most severe and debilitating psychiatric illnesses. Even the amount of information available is inadequate without some straightforward clinical guidelines. A model of risk for illness and treatments of illnesses during pregnancy developed by the authors' group reminds clinicians that nonexposure does not exist. Rather, the decision is which type of exposure is in the best interest of the patient and family-exposure to illness or exposure to treatment. Regardless of the choice, clinicians are encouraged to think in terms of reducing...

Bangladesh Journal of Psychiatry, 2018

The presence of psychiatric disorders during perinatal period imposes negative and long-term effect on maternal health and child development as well as normal family environment. The purpose of our study was to investigate the socio-demographic factors associated with psychiatric morbidity during perinatal period. It was a descriptive cross-sectional study conducted among purposively selected 197 perinatal women attending the Obstetrics & Gynaecology Outpatient Department (OPD) of Bangabandhu Sheikh Mujib Medical University and Dhaka Medical College Hospital, Dhaka from August 2012 to July 2013. Data were collected through face-to-face interview by administering a semistructured questionnaire, containing socio-demographic and other variables and translated Bangla version of Structured Clinical Interview for DSM-IV Axis-I Disorders – Clinician Version (SCID-CV). Majority (79.7%) of the women were included in the age group of 20-34 years. The mean (±SD) age of the respondents were cal...

Journal of Psychiatrists' Association of Nepal, 2015

Background: Prevalence rates for psychiatric disorders during pregnancy have been found to range from 6-13%. Psychiatric caseness during pregnancy not only affects the mother but also affects the health and development of the child. Various factors have been found to be associated with psychiatric caseness in different cultural and social settings including obstetric history. Objective: To evaluate the relation of obstetric history in pregnant population with psychiatric caseness.Methods: This is a cross sectional study with a total of 300 sample collected within 6 months in antenatal clinic of obstetric OPD, TUTH using semi-structured proforma and SRQ-24. Results: 15% of the pregnant women could be labeled as psychiatric cases. Trimester and, complication during current pregnancy showed statistically significant association with psychiatric caseness. Conclusion: As 15% of pregnant ANC attendees were found to be having psychiatric illness, it can be recommended that pregnant females...

Psychiatria Polska, 2015

Pregnancy is a major life change for many women. The related biological changes, especially complications in its course and in the course of delivery, carry a risk of developing a variety of psychological problems and mental disorders. However, their treatment is challenging due to the teratogenic effects of most psychoactive drugs and specific requirements for entering different psychotherapeutic programs. Mental disorders during pregnancy are undoubtedly an important issue for both gynecology and psychiatry. There is still a discussion considering the question whether psychotherapy during pregnancy is safe, although no scientifically valid data contradicting the safety of psychotherapy during pregnancy has been published so far. Together with psychotherapy-as a treatment of choice-clinicians approve some other relatively safe treatment methods for psychiatric disorders in pregnant women. Light therapy, limited pharmacotherapy, ECT are included. The goal of this paper is to review current opinions of clinicians and researches concerning possibilities, indications and outcome of psychological treatments as a way to help pregnant women who suffer from different psychiatric conditions, and also because this subject is not yet present in Polish psychiatric journals.

Trends in Psychiatry and Psychotherapy, 2012

INTRODUCTION: Pregnancy has been shown to increase women’s vulnerability to mental disorders. Common mental disorders (CMDs) have been studied both in the general population and in pregnant vs. non-pregnant women. During pregnancy, CMDs have been considered a potential predictor of obstetric and infant outcomes. METHODS: A search was conducted on the PubMed/MEDLINE, LILACS, and SciELO databases to find relevant articles written in English, Spanish, and Portuguese. No limit was established for year of publication, but only studies involving human beings were included. RESULTS: A total of 25 articles were selected. There was a consensus among studies that the mean prevalence of CMD during pregnancy is 20%. There was also agreement that the occurrence of CMDs during pregnancy is a predictor of postpartum depression and anxiety disorders and that the disorder remains underdiagnosed and undertreated. As for the positive association between CMDs and obstetric and infant complication...

Progress in Neurology and Psychiatry, 2008

It is increasingly recognised that many women with psychotic disorders have children 1,2 and that pregnancies of these women are high-risk. Psychotic disorders increase the risk of stillbir th and infant mortality 3 and can affect a woman's ability to care for herself and her infant. Although women with psychoses are less fertile than the general population, 5 partly as a result of hyperprolactinaemia secondary to antipsychotic drugs, the increasing use of newer atypical drugs such as clozapine and olanzapine, which do not have this effect, is likely to lead to a rise in fertility, particularly in women with affective psychosis. Women come into contact with many healthcare professionals during pregnancy and there are therefore many potential opportunities for prevention or attenuation of these risks. The challenge for health workers caring for women who are pregnant is how to ensure mental health problems are recognised and adequately treated. The NICE guideline on antenatal and postnatal mental health (2007) 6 recommends that at a women's first contact with services in the antenatal period, healthcare professionals should ask about past or present severe mental illness, previous treatment by a psychiatrist/specialist mental health team, including inpatient care, and a family history of perinatal mental illness.

Lancet, 2014

Mental disorders are among the most common morbidities of pregnancy and the postnatal period, and can have adverse effects on the mother, her child, and family. This Series paper summarises the evidence about epidemiology, risk factors, identification, and interventions for non-psychotic mental disorders. Although the phenomenology and risk factors for perinatal mental disorders are largely similar to those for the disorders at other times, treatment considerations differ during pregnancy and breastfeeding. Most randomised controlled trials have examined psychosocial and psychological interventions for postnatal depression, with evidence for effectiveness in treating and preventing the disorder. Few high-quality studies exist on the effectiveness or safety of pharmacological treatments in the perinatal period, despite quite high prescription rates. General principles of prescribing of drugs in the perinatal period are provided, but individual risk-benefit analyses are needed for dec...

2000

Debates em Psiquiatria

Introduction: Emergencies in the pregnancy and postpartum are less frequent than in other groups, but not uncommon. However, the literature on the subject is scarce and controversial. Objective: The objective of this article is to present some recommendations for the management of the most common psychiatric emergencies that may occur in pregnancy or postpartum period. Method: These procedures were focused on the discussion and integration of the findings from peer-reviewed published research on the topic. We searched electronic database PubMed. Relevant abstracts were identified using the following search terms: Psychotropics medications at pregnancy and breastfeeding: (((psychotropic medications) AND (pregnancy)) OR (psychotropic medications)) AND (breastfeeding) - Psychiatric emergencies: (((((((psychiatric emergencies) AND (pregnancy)) OR (psychiatric emergencies)) AND (postpartum)) OR (psychiatric emergencies)) AND (peripartum)) OR (psychiatric emergencies)) AND (breastfeeding)...