scholarly journals Use of Prescribed Psychotropics during Pregnancy: A Systematic Review of Pregnancy, Neonatal, and Childhood Outcomes

2019 ◽  
Vol 9 (9) ◽  
pp. 235 ◽  
Author(s):  
Creeley ◽  
Denton

This paper reviews the findings from preclinical animal and human clinical research investigating maternal/fetal, neonatal, and child neurodevelopmental outcomes following prenatal exposure to psychotropic drugs. Evidence for the risks associated with prenatal exposure was examined, including teratogenicity, neurodevelopmental effects, neonatal toxicity, and long-term neurobehavioral consequences (i.e., behavioral teratogenicity). We conducted a comprehensive review of the recent results and conclusions of original research and reviews, respectively, which have investigated the short- and long-term impact of drugs commonly prescribed to pregnant women for psychological disorders, including mood, anxiety, and sleep disorders. Because mental illness in the mother is not a benign event, and may itself pose significant risks to both mother and child, simply discontinuing or avoiding medication use during pregnancy may not be possible. Therefore, prenatal exposure to psychotropic drugs is a major public health concern. Decisions regarding drug choice, dose, and duration should be made carefully, by balancing severity, chronicity, and co-morbidity of the mental illness, disorder, or condition against the potential risk for adverse outcomes due to drug exposure. Globally, maternal mental health problems are considered as a major public health challenge, which requires a stronger focus on mental health services that will benefit both mother and child. More preclinical and clinical research is needed in order to make well-informed decisions, understanding the risks associated with the use of psychotropic medications during pregnancy.

2009 ◽  
Vol 18 (2) ◽  
pp. 107-113 ◽  
Author(s):  
Hélène Verdoux ◽  
Marie Tournier ◽  
Bernard Bégaud

SummaryBackground– As a large number of persons are exposed to prescribed psychotropic drugs, their utilisation and impact should be further explored at the population level.Aims– To illustrate the interest of pharmacoepidemiological studies of psychotropic drugs by selected examples of major public health issues.Method– Selective review of the literature. Results – Many questions remain unsolved regarding the behavioural teratogenicity of prenatal exposure to psychotropic drugs, the impact of their increasing use in children, the long-term cognitive consequences of exposure to benzodiazepines, and the risks associated with extension of indications of antipsychotic drugs.Conclusion– Pharmacoepidemiological studies need to be further developed owing to the large number of public health questions raised by the extensive and expanding use of psychotropic drugs.


2019 ◽  
Vol 28 (12) ◽  
pp. 788-791
Author(s):  
Bethany Rose

Female genital mutilation (FGM) is any process that injures or removes part or all of the external female genital organs for non-medical reasons. FGM is a growing public health concern in the UK because of an increase in migration from countries where it is widely practised. Education on FGM for nurses is key to supporting women who have undergone the practice, as well as safeguarding girls and women who are at risk. Nurses must understand the history and culture of FGM as well as the long-term health complications to be able to support affected women both professionally and sensitively.


2018 ◽  
Vol 63 (7) ◽  
pp. 492-500 ◽  
Author(s):  
David Rudoler ◽  
Claire de Oliveira ◽  
Binu Jacob ◽  
Melonie Hopkins ◽  
Paul Kurdyak

Objective: The objective of this article was to conduct a cost analysis comparing the costs of a supportive housing intervention to inpatient care for clients with severe mental illness who were designated alternative-level care while inpatient at the Centre for Addiction and Mental Health in Toronto. The intervention, called the High Support Housing Initiative, was implemented in 2013 through a collaboration between 15 agencies in the Toronto area. Method: The perspective of this cost analysis was that of the Ontario Ministry of Health and Long-Term Care. We compared the cost of inpatient mental health care to high-support housing. Cost data were derived from a variety of sources, including health administrative data, expenditures reported by housing providers, and document analysis. Results: The High Support Housing Initiative was cost saving relative to inpatient care. The average cost savings per diem were between $140 and $160. This amounts to an annual cost savings of approximately $51,000 to $58,000. When tested through sensitivity analysis, the intervention remained cost saving in most scenarios; however, the result was highly sensitive to health system costs for clients of the High Support Housing Initiative program. Conclusions: This study suggests the High Support Housing Initiative is potentially cost saving relative to inpatient hospitalization at the Centre for Addiction and Mental Health.


2020 ◽  
Vol 4 ◽  
Author(s):  
Deborah Toner ◽  
Clare Anderson ◽  
Shammane Joseph Jackson

This paper examines discussions among physicians, psychologists, public health officials, religious leaders and others who participated in the Caribbean Conferences on Mental Health between 1957 and 1969. Their discussions demonstrate major changes in the understanding of causes, definitions and appropriate treatments of mental health conditions, compared to the late nineteenth century, which saw a wave of major reforms to the management of mental illness in public asylums. Although major shifts in professional understandings of mental health were evident in the mid-twentieth century, the Caribbean Conferences on Mental Health reveal that the problems hindering the implementation of these new approaches were largely similar to those that Guyana and other Caribbean countries continue to face today.


2021 ◽  
Author(s):  
Rochelle Ann Burgess ◽  
Nancy Kanu ◽  
Tanya Matthews ◽  
Owen Mukotekwa ◽  
Amina Smith-Gul ◽  
...  

Within high-income-countries, the COVID-19 pandemic has disproportionately impacted people from racially minoritised backgrounds. There has been significant research interrogating the disparate impact of the virus, and recently, interest in the long-term implications of the global crisis on young people’s mental health and wellbeing. However, less work explores the experiences of young people from racialised backgrounds as they navigate the pandemic, and the specific consequences this has for their mental health. Forty young people (age 16-25) from black, mixed and other minority backgrounds and living in London, participated in consecutive focus group discussions over a two-month period, to explore the impact of the pandemic on their lives and emotional wellbeing. Thematic analysis identified seven categories describing the impact of the pandemic, indicating: deepening of existing socioeconomic and emotional challenges; efforts to navigate racism and difference within the response; and survival strategies drawing on communal and individual resources. Young people also articulated visions for a future public health response which addressed gaps in current strategies. Findings point to the need to contextualize public health responses to the pandemic in line with the lived experiences of racialised young people. We specifically note the importance of long-term culturally and socio-politically relevant support interventions. Implications for policy and practice are discussed


Author(s):  
Osizwe Raena Jamila Harwell

Chapter two provides an in-depth discussion of Bebe Moore Campbell’s activism as a mental health advocate from 1999-2006 based on interviews with colleagues, family, and friends. It narrates her personal struggle with a daughter who is bipolar and the proactive stance that she took to cope with this difficulty. The chapter reveals how her involvement in the National Alliance on Mental Illness (NAMI), her role as a national spokesperson, and her local activism sparked the birth of the NAMI-Urban LA chapter, serving black and Latino communities. Campbell and a group of black women concerned about their children with mental illness effectively addressed the practical needs of families of color by challenging stigma, lobbying for social policies, and providing information, support, and resources both locally and on a national stage. Considering gendered racial communities as the resource and landscape for much of Campbell’s work, it appears that she maintained a broad friendship circle beyond the Black Action Society and NAMI- Urban LA. Exploring this primarily female “embedded friendship network” further evidences Campbell’s commitment to community and family and broadens context of her activism, writing, and life trajectory.


2009 ◽  
Vol 3 (1) ◽  
pp. 33-41 ◽  
Author(s):  
David P. Eisenman ◽  
Qiong Zhou ◽  
Michael Ong ◽  
Steven Asch ◽  
Deborah Glik ◽  
...  

ABSTRACTObjectives: Chronic medical and mental illness and disability increase vulnerability to disasters. National efforts have focused on preparing people with disabilities, and studies find them to be increasingly prepared, but less is known about people with chronic mental and medical illnesses. We examined the relation between health status (mental health, perceived general health, and disability) and disaster preparedness (home disaster supplies and family communication plan).Methods: A random-digit-dial telephone survey of the Los Angeles County population was conducted October 2004 to January 2005 in 6 languages. Separate multivariate regressions modeled determinants of disaster preparedness, adjusting for sociodemographic covariates then sociodemographic variables and health status variables.Results: Only 40.7% of people who rated their health as fair/poor have disaster supplies compared with 53.1% of those who rate their health as excellent (P < 0.001). Only 34.8% of people who rated their health as fair/poor have an emergency plan compared with 44.8% of those who rate their health as excellent (P < 0.01). Only 29.5% of people who have a serious mental illness have disaster supplies compared with 49.2% of those who do not have a serious mental illness (P < 0.001). People with fair/poor health remained less likely to have disaster supplies (adjusted odds ratio [AOR] 0.69, 95% confidence interval [CI] 0.50–0.96) and less likely to have an emergency plan (AOR 0.68, 95% CI 0.51–0.92) compared with those who rate their health as excellent, after adjusting for the sociodemographic covariates. People with serious mental illness remained less likely to have disaster supplies after adjusting for the sociodemographic covariates (AOR 0.67, 95% CI 0.48–0.93). Disability status was not associated with lower rates of disaster supplies or emergency communication plans in bivariate or multivariate analyses. Finally, adjusting for the sociodemographic and other health variables, people with fair/poor health remained less likely to have an emergency plan (AOR 0.66, 95% CI 0.48–0.92) and people with serious mental illness remained less likely to have disaster supplies (AOR 0.67, 95% CI 0.47–0.95).Conclusions: People who report fair/poor general health and probable serious mental illness are less likely to report household disaster preparedness and an emergency communication plan. Our results could add to our understanding of why people with preexisting health problems suffer disproportionately from disasters. Public health may consider collaborating with community partners and health services providers to improve preparedness among people with chronic illness and people who are mentally ill. (Disaster Med Public Health Preparedness. 2009;3:33–41)


Author(s):  
Anna M. Ross ◽  
Bridget Bassilios

Abstract Background Suicide is a major public health concern and has been recognised as a public health priority. R U OK?Day aims to prevent suicide by encouraging and empowering Australians to reach out to friends and family who might be experiencing personal difficulties. This study aims to update the evaluation of the public awareness campaign ‘R U OK?Day’ that was conducted using 2014 data. Methods Data from 2013 participants were collected via an online survey following the R U OK?Day campaign implemented in 2017. Outcome measures included campaign awareness and participation, past 12-month help-seeking, helping beliefs, helping intentions and helping behaviours. Data were analysed using z-tests, Chi square and regression analyses in SPSS. Results Both campaign awareness and participation have increased since 2014, from 66% and 19% to 78% and 32%. Campaign exposure was associated with stronger beliefs in the importance and the ease of asking “Are you okay?”, and increased the likelihood of intentions to use recommended helping actions by two to three times compared to those not exposed to the campaign. Participants who were exposed to the R U OK?Day campaign were up to six times more likely to reach out to someone who might be experiencing personal difficulties compared to those not exposed to the campaign. Interestingly, those who had sought help from a mental health professional in the past 12 months were more likely to be aware of, and participate in, the campaign, suggesting people experiencing mental health issues recognise the value of seeking—and giving—social support. Conclusions The R U OK?Day campaign continues to be relevant and effective in spreading key messages about the importance of reaching out to others and empowering members of the community to have conversations about life problems. The campaign’s impact is increasing over time through increased campaign awareness and participation, and improving helping beliefs, intentions and behaviours. Ongoing monitoring and evaluation of the campaign’s impact is vital and may inform potential changes needed to further enhance its impact.


1993 ◽  
Vol 17 (2) ◽  
pp. 82-83
Author(s):  
John Barnes ◽  
Greg Wilkinson

Much of the medical care of the long-term mentally ill falls to the general practitioner (Wilkinson et al, 1985) and, for example, a survey in Buckinghamshire showed that these patients consult their general practitioner (GP) twice as often as mental health services. Lodging house dwellers are known to show an increased prevalence of major mental illness and to suffer much secondary social handicap, presenting a challenge to helping services of all disciplines. For this reason we chose a lodging house in which to explore further the relationships between mental illness and residents' present contact with their GP, mental health services and other local sources of help.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
R Rodrigues ◽  
K Nicholson ◽  
P Wilk ◽  
G Guaiana ◽  
S Stranges ◽  
...  

Abstract Background Global studies have demonstrated consistent associations between sleep problems and mental health and well-being in older adults, however Canadian data are lacking. We investigated associations between sleep quantity and quality with both mental illness symptoms and well-being among older adults in Canada. Methods We used cross-sectional baseline data from the Canadian Longitudinal Study on Aging, a national survey of 30,097 community-dwelling adults aged 45 years and older. Self-reported sleep measures included average past-week sleep duration (short [&lt;6h], normal [6-8h], long [&gt;8h]), and sleep quality (satisfied or dissatisfied vs neutral). Mental illness outcomes included depressive symptoms and psychological distress. Mental well-being outcomes included self-rated mental health and satisfaction with life. We used modified Poisson regression models with adjustment for sociodemographic, behavioural, and clinical factors, and stratification by sex and age to explore effect modification. Results In the unadjusted analysis, short and long sleep duration and sleep dissatisfaction were associated with higher mental illness symptoms and lower well-being across all outcomes. Sleep satisfaction was associated with a lower likelihood of mental illness symptoms and better well-being. Short sleep duration was associated with the largest effects on mental health outcomes. Self-rated mental health and depressive symptoms had the largest associations with sleep measures. Effects were larger in males and the 45 to 54 year age group. Conclusions Preliminary evidence suggests sleep duration and quality are associated with symptoms of depression, psychological distress, and poor mental well-being among older adults. We are unable to determine whether sleep problems are a cause or consequence of poor mental health. Nonetheless, sleep may be an important target for public health initiatives to improve mental health and well-being among older adults. Key messages Our findings contribute further evidence that sleep difficulties are associated with adverse health outcomes including higher mental illness symptoms and lower well-being among older adults. Sleep disturbances are an unmet public health problem, and may be an important target for public health initiatives to improve mental health and well-being among older adults.


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