Untreated psychiatric disorder in pregnancy: Weighing the risks

2013 ◽  
Vol 3 (2) ◽  
pp. 83-87 ◽  
Author(s):  
Thea Moore ◽  
Jennifer Pytlarz
Keyword(s):  
Bipolar Disorder ◽  
Mental Illness ◽  
Psychiatric Disorder ◽  
Substance Misuse ◽  
Pregnant Patient ◽  
Medical Guidelines ◽  
Poor Nutrition ◽  
In Pregnancy

Though approximately 15 to 29% of pregnant patients have a psychiatric disorder during pregnancy, only about 5 to 14% seek treatment. Untreated mental illness during pregnancy has been associated with poor nutrition, failure to follow prenatal and medical guidelines, and alcohol or other substance misuse. The risks of untreated mental illness during pregnancy must be carefully evaluated along with the risks posed by medications. This review will evaluate consequences of untreated depression, anxiety, schizophrenia, and bipolar disorder in the pregnant patient.

scholarly journals Is intimate partner violence more common in pregnant women with severe mental illness? A retrospective study

2020 ◽  
Vol 66 (3) ◽  
pp. 225-231 ◽  
Author(s):  
Liana Suparare ◽  
Stuart J Watson ◽  
Ray Binns ◽  
Jacqueline Frayne ◽  
Megan Galbally
Keyword(s):  
Bipolar Disorder ◽  
Mental Illness ◽  
Intimate Partner Violence ◽  
Substance Use ◽  
Pregnant Women ◽  
Partner Violence ◽  
Psychotic Disorders ◽  
Intimate Partner ◽  
Illicit Substance Use ◽  
In Pregnancy

Objective: To examine the risk of past and current experiences of intimate partner violence (IPV) in women with severe mental illness (SMI) in pregnancy. Methods: We examined past and current experiences of IPV in women with SMI in pregnancy. The data of 304 women with SMI including schizophrenia and related psychotic disorders and Bipolar Disorder meeting International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) criteria were extracted from hospital records at King Edward Memorial Hospital, Western Australia. Comparisons were made between our study data and the Australian population data reported by the Australian Bureau of Statistics, which included data on pregnant women in Western Australia. Additional measures included reported demographics, substance use and pregnancy variables. Results: Around 48% of pregnant women with SMI had experienced IPV and were three times the risk when compared with the general pregnant population in Australia. There was no difference in rates of IPV in those women with psychotic disorders when compared with bipolar disorder. Furthermore, the rates of smoking and illicit substance use were significantly higher in pregnant women with SMI who experienced IPV compared with those who have not experienced IPV. Conclusion: These findings suggest women with SMI in pregnancy are at significantly higher risk of having experienced or experiencing IPV. In addition, IPV in pregnant women with SMI may increase the risk of smoking and illicit substance use. Together this suggests that maternity and mental health services should ensure there are both screening and support pathways for IPV that are developed and evaluated specifically for pregnant women with SMI.

scholarly journals Pharmacotherapy in dual diagnosis

2004 ◽  
Vol 10 (6) ◽  
pp. 413-424 ◽  
Author(s):  
Ilana B. Crome ◽  
Tracey Myton
Keyword(s):  
Mental Illness ◽  
Psychiatric Disorder ◽  
Dual Diagnosis ◽  
Pharmacological Treatment ◽  
Substance Misuse ◽  
National Policy ◽  
Evidence Base ◽  
Pharmacological Agents ◽  
The Past ◽  
Available Information

The prevalence of coexisting substance misuse and psychiatric disorder (dual diagnosis, comorbidity) has increased over the past decade, and the indications are that it will continue to rise. There have simultaneously been unprecedented developments in the pharmacological treatment of alcohol, opiate and nicotine misuse. Here we evaluate the evidence on the use of some of these treatments in dual diagnosis (with psychotic, mood and anxiety disorders). The evidence base is limited by the exclusion of mental illness when pharmacological agents for substance misuse are evaluated and vice versa. We set the available information within the context of the psychosocial management of comorbid substance misuse and mental illness, and the framework for service delivery recommended by UK national policy.

scholarly journals Lithium and pregnancy

2000 ◽  
Vol 24 (6) ◽  
pp. 229-231 ◽  
Author(s):  
Kelwyn Williams ◽  
Sarah Oke
Keyword(s):  
Bipolar Disorder ◽  
Mental Illness ◽  
Affective Disorder ◽  
Serious Mental Illness ◽  
Bipolar Affective Disorder ◽  
Unborn Child ◽  
Men And Women ◽  
Child Bearing ◽  
In Pregnancy ◽  
Algorithmic Form

The lifetime prevalence of bipolar affective disorder is approximately 1% in both men and women (Reiger et al, 1998). In women the illness is most prevalent in the child-bearing years (Robins et al, 1984). While lithium for the treatment of bipolar disorder is a cornerstone of modern psychopharmacology (Llewellyn et al, 1998), there are inherent problems in treating this sizeable subgroup of patients, as lithium presents small, but significant, risks to a potential foetus. It is also becoming increasingly obvious that serious mental illness poses a risk to the unborn child. This paper reviews those risks, presents a protocol in algorithmic form for dealing with the prescription of lithium in pregnancy and discusses practical issues pertaining to dosage and lithium monitoring.

scholarly journals MARITAL ADJUSTMENT AMONGST SPOUSE AND PATIENT WITH BIPOLAR DISORDER

2019 ◽  
Vol 3 (8) ◽  
Author(s):  
Dr. Anita Thakur
Keyword(s):  
Bipolar Disorder ◽  
Mental Illness ◽  
Child Care ◽  
Psychiatric Disorder ◽  
Mentally Ill ◽  
Mental Illnesses ◽  
Mixed States ◽  
Marital Functioning ◽  
Age And Gender ◽  
And Gender

Background: Bipolar disorder (BD) is a complex mental disorder which is characterized by episodes of depression/ mania/hypomania/mixed states along with interepisodic phases of remission.  This study is conducted with hope that a better understanding of marital functioning will help to address the needs of both patient and spouse resultantly improving the outcome of marriage and illness. Methods: This study is conducted with 60 married patients with BD along with their spouses and 61 subjects free of any psychiatric disorder. Spouses and controls were age and gender matched.  Results: Less than half of the spouses felt cheated and about one-third of the spouses reported that they felt (to little or some extent) that they should separate from their spouses. About one-fifth (21.7%) of the spouses believed that marriage can be a treatment of mental illnesses and about one-fourth (23.3%) believed that marriage can be a cure from mental illnesses. About one-third (36.7%), of the spouses felt that marriage can help in improving the mental illness. About half of the spouses (45%) also believed that marriage can worsen mental illness. Conclusion: We conclude that when comparisons were made based on the onset of illness prior or after marriage, it was seen that higher proportion of spouse of patients with bipolar disorder who had illness prior to marriage were worried that children may develop mental illness and were not fully satisfied with the child care provided by mentally ill spouse. Keywords: Bipolar disorder (BD), Marriage

Navigating Tx of Bipolar Disorder in Pregnancy

Ob Gyn News ◽  
2005 ◽  
Vol 40 (3) ◽  
pp. 11
Author(s):  
DIANA MAHONEY
Keyword(s):  
Bipolar Disorder ◽  
In Pregnancy

424 Advanced gestational age is a predictor of non-completion of sleep apnea testing in pregnancy

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A168-A168
Author(s):  
Mihaela Bazalakova ◽  
Abigail Wiedmer ◽  
Lauren Rice ◽  
Sakshi Bajaj ◽  
Natalie Jacobson ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Gestational Age ◽  
Retrospective Chart Review ◽  
Pregnant Patient ◽  
Clinic Visit ◽  
Early Screening ◽  
Home Sleep Apnea Testing ◽  
Living Children ◽  
Apnea Testing ◽  
In Pregnancy

Abstract Introduction Sleep apnea is emerging as an important and underdiagnosed comorbidity in pregnancy. Screening, diagnosis, and initiation of therapy are all time-sensitive processes during the dynamic progression of gestation. Completion of referral and testing for sleep apnea during pregnancy requires a significant commitment of time and effort on the part of the pregnant patient. We evaluated for predictors of non-completion of sleep apnea testing within our obstetric-sleep referral pipeline, in an effort to inform and optimize future referrals. Methods We performed a retrospective chart-review of 405 pregnant patient referrals for sleep apnea evaluation at the University of Wisconsin-Madison/UnityPoint sleep apnea pregnancy clinic. We used logistic regression analysis to determine predictors of lack of completion of sleep apnea testing. Results The vast majority of referrals (>95%) were triaged directly to home sleep apnea testing with the Alice PDX portable device, rather than a sleep clinic visit. The overall rate of referral non-completion was 59%. Predictors of non-completion of sleep apnea evaluation in our pregnant population included higher gestational age (GA) at referral (1–12 wks GA: 30%, 13–26 wks GA: 31%, and 27–40 wks GA: 57% non-completers, p=0.006) and multiparity with 1 or more living children (65% non-completers if any living children, compared to 45% non-completers if no living children, p=0.002). Age, race, and transportation were not predictors of failure to complete sleep apnea testing. Conclusion We have identified several predictors of pregnant patients’ failure to complete sleep apnea evaluation with objective home sleep apnea testing after referral from obstetrics. Not surprisingly, higher gestational age emerged as a strong negative predictor of referral completion, with >50% of patients referred in the third trimester not completing sleep apnea testing. Early screening and referral for sleep apnea evaluation in pregnancy should be prioritized, given the time-sensitive nature of diagnosis and therapy initiation, and demonstrated reduced completion of referrals in advanced pregnancy. Support (if any) None

Parsing the effects of comorbid adult ADHD and substance misuse on affective lability in bipolar disorder

2020 ◽  
Vol 266 ◽  
pp. 338-340
Author(s):  
Amir Garakani ◽  
Frank D. Buono ◽  
Kaitlyn Larkin ◽  
Joseph F. Goldberg
Keyword(s):  
Bipolar Disorder ◽  
Adult Adhd ◽  
Substance Misuse ◽  
Affective Lability
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