CHALLENGES FOR HEALTHCARE PROVIDERS IN TREATING WOMEN WITH PSYCHIATRIC DISORDERS DURING PREGNANCY

Main Article Content

Adrienne Einarson

Keywords

Pregnancy, antidepressants, mental health, health care providers, stigma

Abstract

There continues to be a stigma surrounding mental illness, which includes women with psychiatric illnesses who become pregnant. In addition, both women and their health care providers often have an increased risk perception surrounding the safety of psychotropic drug use in pregnancy, resulting in physicians hesitant to prescribe and women afraid to take. Consequently, this creates many challenges and barriers when it comes to treating women pharmacologically during pregnancy and lactation.


The treatment of mental illness in the perinatal period is an important clinical decision, as it involves not one but two patients, the mother and her child. With careful evidence-based considerations of the risks and benefits of treatments, as well as other possible co-morbidities, most often it will result in positive outcomes for both patients. The health care provider should discuss these risks and benefits with each individual, while being cognizant of the many outside influences which may affect decision-making by both the clinician and the patient to treat the psychiatric illness during pregnancy.

Abstract 586 | PDF Downloads 414

References

1. http://www.mentalhealthcommission.ca/englis h/pages/default.aspx (Accessed July 15, 2012).
2. Shrivastava A, Johnston M, Bureau Y. Stigma of mental illness-1: Clinical reflections. Mens Sana Monogr 2012 Jan;10(1):70-84.
3. Wallace JE. Mental health and stigma in the medical profession. Health (London). 2012 Jan;16(1):3-18.
4. Kassam A, Papish A, Modgill G, Patten S. The development and psychometric properties of a new scale to measure mental illness related stigma by health care providers: The Opening Minds Scale for Health Care Providers (OMS-HC). BMC Psychiatry 2012 Jun 13;12(1):62.
5. Farley-Toombs C. The stigma of a psychiatric diagnosis: prevalence, implications and nursing interventions in clinical care settings. Crit Care Nurs Clin North Am. 2012 Mar;24(1):149-56
6. Goodman JH. Women's attitudes, preferences and perceived barriers to treatment for perinatal depression. Birth 2009 Mar;36(1):60-9.
7. Gawley L, Einarson A, Bowen A. Stigma and attitudes towards antenatal depression and antidepressant use during pregnancy in healthcare students. Adv Health Sci Educ Theory Pract 2011 Dec; 16(5):669-79.
8. http://www.hc-sc.gc.ca/dhpmps/ medeff/advisoriesavis/ prof/_2005/paxil_4_hpc-cps-eng.php (Accessed July 26, 2012).
9. http://www.hc-sc.gc.ca/ahcasc/ media/advisories-avis/_2006/2006_11- eng.php (Accessed July 26, 2012).
10. Diav-Citrin O, Ornoy A. Selective serotonin reuptake inhibitors in human pregnancy: to treat, or not to treat? Obstet Gynecol Int 2012;2012:698947
11. http://www.fda.gov/Safety/MedWatch/SafetyI nformation/SafetyAlertsforHumanMedicalPro ducts/ucm283696.htm (Accessed July 26, 2012)
12. http://www.pphnlawyers.com/www.lawyersandsettlements.com/case/paxilheart-defects-newborn.html (Accessed July 26, 2012).
13. Mulder E, Davis A, Gawley L, Bowen A, Einarson A. Negative impact of nonevidence- based information received by women taking antidepressants during pregnancy from health care providers and others. Obstet Gynaecol Can Jan 2012; 34(1):66-71.
14. Einarson A, Davis W. PSI conference(abstract) Las Vegas, June 2012