Psychiatric disorders in pregnancy

doi:10.1017/CBO9780511544552.021

20 - Psychiatric disorders in pregnancy

from Section 5 - Other disorders

Published online by Cambridge University Press: 19 October 2009

Timothy J. G. Pavy

Edited by

David R. Gambling ,

M. Joanne Douglas and

Robert S. F. McKay

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Timothy J. G. Pavy: Affiliation:
Staff Specialist, Anaesthetist and Head of Department, Department of Anaesthesia and Pain Medicine, King Edward Memorial Hospital, Subiaco, Western Australia
David R. Gambling: Affiliation:
University of California, San Diego
M. Joanne Douglas: Affiliation:
University of British Columbia, Vancouver
Robert S. F. McKay: Affiliation:
University of Kansas

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Summary

Introduction

The peak incidence of affective disorders in women occurs at 23 to 44 years of age, which coincides with the prime child bearing years. Pregnancy and childbirth represent major life stresses, as well as a time of fundamental psychological and social change. The experience of childbirth constitutes a major mental health hazard for women, with an estimated fivefold increase in the appearance of mental illness in the year following childbirth. Women who are pregnant, or have recently given birth, may experience relapses of earlier mental disease or develop a new disorder. Women with psychiatric disorders become pregnant and their psychiatric condition can present management problems at different stages of pregnancy. Less commonly, previously well women may develop a major psychiatric disturbance during or after pregnancy, which may or may not herald a chronic condition. Many of these individuals take medications that have the potential to interact with anesthetic agents and other drugs. These women require considerable tact and skill on the part of their attendants.

The first three years of a consultation-liaison psychiatry service to an obstetric inpatient unit in an Australian hospital had a referral rate of 1.2% of obstetric admissions, totalling 90 consultations over three years. The commonest DSM-III-R psychiatric diagnoses were personality disorders (19%), mood disorders (17%), schizophrenic disorders (15%), and adjustment disorders. Reasons for referral included coping problems, depression, anxiety or fear, and a history of major psychiatric illness.

Obstetric anesthesiologists may have their management skills tested with women who have personality disorders.

Type: Chapter
Information: Obstetric Anesthesia and Uncommon Disorders , pp. 363 - 370

DOI: https://doi.org/10.1017/CBO9780511544552.021 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2008

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