2002 International International Biennial Scientific Meeting

A CHART REVIEW STUDY TO INVESTIGATE THE CLINICAL CHARACTERISTICS OF PERINATAL PSYCHIATRIC PATIENTS

Cynthia L Battle, Caron Zlotnick, Margaret Howard, and Teri B Pearlstein

Brown University, Rhode Island, USA

Cynthia_Battle@brown.edu

Objectives: This retrospective chart review study seeks to describe the clinical and psychosocial characteristics of pregnant and postpartum women presenting for psychiatric treatment, in order to better understand this population and assist in the development of treatment options.

Methods: Participants are pregnant and postpartum women who received psychiatric services at two treatment locations affiliated with Brown University School of Medicine. In addition to the Edinburgh Postnatal Depression Scale collected at intake, 2 reviewers used a Case Record Form to record relevant data regarding demographics, clinical diagnoses, psychiatric history, treatment administered, and discharge information.

Results: Approximately 500 records will ultimately be reviewed. Based on our existing sample, the majority of women seeking psychiatric services during pregnancy and postpartum (over 80%) were diagnosed with Major Depressive Disorder. Roughly 1/3 also carry a co-morbid Axis I diagnosis, typically substance abuse or an anxiety disorder. Many reported a prior history of mental health and/or substance abuse problems; however, for about 30% of these women, this is their first contact with the mental health system. Consistent with prior research, this study found that family problems are very common among childbearing women seeking psychiatric services. Three-fourths of women reported problems in their current family system, most commonly lack of emotional and instrumental support from the partner. Although many women (74%) were open to pharmacologic treatment, a sizable percentage of pregnant women and postpartum breastfeeding women are not comfortable taking medications.

Preliminary conclusions and treatment implications: Current family problems should be carefully assessed and, when appropriate, targeted during treatment. Axis I disorders often co-morbid with MDD, such as substance abuse and anxiety, should also be carefully assessed and treated. Because many pregnant and breastfeeding women are reluctant to use pharmacologic treatments, a wider range of empirically-supported psychosocial treatments should be developed and made available for this population.