The consistent finding of reduced 'reproductive fitness' in those with non-affective psychoses needs to be incorporated in the genetic epidemiology of these disorders. Despite this reduction in fertility and fecundity, many patients with psychoses are parents. Services need to remain mindful of the special needs of these patients.
To help improve services for parents with psychotic disorders, patients with such disorders in three treatment agencies in Queensland, Australia, were surveyed about whether they were parents, how much contact they had with their offspring, and who provided assistance with child care. Of the 342 individuals with psychotic disorders who participated in the study, 124 were parents. Forty-eight parents in the study had children under age 16, and 20 of these parents (42 percent) had their children living with them. Most parents relied on relatives or friends for assistance with child care. Barriers to child care services identified by parents were inability to pay, lack of local services, and fear of losing custody of children.
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Clinical experience and past research suggest that women with psychotic disorders have special needs when it comes to the provision of family planning and obstetric care. The aim of this study was to examine variables related to these issues in a representative sample of women with psychotic disorders who were in contact with mental health services. Of the 110 women who completed the survey, 65 (59.1%) were mothers. These women had a total of 257 pregnancies and 198 live births. One hundred and thirty-four (52%) of the pregnancies were unplanned and twenty-five percent of these pregnancies ended in termination. This population suffers from a high rate of unwanted pregnancies and reproductive losses. Further research is needed to assess the pre-and peri-conceptual needs of these women in order to optimize outcomes for the mothers and their foetuses.
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