Reproductive Decision-Making Capacity in Women With Psychiatric Illness: A Systematic Review

Ross, Nina; Webster, Tinsley G.; Tastenhoye, Camille; Hauspurg, Alisse; Foust, Jill; Gopalan, Priya; Friedman, Susan Hatters

doi:10.1016/j.jaclp.2021.08.007

Cited by 8 publications

(7 citation statements)

References 30 publications

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“…Debido a su rareza, no existen recomendaciones formales sobre el momento del parto en pacientes con negación psicótica del embarazo. Existen indicaciones psiquiátricas para la inducción del parto, una de las cuales incluye psicosis no controlada (13). Algunos autores sugieren que esperar hasta una edad de gestación posterior a las 39 semanas aumenta el riesgo de autolesiones, parto extrahospitalario y neonaticidio (14).…”

Section: Discussionunclassified

Negación psicótica del embarazo. Reporte de caso

Reyna-Villasmil

2024

RSOGV

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Denial of pregnancy is a rare, potentially dangerous disorder that can be divided into two variants: psychotic and nonpsychotic. Psychotic denial of pregnancy is typically accompanied by a history of mental illness. Negative effects include psychological distress, unsupported births outside of hospital, and a potential rise in mother and newborn morbi-mortality. It is crucial to include a personal and/or family history of psychopathology as part of the anamnesis because this condition should be treated by a psychiatrist. Regarding the management of this disorder during pregnancy or puerperium, there are no specific recommendations. To provide comprehensive care, a multidisciplinary approach is typically required. A case of psychotic denial of pregnancy is presented. Keywords: Psychotic denial of pregnancy, Pregnancy denial, Mental illness, Psychiatry, Mental health.

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Section: Discussionunclassified

Negación psicótica del embarazo. Reporte de caso

Reyna-Villasmil

2024

RSOGV

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“…Careful history taking and early intervention [26] Early phases of disorder Negative influence of hyperprolactinemia on cognition Screening, prevention, and monitoring of hyperprolactinemia [27,28] Sexual dysfunction Sexual health interventions [29] Abortion and sexual violence Psychoeducation, family planning [30][31][32][33][34][35] Sexual and reproductive health…”

Section: Prodromal Signs Of Psychosis Differ Between Men and Womenmentioning

confidence: 99%

“…High prolactin levels reduce fertility. Yu and collaborators [29] asked about reproductive concerns in 15 women with schizophrenia (age [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. The women's main concerns were psychological barriers to reproduction such as discouragement by their partners and by medical/psychiatric staff.…”

Section: Reproductive Health At the Early Stages Of Illnessmentioning

confidence: 99%

“…Because women with schizophrenia show low rates of sexual satisfaction and high rates of both sexual dysfunction and sexual coercion [34], sexual health interventions are particularly recommended for women. A systematic review and meta-analysis that included 10 observational studies of 3,570 patients, 1,161 of whom suffered from schizophrenia [35], found statistically significant correlations between schizophrenia and sexual dysfunction in both men and women and advocated for psychological as well as pharmacological (prolactin-lowering) interventions. Therapeutic conversations about sex need to be attuned to age, and cultural context, to intimate partner status, and to the different needs and potential risks of sexual activity in men and women.…”

Section: Reproductive Health At the Early Stages Of Illnessmentioning

confidence: 99%

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Improving treatment of women with schizophrenia: a review of the recent literature

González-Rodríguez,

Cobo,

Seeman

2023

Exploration of Medicine

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Effective clinical management of women with schizophrenia is therapeutically challenging. While there have been recent advances in the understanding of neurobiological, hormonal, and female reproductive cycle factors that play a decisive role in the development and progression of schizophrenia in women, this knowledge has not yet been fully translated into treatment practice. The aim was to apply the best evidence available to optimally treat women with schizophrenia at various periods of the lifespan. A narrative review was conducted of recent advances (2018–2023) in aspects of schizophrenia in women that demand sex-specific treatment. Sex steroids impact antipsychotic absorption, distribution, metabolism, elimination, passage through the blood-brain barrier, and blood flow rate to the brain. For these reasons, premenopausal women with schizophrenia, as compared to male age peers, require lower doses of most antipsychotic drugs and suffer comparatively more adverse events (metabolic, sexual, and cardiovascular) at similar doses. Apart from pharmacologic treatment, women have specific reproductive planning needs and need protection from sexual exploitation and domestic abuse. In addition, when pregnant, schizophrenia women show a high risk of gestational diabetes and pre-eclampsia/eclampsia that requires prevention. Prevention is also needed against long-term health hazards for their offspring. Another period of therapeutic challenge specific to women is menopause. The collected evidence points to women-specific recommendations for both biological and psychosocial treatment strategies for schizophrenia.

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“…Most patients with psychiatric illnesses have decision-making capacity regarding reproductive issues. 22 Although EC is supported by the American Academy of Pediatrics, 7 patients age <18 have varying rights to consent across states, 21 and merit special consideration.…”

Section: Emergency Contraception For Special Populationsmentioning

confidence: 99%

Emergency contraception for psychiatric patients

Makino¹

2022

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M s. A, age 22, is a college student who presents for an initial psychiatric evaluation. Her body mass index (BMI) is 20 (normal range: 18.5 to 24.9), and her medical history is positive only for childhood asthma. She has been treated for major depressive disorder with venlafaxine by her previous psychiatrist. While this antidepressant has been effective for some symptoms, she has experienced adverse effects and is interested in a different medication. During the evaluation, Ms. A remarks that she had a "scare" last night when the condom broke while having sex with her boyfriend. She says that she is interested in having children at some point, but not at present; she is concerned that getting pregnant now would cause her depression to "spiral out of control."Unwanted or mistimed pregnancies account for 45% of all pregnancies. 1 While there are ramifications for any unintended pregnancy, the risks for patients with mental illness are greater and include potential adverse effects on the neonate from both psychiatric disease and psychiatric medication use, worse obstetrical outcomes for patients with untreated mental illness, and worsening of psychiatric symptoms and suicide risk in the peripartum period. 2 These risks become even more pronounced when psychiatric medications are reflexively discontinued or reduced in pregnancy, which is commonly done contrary to best practice recommendations. In the United States, the recent Supreme Court decision in Dobbs v Jackson Women's Health Organization has erased federal protections for abortion previously conferred by Roe v Wade. As a result, as of early October 2022, abortion had been made illegal in 11 states, and was likely to be banned in many others, most commonly in states where there is limited support for either parents or children. Thus, preventing unplanned pregnancies should be a treatment consideration for all medical disciplines. 3 for psychiatric patients

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Reproductive Decision-Making Capacity in Women With Psychiatric Illness: A Systematic Review

Cited by 8 publications

References 30 publications

Negación psicótica del embarazo. Reporte de caso

Negación psicótica del embarazo. Reporte de caso

Improving treatment of women with schizophrenia: a review of the recent literature

Emergency contraception for psychiatric patients

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