Short-Term Outcomes of Mothers and Newborn Infants with Comorbid Psychiatric Disorders and Drug Dependency

Abstract

Psychiatric comorbidity, especially depression, is common and affects almost half of drug-using mothers. Antenatal care, drug use and social outcomes are worse for DD mothers and their infants. It is recommended that all drug-using women be assessed antenatally for psychosocial disorders so that timely mental health intervention can be offered, if required.

Psychiatric Co-Morbidities in Pregnant Women with Opioid Use Disorders: Prevalence, Impact, and Implications for Treatment

“…Using a cross-sectional study, Steer and Schut compared the rate of mood disorders between pregnant women with OUD and nonpregnant women with OUD, but did not find a significant difference in prevalence rates between the two groups. One study (Oei et al 2009) found that pregnant women with OUD and poly-substance use were more likely to have comorbid psychiatric disorders than pregnant women with OUD but without poly-substance use, and rates of nicotine use were not statistically significantly different between the two groups (83.6 vs. 81.3%, p  = 0.42) [21]. Chisolm et al and Eggleston et al found that pregnant women with SUD who smoked cigarettes were more likely to have comorbid psychiatric disorders than nonsmoking pregnant women with SUD (although almost 90% of the study sample smoked cigarettes) [22••].…”

“…Four studies found no differences in the drug and alcohol use domains between pregnant women with and without psychiatric comorbidities, suggesting that substance use disorder severity is comparable between participants with and without psychiatric comorbidity [15, 16••, 21, 30]. It should be noted that part of what is being seen in the lack of severity in the SUD domain relates to a relative ceiling effect seen in patients with OUD where they are all so severe that it is difficult to find differences in this domain.…”

“…However, it is difficult to have confidence in these results due to several design flaws in the studies including small sample sizes ranging from 78 to 174, use of different instruments to diagnose the comorbid diagnosis, variable time courses, and assessed adherence by different measures. Also, two of the studies did not have treatment adherence as the primary goal of the study, which is of significant concern [21]. …”

Reasons for Rehospitalization in Children Who Had Neonatal Abstinence Syndrome

“…31,32 The association between maternal substance use and child maltreatment is not new. Mothers who use drugs sometimes have poor parenting and coping skills, 33 psychiatric comorbidities 34 and insufficient social support, which amalgamate to exacerbate parenting stress, poor attachment, 35 and vulnerability for child harm, particularly if the infant is discharged early from medical care before resolution of NAS (leading to an irascible and difficult infant). Our results show that NAS increases the risk of hospitalization for child maltreatment or trauma even when prematurity is taken into account.…”

Intercepting the intergenerational cycle of maternal trauma and loss through mother–infant psychotherapy: A case study using attachment-derived methods

“…Post traumatic stress disorder (PTSD) (Lara et al, 2009) and depressive disorder (Fraser, Harris-Britt, Thakkallapalli, Kurtz-Costes, & Martin, 2010;Oei, et al, 2009) are common. Moreover, the lifestyle of illegal drug abusers is particularly dangerous and violent, and these women are often victims of relational violence and face untimely deaths (Kahila, Gissler, Sarkola, Autti-Rämö, & Halmesmäki, 2010;Nair, Schuler, Black, Kettinger, & Harrington, 2003).…”