Elsevier

Neurologic Clinics

Volume 22, Issue 4, November 2004, Pages 863-893
Neurologic Clinics

Psychiatric disorders in pregnancy

https://doi.org/10.1016/j.ncl.2004.07.003Get rights and content

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Incidence and course of psychiatric illness in pregnancy

Historically, pregnancy has been perceived as a time of emotional well-being. There is limited data, however, to support such a contention. There are few investigations of the incidence or prevalence of psychiatric illnesses during pregnancy. There are even fewer studies that have looked at the course of pre-existing psychiatric illness across pregnancy. Although depression has received the most investigative attention, it is not the most common psychiatric illness in women.

Treatment options

The overlap in the potential treatment options for various psychiatric illnesses during pregnancy and lactation warrant their discussion by category rather than by illness. There are limited studies of the efficacy of any specific treatment during pregnancy, as the literature focuses on the reproductive safety of such treatments. There is no data to suggest that a treatment is less effective in pregnancy than in nongravid conditions.

Summary

This review, although not exhaustive, provides information on the potential impact of psychiatric illness on obstetric outcome. There is clear evidence that psychiatric illness poses a risk to pregnancy outcome. The reproductive safety data on many of the available treatments fail to demonstrate a clear risk from treatment. The medications with clear teratogenic, neonatal, and developmental risks are, not surprisingly, those used to treat some of the most severe and debilitating psychiatric

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