1 Background of History of Perinatal Psychiatry 2 Perinatal Mood and Anxiety Disorders (PMADs): Overview and Etiology 3 Approach to Perinatal Psychiatry - General strategies 4 The Perinatal Psychiatric Interview 5 Risk of untreated symptoms of PMADs in pregnancy 6 Risk of medication exposures in pregnancy and lactation 7 Special considerations: a. Adolescent pregnancy b. Hyperemesis Gravidum c. Grief and loss 8 Anxious patients 9 Depressed patients 10 Manic patients 11 Psychotic patients 12 Substance use disorders in pregnancy and lactation 13 Eating disorders in pregnancy and lactation 14 Trauma disorders in pregnancy and lactation 15 Psychotherapy treatment options for PMADs 16 Care of the suicidal patient in pregnancy or during the postpartum period 17 Care of the homicidal patient in pregnancy or during the postpartum period - managing intrusive thoughts; special considerations for OCD 18 Documentation considerations 19 Importance of collaborative care with OBGYN and Pediatrics
Elizabeth Cox, MD
The University of North Carolina at Chapel Hill
Department of Psychiatry
Center for Women's Mood Disorders
Chapel Hill, NC 27514
This text provides background on the history of perinatal psychiatry, and discusses future directions in the field. It clearly defines perinatal mood and anxiety disorders (PMADs), which are the most common complication of pregnancy. When left untreated, PMADs are morbid and devastating for both the patient and their entire family. It reviews gold standard recommendations for the treatment of PMADs, including evidence-based psychotherapies, as well as risk-benefit analysis of psychotropic medication use in pregnancy and lactation. Additionally, common presentations of depression, anxiety, and trauma in pregnancy and postpartum women, as well as mania, psychosis, suicidal and homicidal thoughts are reviewed.
Women’s Mood Disorders: A Clinician’s Guide to Perinatal Psychiatry highlights special considerations in pregnancy, including teenage pregnancies, hyperemesis gravidum, eating disorders, substance abuse disorders, as well as infertility, miscarriage and loss. The text concludes with outlining the importance of collaborative care in providing gold standard treatment of perinatal women and review documentation and legal considerations. This handbook will help educate and train future psychiatrists and OBGYNs in feeling confident and comfortable assessing and treating pregnant women who suffer from PMADs.