Access to Pharmacotherapy Amongst Women with Bipolar Disorder during Pregnancy: a Preliminary Study
Department of Psychiatry; Systems and Psychosocial Advances Research Center; Department of Obstetrics and Gynecology; Department of Family Medicine and Community Health
Maternal and Child Health | Mental and Social Health | Mental Disorders | Obstetrics and Gynecology | Psychiatry | Psychiatry and Psychology | Therapeutics | Women's Health
Bipolar disorder among pregnant women has deleterious effects on birth and child outcomes and is currently under-detected, not addressed effectively, or exacerbated through inappropriate treatment. The goal of this study was to identify perspectives of pregnant and postpartum women with bipolar disorder on barriers and facilitators to psychiatric treatment during pregnancy. In-depth interviews were conducted with pregnant and postpartum women who scored > /= 10 on the Edinburgh Postnatal Depression Scale and met DSM-IV criteria for bipolar disorder I, II or not otherwise specified using the Mini International Neuropsychiatric Interview version 5.0. Interviews were transcribed, and resulting data were analyzed using a grounded theory approach to identify barriers and facilitators to bipolar disorder treatment access in pregnancy. Participant identified barriers included perception that psychiatric providers lack training and experience in the treatment of psychiatric illness during pregnancy, are reluctant to treat bipolar disorder among pregnant women, and believe that pharmacotherapy is not needed for psychiatric illness during pregnancy. Facilitators included participants' perception that providers' acknowledge risks associated with untreated or undertreated psychiatric illness during pregnancy and provide psycho-education about the risks, benefits and alternatives to pharmacotherapy. Psychiatric providers are critically important to the treatment of bipolar disorder and need knowledge and skills necessary to provide care during the perinatal period. Advancing psychiatric providers' knowledge/skills may improve access to pharmacotherapy for pregnant women with bipolar disorder.
Bipolar disorder, Medications, Perinatal, Postpartum, Pregnancy, Treatment
DOI of Published Version
Psychiatr Q. 2018 Mar;89(1):183-190. doi: 10.1007/s11126-017-9525-8. Link to article on publisher's site
The Psychiatric quarterly
Byatt, Nancy; Cox, Lucille; Moore Simas, Tiffany A.; Biebel, Kathleen; Sankaran, Padma; Swartz, Holly A.; and Weinreb, Linda, "Access to Pharmacotherapy Amongst Women with Bipolar Disorder during Pregnancy: a Preliminary Study" (2018). Psychiatry Publications and Presentations. 818.