Affiliation:
1. Baylor College of Medicine, Houston, Texas, United States
2. University of North Carolina at Greensboro, Greensboro, North Carolina, United States
3. Texas Tech University Health Science Center, Amarillo, TX, United States
Abstract
Background:
Adolescent pregnancy is a major public health concern with medical,
psychiatric, and social implications. Within this population, there is an elevated rate of
co-occurring psychiatric conditions including mood disorders, anxiety disorders, suicidality,
and substance use. However, little is known about the assessment and treatment of adolescent
pregnancy within the context of these co-occurring psychiatric conditions, particularly
in an emergency situation.
Objective:
This article utilizes a case report to illustrate the challenges faced in consultative
psychiatry in the assessment and treatment of a pregnant suicidal youth with a complex psychosocial
history. Topics addressed include: 1) The role of childhood trauma and suicidality
in adolescent pregnancy 2) A consideration of the risks and benefits of treating adolescents
with psychotropics during pregnancy.
Method:
A literature search was performed with the key words of adolescent, pregnancy,
child sexual abuse and psychiatric illness. In addition, expert opinions of a reproductive psychiatrist
and a psychiatrist who had specialized in addiction and adolescents were enlisted on
key aspects of the case formulation and treatment.
Results:
Several studies were found that focused on depression, substance abuse and trauma
in adolescent pregnancy. There were more studies that looked at psychopharmacological
treatment in adult pregnant women and a few that focused on adolescents.
Conclusion:
Addressing the crisis of psychiatric illness in adolescent pregnancy requires a
thorough approach in understanding the severity of the illness and the contribution of child
abuse and suicidality. Psychotherapeutic interventions are most certainly always necessary
and beneficial when dealing with this population. Deciding when to start and maintain medication
during pregnancy should be individualized, with considerations of the risks of untreated
illness and of medication exposure.
Publisher
Bentham Science Publishers Ltd.
Subject
Psychiatry and Mental health,Pediatrics, Perinatology, and Child Health
Reference71 articles.
1. Abas M.; Ostrovschi N.V.; Prince M.; Gorceag V.I.; Trigub C.; Oram S.; Risk factors for mental disorders in women survivors of human trafficking: A historical cohort study. BMC Psychiatry 2013,13(1),204
2. Depression and postpartum depression: Resource overview American College of Obstetrics and GynecologyRetrieved January 12, 2017, from
ext-link-type="uri" xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="http://www.acog.org/womenshealth/depression-and-postpartum-depression#resources">http://www.acog.org/womenshealth/depression-and-postpartum-depression#resources2015
3. Aftab A.; Shah A.; Behavioral emergencies: Special considerations in the pregnant patient. Psychiatr Clin North Am 2017,40(3),435-448
4. Anderson E.L.; Reti I.M.; ECT in pregnancy: A review of the literature from 1941 to 2007. Psychosom Med 2009,71,235-242
5. Archer J.; Bower P.; Gilbody S.; Lovell K.; Richards D.; Gask L.; Coventry P.; Collaborative care for depression and anxiety problems. Cochrane Database of Systematic Reviews. Issue 10. Art No 2012,CD006525,pub2
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