The detection and treatment of psychiatric disorders and substance use among pregnant women cared for in obstetrics
The detection and treatment of psychiatric disorders and substance use among pregnant women cared for in obstetrics
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DOI：
10.1176/appi.ajp.158.2.213
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发表时间：
2001-02-01
影响因子：
17.7
通讯作者：
Anders, TF
中科院分区：
文献类型：
--
作者：
Kelly, RH;Zatzick, DF;Anders, TF
目的：本次调查评估的检测和治疗的精神疾病和危险物质的使用孕妇在产科sector.Method：初级保健评估的精神疾病患者健康问卷和修改后的CAGE问卷被用来评估目前的精神疾病和危险物质的使用之间的186名妇女接受产前护理。对医疗记录进行了审查，以寻找产科提供者认识到精神病和药物使用症状和诊断以及开始评估和治疗的证据。患者的特点和图表记录的评价和治疗之间的关联是determined.Results：七十（38%）的妇女符合精神疾病或物质使用的筛选标准。在筛查呈阳性的妇女中，43%的病例记录了症状，18%的病例记录了诊断，35%的病例记录了评估，23%的病例记录了治疗。精神疾病和/或物质使用筛查呈阳性的患者，如果他们受教育程度较低，产前护理不足，或分娩时住院时间较长，则更有可能进行有记录的心理健康评估。在产科接受治疗的妇女中，有相当多的人患有未得到承认和治疗的精神疾病和使用药物。鉴于产前精神障碍对母婴结局的潜在影响，需要进一步调查产科对孕妇的精神评估和治疗。
Objective: This investigation assessed the detection and treatment of psychiatric disorders and at-risk substance use among pregnant women in the obstetric sector.Method: The Primary Care Evaluation of Mental Disorders Patient Health Questionnaire and modified CAGE questionnaires were used to assess current psychiatric disorders and at-risk substance use among 186 women receiving prenatal care. Medical records were reviewed for evidence of obstetrical providers' recognition of psychiatric and substance use symptoms and diagnoses and initiation of evaluations and treatments. The associations between patient characteristics and chart-documented evaluations and treatments were ascertained.Results: Seventy (38%) of the women met screening criteria for psychiatric disorders or substance use. Among women who screened positive, symptoms were recorded in 43% of the charts, diagnoses in 18%, evaluations in 35%, and treatments in only 23% Patients who screened positive for psychiatric disorders and/or substance use were significantly more likely to have a documented mental health evaluation if they were less well educated, had inadequate prenatal care, or had longer hospital stays at delivery.Conclusions: A substantial number of women treated in obstetrics have unrecognized and untreated psychiatric disorders and substance use. Given the potential impact of antenatal mental disturbances on maternal and infant outcomes, further investigations into the psychiatric evaluation and treatment of pregnant women in the obstetrical sector are required.