Psychiatric Co-Morbidities in Pregnant Women with Opioid Use Disorders: Prevalence, Impact, and Implications for Treatment.
Psychiatric Co-Morbidities in Pregnant Women with Opioid Use Disorders: Prevalence, Impact, and Implications for Treatment.
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DOI：
10.1007/s40429-017-0132-4
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发表时间：
2017-01-01
影响因子：
4.3
通讯作者：
Allgood, Kacy
中科院分区：
文献类型：
--
作者：
Arnaudo, Camila L;Andraka-Christou, Barbara;Allgood, Kacy
综述目的：本综述旨在探讨三个问题：阿片类药物使用障碍（OUD）孕妇共病精神诊断的患病率是多少？共病性精神疾病如何影响OUD孕妇？同时存在的精神疾病如何影响患有OUD的孕妇坚持并完成OUD治疗的能力？最新发现：根据这篇文献综述，25-33%的OUD孕妇有精神合并症，其中抑郁和焦虑尤为常见。然而，在回顾的17项研究中，只有5项研究将双重诊断的患病率作为主要结局指标，它们的N值通常很小，确定精神病学诊断的方法是可变的，并且许多研究是在接受治疗的妇女中进行的，这带有隐性选择偏差。在参加SUD治疗项目的女性中，那些有精神疾病的女性比那些没有精神疾病的女性更有可能有心理和家庭/社会功能受损。伴随精神疾病的严重程度似乎预示着治疗依从性较差，但需要更多的研究来阐明这种关系与精神疾病较轻的关系。摘要：虽然阿片类药物使用障碍的孕妇中精神疾病的共同发生似乎很常见，但需要采用经过验证的诊断工具和纵向评估的大型基于人群的研究来获得共同发生疾病的明确比率和特征。在为孕妇OUD患者提供社会支持的环境中，综合产前、成瘾和精神治疗是维持妇女接受治疗的最有效方法。对于双重诊断为OUD的孕妇，仍需要更多的研究来确定最佳的治疗环境、治疗方式和药物管理。
PURPOSE OF REVIEW: This review seeks to investigate three questions: What is the prevalence of comorbid psychiatric diagnoses among pregnant women with opioid use disorder (OUD)? How do comorbid psychiatric illnesses impact pregnant women with OUD? And how do comorbid psychiatric illnesses affect the ability of pregnant women with OUD to adhere to and complete OUD treatment?RECENT FINDINGS: Based on this literature review, 25-33% of pregnant women with OUD have a psychiatric comorbidity, with depression and anxiety being especially common. However, of the 17 studies reviewed only 5 have prevalence rates of dual diagnosis in pregnant women with OUD as their primary outcome measures, their N's were typically small, methods for determining psychiatric diagnosis were variable, and many of the studies were undertaken with women presenting for treatment which carries with its implicit selection bias. Of the women enrolled in treatment programs for SUD, those with psychiatric comorbidity were more likely to have impaired psychological and family/social functioning than those without psychiatric comorbidity. Greater severity of comorbid psychiatric illness appears to predict poorer adherence to treatment, but more research is needed to clarify this relationship with the psychiatric illness is less severe.SUMMARY: While cooccurrence of psychiatric disorders in pregnant women with opioid use disorder appears to be common, large population-based studies with validated diagnostic tools and longitudinal assessments are needed to obtain definitive rates and characteristics of cooccurring illnesses. Integrated prenatal, addiction, and psychiatric treatment in a setting that provides social support to pregnant patients with OUD is most effective in maintaining women in treatment. More research is still needed to identify optimal treatment settings, therapy modalities, and medication management for dually diagnosed pregnant women with OUD.