Back to Search
Start Over
Risk-Benefit Decision Making for Treatment of Depression During Pregnancy
- Source :
- American Journal of Psychiatry. 157:1933-1940
- Publication Year :
- 2000
- Publisher :
- American Psychiatric Association Publishing, 2000.
-
Abstract
- The Committee on Research on Psychiatric Treatments of the American Psychiatric Association identified treatment of major depression during pregnancy as a priority area for improvement in clinical management. The goal of this article was to assist physicians in optimizing treatment plans for childbearing women.The authors' work group developed a decision-making model designed to structure the information delivered to pregnant women in the context of the risk-benefit discussion. Perspectives of forensic and decision-making experts were incorporated.The model directs the psychiatrist to structure the problem through diagnostic formulation and identification of treatment options for depression. Reproductive toxicity in five domains (intrauterine fetal death, physical malformations, growth impairment, behavioral teratogenicity, and neonatal toxicity) is reviewed for the potential somatic treatments. The illness (depression) also is characterized by symptoms of somatic dysregulation that compromise health during pregnancy. The patient actively participates and provides her evaluation of the acceptability of the various treatments and outcomes. Her capacity to participate in this process provides evidence of competence to consent. Included in the decision-making process are the patient's significant others and obstetrical physician. The process is ongoing, with the need for incorporation of additional data as the pregnancy and treatment response progress.The conceptual model provides structure to a process that is frequently stressful for both patients and psychiatrists. By applying the model, clinicians will ensure that critical aspects of the risk-benefit discussion are included in their care of pregnant women.
- Subjects :
- Adult
Risk analysis
medicine.medical_specialty
Context (language use)
Risk Assessment
Patient Care Planning
Pregnancy
Informed consent
Forensic psychiatry
medicine
Humans
Medical prescription
Psychiatry
Depression (differential diagnoses)
Depressive Disorder
Jurisprudence
Physician-Patient Relations
Informed Consent
business.industry
Infant, Newborn
Forensic Psychiatry
medicine.disease
Antidepressive Agents
Pregnancy Complications
Psychiatry and Mental health
Treatment Outcome
Practice Guidelines as Topic
Female
Risk assessment
business
Subjects
Details
- ISSN :
- 15357228 and 0002953X
- Volume :
- 157
- Database :
- OpenAIRE
- Journal :
- American Journal of Psychiatry
- Accession number :
- edsair.doi.dedup.....8009b9421969bff61d8c5ef20f15c89b