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Management of Psychiatric Disorders in Pregnancy

Health Services Research Department, Institute of Psychiatry

Edited by Kimberley Yonkers and Bertis Little. London: Arnold. 2001. 266 pp. £55.00 (hb). ISBN: 0-340-76126-1

There is increasing awareness of the impact of antenatal and postnatal psychiatric disorders on the pregnant woman, the foetus and, after delivery, the whole family. Many psychiatrists treat patients who become pregnant, but this is one of the few books in which one can find details on the natural history of psychiatric disorders during pregnancy, with discussion of treatment options, particularly whether or not to prescribe medication.

Most chapters include a review of the relevant research literature, although not all give useful summaries of the clinical management of patients, which busy clinicians will probably be looking for. The chapters on the management of pregnancy in the woman with schizophrenia (J.K. Tekell) and bipolar disorder (L.L. Davis et al) were particularly comprehensive and helpful. Psychological treatments in the pregnant woman generally received less attention than pharmacological, other than a sole chapter on interpersonal therapy. There was also no discussion of the different models of perinatal services or the vexed question of whether postpartum disorders, particularly postnatal depression, can be prevented or attenuated by interventions during pregnancy.

Nevertheless this book is a useful resource and despite its multi-author nature, there was a consistent message. Clinicians must be aware of the risks and benefits of different interventions when treating pregnant women with psychiatric disorders, particularly as the adverse effects of psychiatric illness on the mother and foetus may be greater than those caused by psychotropic medication. There is a growing body of research into the effects of antenatal stress on the foetus, suggesting that psychiatric disorders may have subtle biological effects on the developing foetus, in addition to the genetic and psychosocial consequences of these disorders. This book is therefore timely in providing a useful summary of many of the management issues in pregnancy for psychiatrists, obstetricians and primary care professionals.

This Article Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Howard, L. M. Search for Related Content PubMed Articles by Howard, L. M.