Though there are distinct technical advantages to medical advances allowing prenatal diagnosis of fetal abnormalities, the psychological impact of the use of these procedures has been given little consideration. While early detection of impairment may provide parents with an opportunity for emotional preparation, it also may precipitate a long period of distress. Toward the end of clarifying this indeterminate impact of prenatal diagnosis of fetal abnormality, the literature addressing the emotional consequences of giving birth to an impaired infant is examined for its relevance to the prenatal diagnostic situation. The clinical and research implications of this extrapolation of an existing literature to an important new question are considered. It is concluded that health care professionals must begin to explore systematically the psychological impact of the use of this technology, and must use their increased understanding clinically to promote not only the physical health of the neonate, but also its emotional well-being and that of its parents.

This investigation addresses two issues central to psychiatric hospitalization: (1) Can alternative treatments be effective? and (2) How can patients appropriate for the alternatives be identified? This random design study found that a majority of patients assessed as requiring immediate psychiatric hospitalization could utilize a combination of emergency housing and outpatient treatment to avoid hospitalization. Five key variables examined at intake proved useful in predicting ability to succeed in the alternative treatment setting. Patients who failed in the alternative setting had trouble utilizing leisure time, were grandiose, exhibited eating problems, had difficulty with family, and showed an absence of paranoia.

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