This study aims to investigate the characteristics and mental health status of pregnant women with disordered personality traits. A cross-sectional study of a stratified sample of 545 women attending antenatal booking at a South London maternity service was conducted. Disordered personality traits were assessed using the Standardised Assessment of Personality-Abbreviated Scale (SAPAS). Mental disorders were assessed using the Structured Clinical Interview DSM-IV (SCID). Logistic regression was used to model associations, adjusting for confounders. Complete SAPAS data were collected for over 99% of women (n = 541). The weighted prevalence of elevated disordered personality traits (SAPAS ≥ 3) was 16.2% (95% CI 12.6-20.5). Women with elevated disordered personality traits were younger, less likely to live alone and more likely to report living in insecure accommodation. Among women with elevated disordered personality traits, the most common mental disorders were anxiety disorders (31.4%) and depressive disorders (17.6%). Each extra item endorsed on the SAPAS was associated with an 82% higher odds of meeting criteria for an Axis I mental disorder (adjusted OR 1.82 (1.42-2.33); p < 0.001). Women with elevated disordered personality traits were at significantly increased risk of experiencing thoughts of self-harm (adjusted OR 2.12 (1.33-3.40); p = 0.002). Pregnant women with disordered personality traits are a particularly vulnerable population, with multiple psychosocial problems that are likely to require tailored support to ameliorate future health risks for mother and baby.
Aims and method
With increasing recognition of the prevalence and impact of perinatal mental health (PMH) disorders comes a responsibility to ensure that tomorrow's doctors can support families during the perinatal period. Online surveys seeking information about the inclusion of PMH education in undergraduate curricula were sent to psychiatry curriculum leads and student psychiatry societies from each university medical school in the UK between April and September 2021.
Results
Responses were received from 32/35 (91.4%) medical schools. Two-thirds reported specific inclusion of PMH content in the core curriculum, typically integrated into general adult psychiatry or obstetric teaching. Students at the remaining schools were all likely to be examined on the topic or see perinatal cases during at least one clinical attachment.
Clinical implications
PMH education offers an opportunity for collaboration between psychiatry and other disciplines. Future work looking at educational case examples with objective outcomes would be valuable.
BackgroundPeople held in immigration removal centres have a range of vulnerabilities relating both to disappointment at imminent removal from the country of hoped‐for residence and various antecedent difficulties. An important subgroup in the UK is of foreign national ex‐prisoners who have served a period of incarceration there. Prisoners generally have higher rates of mental disorders than the general population. It is, however, not clear whether foreign national ex‐prisoners in UK immigration removal centres have higher rates of mental disorders than other detainees.AimsTo compare the screened prevalence of mental disorders, levels of unmet needs and time in detention between foreign national ex‐prisoners and others in Immigration Removal Centres in England.MethodsWe conducted a secondary analysis of cross‐sectional survey data from a previously published study in one Immigration Removal Centre.ResultsThe 28 foreign national ex‐prisoners had been in immigration detention for longer and reported greater levels of unmet needs than the other 66 detainees. The highest levels of unmet needs among the foreign national ex‐prisoners were in the areas of psychological distress and intimate relationships. After adjusting for time spent in detention, there was evidence to suggest that foreign national ex‐prisoners had a higher screened prevalence of substance use disorders, autism spectrum disorders and attention‐deficit hyperactivity disorder than the other detainees.Conclusions/Implications for Clinical PracticeThis study supports the view that foreign national ex‐prisoners are a vulnerable group within immigration detention who have needs for enhanced and specialist service provision, including appropriate arrangements for health screening and active consideration to alternatives to their detention.
Background
Self-harm and suicide are important causes of morbidity and mortality in Sri Lanka, but our understanding of these behaviours is limited. Qualitative studies have implicated familial and societal expectations around sex and relationships. We conducted an explorative analysis using case-control data to investigate the association between sex education and self-poisoning in Sri Lanka.
Methods
Cases (N=298) were self-poisoning inpatients on a toxicology ward, Teaching Hospital Peradeniya. Controls (N=500) were sex and age frequency matched to cases and were outpatients/visitors to the same hospital. Participants were asked whether they had received sex education, and to rate the quality and usefulness of any sex education received. Logistic regression models adjusted for age, sex, and religion quantified the association between receipt, quality and usefulness of sex education and self-poisoning. We tested whether the associations differed by sex.
Results
Roughly 1-in-3 cases and 1-in-5 controls reported having not received sex education. Individuals who did not receive sex education were nearly twice as likely to have self-poisoned than those who did (OR 1.68 (95% CI 1.11-2.55)). Those who reported the sex education they received as not useful were more likely to have self-poisoned compared to those who reported it useful (OR 1.95 (95% CI 1.04-3.65)). We found no evidence of an association between self-poisoning and the self-rated quality of sex education, or that associations differed by participant sex.
Conclusion
As sex education is potentially modifiable at the population-level, further research should aim to explore this association in more depth, using qualitative methods and validated measurement tools.
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