Co‐occurring Psychiatric Symptoms Are Associated with Increased Psychological, Social, and Medical Impairment in Opioid Dependent Pregnant Women

Abstract

The interaction of psychiatric symptoms with drug dependence during pregnancy is not well understood. This study examines the relationship of psychiatric symptoms to severity of drug use and drug related problems among participants in a clinical trial of pharmacologic treatment of opioid dependence during pregnancy (N=174). 64.6% reported additional psychiatric symptoms (48.6% mood symptoms, 40.0% anxiety symptoms, and 12.6% suicidal thinking). Women who endorsed co-occurring psychiatric symptoms showed more severe impairment on the Addiction Severity Index (ASI). Further investigation is warranted to understand the effect of psychiatric symptoms on long-term maternal and neonatal outcomes.

Co-Occurring Psychiatric Symptoms in Opioid-Dependent Women: The Prevalence of Antenatal and Postnatal Depression

“…The percentage of women screening positive for depression at treatment entry is consistent with the rates of depression reported by Fitzsimons et al (4). The number of psychiatric disorders diagnosed in the sample is similar to that reported by Benningfield et al (27), although rates in the Benningfield et al study were obtained through use of a screening tool rather than full diagnosis.…”

A Multidisciplinary Approach to the Treatment of Co-occurring Opioid Use Disorder and Posttraumatic Stress Disorder in Pregnancy: A Case Report

“…For example, Jones and colleagues (Jones, Svikis, Rosado, Tuten, & Kulstad, 2004) found the prevalence of PTSD among women with substance use disorders to be as high as 62%, compared to 12% among pregnant women without substance use disorders (Jones et al, 2004; Morland et al, 2007) Conversely, pregnant women who are diagnosed with PTSD are more than twice as likely to use substances as those without trauma history (Morland et al, 2007; Rogal et al, 2007). Psychiatric comorbidity appears to complicate the treatment of substance use disorders during pregnancy, as is also the case for non-pregnant women (Benningfield et al, 2010). …”

The opioid epidemic and neonatal abstinence syndrome in the USA: a review of the continuum of care

“…Up to 95% of women with OUD also smoke tobacco during pregnancy and should receive smoking cessation counselling at each prenatal visit 44–48. Screening for co-occurring psychiatric disorders is essential as rates of anxiety and depression range from 65% to 73% 49 50. Failure to identify and treat psychiatric disorders in pregnancy results in an increased risk of treatment discontinuation and postpartum depression 49 51 52.…”

“…Screening for co-occurring psychiatric disorders is essential as rates of anxiety and depression range from 65% to 73% 49 50. Failure to identify and treat psychiatric disorders in pregnancy results in an increased risk of treatment discontinuation and postpartum depression 49 51 52. Finally, all pregnant women with OUD should be screened for physical and sexual violence and referred to social work and/or social service organisations due to high rates of unstable housing, incarceration and inadequate resources 27 53…”