Other pages in this set

Page 2

Preview of page 2

Here's a taster:

Antenatal and postnatal mental health
About this booklet
This is a quick reference guide that summarises the recommendations NICE has made to the NHS in
`Antenatal and postnatal mental health: clinical management and service guidance' (NICE clinical
guideline 45).
Who should read this booklet?
This quick reference guide is for GPs, obstetricians, midwives, health visitors, mental healthcare
professionals and other staff who care for women who are planning a pregnancy or are pregnant,
or during the postnatal period (the first year after birth).…read more

Page 3

Preview of page 3

Here's a taster:

Antenatal and postnatal mental health Contents
Contents
Key priorities for implementation 4
Principles of care 6
Prediction, detection and initial management 7
Preventing mental disorders 9
The treatment of pregnant and breastfeeding women: 10
balancing risks and benefits
Psychotropic medication 12
Guidance for specific disorders 14
Service organisation 18
Implementation 19
Further information 20
Introduction
Mental disorders during pregnancy and the postnatal period can have serious consequences for the
mother, her infant and other family members.…read more

Page 4

Preview of page 4

Here's a taster:

Antenatal and postnatal mental health Key priorities for implementation
Key priorities for implementation
Prediction and detection
At a woman's first contact with services in both the antenatal and the postnatal periods, healthcare
professionals (including midwives, obstetricians, health visitors and GPs) should ask questions about:
­ past or present severe mental illness including schizophrenia, bipolar disorder, psychosis in the
postnatal period and severe depression
­ previous treatment by a psychiatrist/specialist mental health team including inpatient care
­ a family history of perinatal mental illness.…read more

Page 5

Preview of page 5

Here's a taster:

Antenatal and postnatal mental health Key priorities for implementation
Management of depression
When choosing an antidepressant for pregnant or breastfeeding women, prescribers should, while
bearing in mind that the safety of these drugs is not well understood, take into account that:
­ tricyclic antidepressants, such as amitriptyline, imipramine and nortriptyline, have lower known
risks during pregnancy than other antidepressants
­ most tricyclic antidepressants have a higher fatal toxicity index than selective serotonin reuptake
inhibitors (SSRIs)
­ fluoxetine is the SSRI with the lowest known risk…read more

Page 6

Preview of page 6

Here's a taster:

Antenatal and postnatal mental health Principles of care
Principles of care
Providing and using information effectively
Give culturally sensitive information to women with an existing mental disorder who are planning a
pregnancy or are pregnant, and to those who develop a mental disorder during pregnancy or the
postnatal period.
­ This should include the impact of the disorder and its treatment on the health of the woman
and the fetus or child (including the proper use and likely side effects of medication).…read more

Page 7

Preview of page 7

Here's a taster:

Prediction, detection and
Antenatal and postnatal mental health initial management
Prediction, detection and initial management
Prediction and detection
Prediction
In all communications (including initial referral) with maternity services, include information on
any relevant history of mental disorder.…read more

Page 8

Preview of page 8

Here's a taster:

Prediction, detection and
Antenatal and postnatal mental health initial management
Referral and initial care
After identifying a possible mental disorder, consider further assessment, in consultation with
colleagues if necessary.
If there are significant concerns, the woman should normally be referred to her GP for assessment.
­ If she has, or is suspected to have, severe mental illness (for example, schizophrenia or
bipolar disorder), she should be referred to a specialist mental health service, including, if
appropriate, a specialist perinatal mental health service.…read more

Page 9

Preview of page 9

Here's a taster:

Antenatal and postnatal mental health Preventing mental disorders
Preventing mental disorders
Treating subthreshold symptoms in pregnant women
For symptoms of depression and/or anxiety that do not meet diagnostic criteria but significantly
interfere with personal and social functioning, consider:
­ brief psychological treatment (four to six sessions), such as interpersonal psychotherapy (IPT)
or cognitive behavioural therapy (CBT), for women who have had a previous episode of
depression or anxiety
­ social support (regular informal individual sessions or group-based) for those who have not
had a previous…read more

Page 10

Preview of page 10

Here's a taster:

The treatment of pregnant and
Antenatal and postnatal mental health breastfeeding women: balancing
risks and benefits
The treatment of pregnant and breastfeeding women:
balancing risks and benefits
All pregnancies carry a background risk, although this may be increased by the presence of a mental
disorder. Treatment can reduce the risk, but the use of some psychotropic drugs may increase it.
Psychological treatments
Women requiring psychological treatment should be seen for treatment normally within
1 month of initial assessment, and no longer than 3 months afterwards.…read more

Comments

No comments have yet been made

Similar Psychology resources:

See all Psychology resources »See all resources »