Pages in this set

Page 1

Preview of page 1
Issue date: February 2007 (reissued April 2007)



Antenatal and postnatal
mental health
Clinical management and service
guidance




NICE clinical guideline 45
Developed by the National Collaborating Centre for Mental Health

Page 2

Preview of page 2
NICE clinical guideline 45
Antenatal and postnatal mental health: clinical management and service
guidance

Ordering information
You can download the following documents from www.nice.org.uk/CG045
· The NICE guideline (this document) ­ all the recommendations.
· A quick reference guide ­ a summary of the recommendations for
healthcare professionals.
· `Understanding…

Page 3

Preview of page 3
Contents
Introduction ......................................................................................................4
Patient-centred care.........................................................................................5
Key priorities for implementation......................................................................6
1 Guidance ................................................................................................10

1.1 Principles of care for all women with mental disorders during
pregnancy and the postnatal period 10
1.2 Prediction, detection and initial management of mental disorders 12
1.3 Prevention of mental disorders 15
1.4 Care of women with…

Page 4

Preview of page 4
Introduction
This guideline makes recommendations for the prediction, detection and
treatment of mental disorders in women during pregnancy and the postnatal
period (up to 1 year after delivery). It includes advice on the care of women
with an existing mental disorder who are planning a pregnancy, and on the
organisation…

Page 5

Preview of page 5
Patient-centred care

Treatment and care should take into account the woman's individual needs
and preferences. Women with mental disorders during pregnancy or the
postnatal period should have the opportunity to make informed decisions
about their care and treatment in partnership with their healthcare
professionals. If women do not have the…

Page 6

Preview of page 6
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…

Page 7

Preview of page 7
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. This is because of the lower threshold for access to
psychological therapies during pregnancy and the postnatal period
arising from the changing risk­benefit ratio…

Page 8

Preview of page 8
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…

Page 9

Preview of page 9
- non-directive counselling delivered at home (listening visits)
- brief cognitive behavioural therapy or interpersonal
psychotherapy.

Organisation of care

· Clinical networks should be established for perinatal mental health
services, managed by a coordinating board of healthcare professionals,
commissioners, managers, and service users and carers. These
networks should provide:

-…

Page 10

Preview of page 10
1 Guidance
The following guidance is based on the best available evidence. The full
guideline (www.nice.org.uk/CG045fullguideline) gives details of the methods
and the evidence used to develop the guidance (see section 5 for details).


1.1 Principles of care for all women with mental
disorders during pregnancy and the postnatal period…

Comments

No comments have yet been made

Similar Psychology resources:

See all Psychology resources »See all resources »