Although women with serious mental illness have high rates of lifetime sexual partners, they infrequently use contraception. Consequently, the prevalence of sexually transmitted infections is high in this population. In addition, while the overall rate of pregnancy in women with schizophrenia of child-bearing age is lower than in the general population, the percentage of pregnancies that are unwanted is higher than that in the general population. The objective of this paper is to help clinicians explore knowledge of appropriate methods of contraception for women who suffer from schizophrenia. The authors reviewed recent literature on the use of contraceptive methods by women with schizophrenia treated with antipsychotic and adjunctive medications. Contraceptive counseling to women and their partners is an important part of comprehensive care for women with serious and persistent mental illness. Women with schizophrenia who smoke, are overweight, or have diabetes, migraine, cardiovascular disease, or a family history of breast cancer should be offered non-hormonal contraception. Women with more than one sexual partner should be advised on barrier methods in addition to any other contraceptive measures they are using. Clinicians should be alert for potential interactions among oral hormonal contraceptives, smoking, and therapeutic drugs. Long-lasting contraceptive methods, such as intrauterine devices, progesterone depot injections, or tubal ligation are reasonable options for women having no wish to further expand their families.

Prescribing contraceptives for women with schizophrenia.

Aims and objectives To determine what problems female psychiatric patients have in terms of reproductive health. Background The reproductive health problems faced by female psychiatric patients are matters that have been neglected in the areas of both psychiatry and women's health. This study aims to make a contribution from Turkey to the literature in this neglected field. Design The study is descriptive and was conducted with 292 female patients treated in an acute inpatient psychiatric ward. Methods Data were collected through face-to-face interviews and a questionnaire based on the literature and prepared by the researchers which was designed to determine the kinds of reproductive health issues the patients were experiencing. Results It was found that compared with healthy women, the distinctive features of the participants in terms of sexuality were more negative; in particular, patients diagnosed with bipolar disorder were more likely to have been forced by their partners to have sex, they had suffered from rape or sexually transmitted diseases, the majority of those who had previous sexual experience had tried to use contraceptives but had been unable to continue using them, they were most likely to choose the method of withdrawal for contraception, their rates of pregnancy and abortion were high, they received less antenatal care, and they were more likely to have smoked during pregnancy. Conclusions It was found that female patients with psychiatric disorders had more negative attributes with regard to marriage, sexuality, family planning, maternal characteristics and pregnancy, compared with a corresponding healthy population. Relevance to clinical practice The results of this study may be useful for nurses in the clinical field for calling an attention and raising an awareness of the reproductive health problems of women with psychiatric disorders, taking the necessary preventive measures, and developing damage-reducing strategies.

Reproductive health in women with serious mental illnesses

Sexual health of women with schizophrenia: A review.

Ethically justified guidelines for family planning interventions to prevent pregnancy in female patients with chronic mental illness

For individuals with a psychotic disorder, dating can present several challenges and lead many to be excluded from intimate relationships. These difficulties may stem from a number of factors, including impairments in social and sexual functioning. Although scientific interest in this topic is mounting, the last quantitative review of the literature dates back to 2003. Objectives The aim of this systematic review was to collect, evaluate, and synthesize quantitative data from studies published in the last 15 years on romantic relationships and sexuality in the context of a psychotic disorder. Methods Articles were retrieved from PsycINFO, PubMed, Web of Science, and ProQuest databases and were retained if they met the following inclusion criteria: (a) original research or meta-analysis, (b) complete or partial sample with a psychotic disorder diagnosis, (c) provision of quantitative data specific to the population of interest, and (d) studies focusing on romantic relationship and/or sexuality variables as correlates, predictors, mediators, or outcomes. Study quality was evaluated using PRISMA criteria. Results 43 studies were identified, 24 of which were categorized as obstacle-related (e.g., focusing on negative aspects of intimacy, such as risky behaviors) and 19 of which were deemed neutral or recovery-oriented (e.g., focusing on positive aspects of intimacy, such as marital functioning). Conclusions and implications for practice Results highlight a need for greater communication and assistance in the areas of intimacy and sexuality for persons with psychotic disorders. Better access to resources such as dating skills and couples therapy programs as well as more consumer-oriented research is needed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Romantic relationships, sexuality, and psychotic disorders: A systematic review of recent findings.

Background and aim: Despite the importance of reproductive behaviours of patients with mental illness, there are only few studies concerning the family planning needs and contraceptive use of psychiatric patients. The aim of this study is to assess family planning needs and contraceptive use in female psychiatric outpatients. Methods: The study was conducted in the outpatient clinic of Bakirkoy Neuropsychiatry Hospital, Istanbul, Turkey. Schizophrenic, bipolar and unipolar depressive patients in remission (50 patients in each group) were compared with a control group of 50 healthy individuals. A semi-structure d questionnaire was used for sociodemographic characteristics, family planning needs and contraceptive use. Results: Of schizophrenic patients only 26.6% and of bipolar patients only 37.5% had gynecological examination during the last three years compared to 56% in healthy individuals. Of schizophrenic patients only 40% discussed family planning issues with partner and of bipolar patients only 50% compared to 90% in controls. Conclusion: Schizophrenic and bipolar female patients’ awareness and attitudes on family planning and contraceptive use were unsatisfactory. Both psychiatrists and family physicians should be aware of the needs of psychiatric outpatients on contraceptive counseling.

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Kadriye Pehlivanoglu

Papers

Family Planning Needs and Contraceptive Use in Female Psychiatric Outpatients