Family planning needs of female chronic psychiatric outpatients.
TL;DR: The authors discuss the special contraceptive needs of chronic psychiatric patients and encourage psychiatrists to inquire about patients' family planning practices.
Abstract: The authors investigated the pregnancy outcomes, contraceptive behavior, and contraceptive needs of 80 female chronic psychiatric outpatients
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TL;DR: HIV prevention efforts targeting adults with SMI must occur on multiple levels, address several domains of influence, and be integrated into existing services (e.g., psychotherapy, substance abuse treatment, housing programs).
284 citations
01 Jan 1996
TL;DR: In this article, the authors compared the sexual, reproduction, and childrearing characteristics of women with schizophrenia-spectrum disorders with those of women without serious mental illness, and found that women with schizophrenic disorders had more lifetime sexual partners, were less likely to have a current partner, and were more likely to engage in prostitution.
Abstract: Objective: This study compared sexuality, reproduction, and childrearing characteristics of women with schizophrenia-spectrum disorders with those of women without serious mental illness. Methods: A semistructured interview was given to 46 women meeting Research Diagnostic Criteria for schizophrenia or schizoaffective disorder and to 50 control subjects without major mental illness who were matched for age, race, education, employment status, and religion. Results: Compared with the control subjects, the women with schizophrenic disorders had more lifetime sexual partners, were less likely to have a current partner, and were more likely to have been raped and to have engaged in prostitution. Despite being at high risk for HIV infection,
230 citations
TL;DR: Little attention has been paid in research and service development to the fact that the majority of mentally ill women are mothers, and strategies for assessing and meeting the resulting unmet needs should be developed and evaluated.
Abstract: Background The majority of women with severe mental illness are mothers. Little is known about their experiences and the extent to which their needs are met. Methods Semi-structured interviews were carried out with 22 women with schizophrenia, bipolar affective disorder or severe depression with psychotic symptoms in Inner London. Participants' experiences, views about services and needs for support in parenting were discussed. Interviews were transcribed verbatim and qualitative thematic analysis carried out. Results Most participants who looked after their children described motherhood as rewarding and central to their lives. However, they described the demands associated with parenting and at the same time coping with severe mental illness as considerable, and some feared that their children would be adversely affected by their illnesses. Parenting responsibilities created practical impediments to engaging with mental health services. Fear of losing custody or access to children dominated interactions with mental health and social services, making most participants reluctant to disclose difficulties in parenting to professionals. A widespread assumption that mentally ill women are inherently poor parents, regardless of the facts of individual cases, was described, and stigma was seen as affecting children as well as mothers. Services were perceived as offering little continuing support in relation to parenting, intervening only in crises. Conclusion Little attention has so far been paid in research and service development to the fact that the majority of mentally ill women are mothers. Strategies for assessing and meeting the resulting unmet needs should be developed and evaluated.
207 citations
TL;DR: Data is reviewed about how schizophrenia affects sexuality, pregnancy, the puerperium, parenting, and family planning to reduce unwanted pregnancies and incorporate family planning measures into mental health care delivery systems.
Abstract: This article reviews data about how schizophrenia affects sexuality, pregnancy, the puerperium, parenting, and family planning. Women with schizophrenia have high rates of coerced sex, sexual risk behavior, and unwanted pregnancies. High rates of obstetric complications and custody loss increase morbidity for women and their offspring. Since untreated psychosis increases these problems, the risks of withholding pharmacotherapy must be weighed against the risks of prescribing medications during pregnancy. The puerperium is a time when women are especially vulnerable to exacerbations of schizophrenia. Mothers with schizophrenia may have a reduced ability to read children's cues, and they often have weak social support networks. Their children may be more difficult to raise than other children. Parenting rehabilitation can address some of these problems. Often, women with schizophrenia who are sexually active and do not wish to become pregnant do not use contraception. Incorporating family planning measures into mental health care delivery systems may reduce unwanted pregnancies.
166 citations
Cites background from "Family planning needs of female chr..."
...Surveys reveal that even though many sexually active women with serious mental illnesses do not want to become pregnant, they do not use birth control (Rozensky and Berman 1984; Coverdale and Aruffo 1989)....
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TL;DR: Specific ways in which treatment can be sensitive to gender-relevant issues in schizophrenia are discussed, including the need for future research on gender differences in schizophrenia to consider the very different community lives of men and women.
Abstract: Gender differences were studied in the lives of 122 young adults (mean age = 23.11 years) with schizophrenia or schizophrenia-related disorders who are participants in a long-term study of progressive community care. Across the first 2 years, males who required hospitalization showed a trend toward greater recidivism and spent more time in institutions than women who required hospitalization. Women spent more time in inpatient medical settings for nonpsychiatric reasons. In community living domains, significant gender differences were found in parent roles, frequency of heterosexual relationships and behaviors, substance use, arrest rates, the number who spent time in jail, and residential settings. In the study to date, more males than females have committed suicide. We discuss specific ways in which treatment can be sensitive to these gender-relevant issues. We also note the need for future research on gender differences in schizophrenia to consider the very different community lives of men and women.
103 citations