Certification in psychiatry: Designing evidence based and organizationally relevant management proformas and protocols

IPS PERINATAL PSYCHIATRY TASK FORCE SYMPOSIUM ANCIPS 2022: Prescribing Psychotropics In Pregnancy And Lactation The management of mental health problems during pregnancy and the postnatal period differs from disorders occurring at other times.The impact of the mental illness and treatment thereof is on the mother, the child and the family. 1 in 5 women experience some form of perinatal mental illness Only 50% are diagnosed 15% have depression ,anxiety disorders. Severe mental illness can be 2 to 3 per 1000 Postpartum psychosis can be 1 to 2 in 1000 COVID times has seen an increase in depression and anxiety in the perinatal period(Wang 2020,Wu 2020) Psychosis can re-emerge or be exacerbated during pregnancy and the postnatal period. Although response to treatment is good, these problems frequently go unrecognized and untreated in pregnancy and the postnatal period. Psychiatric relapse in the setting of medication discontinuation for pregnancy is extremely common. Hence an appropriate treatment plan for psychiatric disorders during pregnancy and lactaction needs to be individualized and protocolised. Domestic violence during the perinatal period is recognised as major public health issues (Buist et al. 2005) and are associated with poor outcomes for women and their children and partners(Murray et al. 2003).It also contributes to increased risk of mental illness in pregnancy and lactation Intervention studies indicate that mental health problems during the perinatal period can be minimised if women and families engage in appropriate service (Armstrong et al. 2002;Kemp et al. 2011;Shaw et al. 2006). However concerns with regards to knowledge gaps and safety issues in prescribing psychotropic medication exist. This symposium by the Perinatal Psychiatry Task Force will address the important area of perinatal psychiatry ie prescribing of psychotropics in pregnancy and lactaction.The format will be discussion of the same with illustrative cases. Sub-topicsSpeaker1. Organ donation:Lt col SP Panda2. Gender reassignment surgeryLt col Vishal Chopra3. Bariatric surgeryLt col Arun Dwivedi4. Consent for surgery and other medicolegal conditions related in Intellectual disability, cognitive disorders and psychosisSurg Lt Cdr Amit Chail

Development and Validation of a Scale to Measure Anxiety Specific to Pregnancy During the COVID-19 Pandemic: The Antenatal COVID-19 Anxiety Scale.

Objective: In the context of the coronavirus disease 2019 (COVID-19) pandemic, anxiety during pregnancy should be assessed from a composite context of anxiety/fear of COVID-19 infection and pregnancy-specific anxiety. The objective of this study was to develop and validate a scale that measures anxiety related to situations specific to pregnancy during the COVID-19 pandemic-the Antenatal COVID-19 Anxiety (AnCAn) Scale.Methods: Items were generated based on a literature review and focused group discussions. Face and content validation was completed. Data were collected from 557 pregnant women attending antenatal clinics of 5 tertiary care general hospitals in India. An exploratory factor analysis was conducted to measure structural validity and to identify latent factors. Screening accuracy was assessed using scores on the 7-item Generalized Anxiety Disorder scale. Data were collected between July and October 2020.Results: The principal component analysis showed that the 12 items of the scale significantly loaded onto 2 latent factors, with Eigen values of 6.575 and 1.213, respectively. Factor solution showed that 6 items correlated with each of the 2 factors. Both sensitivity and specificity of AnCAn total and subscores were > 70%.Conclusions: We conclude that the AnCAn Scale holds good psychometric properties, and it identifies and distinguishes 2 latent factors: (1) anxiety related to acquiring infection and (2) anxiety related to spreading infection and social role obligations, which are compositely related to anxiety specific to COVID-19 and pregnancy.

Anxiety among pregnant women during the COVID-19 pandemic in India - A multicentric study.

While higher anxiety during antenatal period cause several maternal and foetal health related complications, lower anxiety levels are found to be associated with lesser "precautionary behaviours" and consequently greater risk of infection, during the COVID-19 pandemic. In this study, we aimed to assess rates and determinants of generalized anxiety at the time of the pandemic as well as anxiety that was specific to the context of being pregnant during the COVID-19 pandemic. (COVID-19-antenatal anxiety) in Indian women. This hospital-based, cross-sectional study using face-to-face interviews was conducted at antenatal clinics of five medical college hospitals in India. The Generalized Anxiety Disorder-7 scale (GAD -7) and a customized scale to assess antenatal COVID-19 anxiety along with other tools that assessed social support and COVID-19-risk perception were administered to 620 pregnant women. We found that the percentage of women with moderate or severe anxiety based on GAD -7 was 11.1%. Multivariate analysis showed that higher COVID-19-risk perception, greater antenatal COVID-19 anxiety and lower perceived support significantly predicted moderate and severe generalized anxiety. Greater number of weeks of gestation, lower education, semiurban habitat and lower perceived social support were significant predictors of antenatal COVID-19 anxiety. We conclude that the rates of anxiety in pregnant women though not very high, still warrant attention and specific interventions.