ABSTRACT
Obstetric patients are at increased risk for psychological distress and the development or exacerbation of mental illness, particularly in the setting of pregnancy or delivery complications. Inpatient antepartum, labor and delivery, and postpartum hospitalization is an important opportunity for psychiatric support and intervention. The aims of this paper are to review the unmet mental health needs in obstetric inpatient care, examine the current state of obstetric consultation-liaison (OB CL) psychiatry services, present one existing model of such a service at the authors' institution, provide broad recommendations for the structure and implementation of this service, and detail areas of future research within the area of OB CL psychiatry. We argue that the inpatient obstetric setting is a critical space for mental health evaluation, education and intervention, and that dedicated OB CL psychiatry services are a potentially valuable tool in addressing the perinatal mental health crisis.
Subject(s)
Mental Disorders , Psychiatry , Female , Humans , Pregnancy , Inpatients , Mental Disorders/therapy , Mental Disorders/psychology , Mental Health , Referral and ConsultationABSTRACT
BACKGROUND: Chronic pelvic pain (CPP) in women is both common and disabling, and access to interdisciplinary care is limited. Patient education programs may represent a pragmatic approach to delivering interdisciplinary care, but to date the specific educational needs of patients with CPP are unknown. METHOD: We surveyed 136 patients at a tertiary CPP treatment center to identify their educational needs and preferences; 71 (52%) completed surveys. Based on the results, we developed an interdisciplinary educational program, including expert presentations and an extensive participant handbook. We modified our program to a webinar format following the advent of COVID-19. Participants registered for the webinar only or for our study involving completion of three measures of pain-related functioning before and 2 months after the webinar. RESULTS: Our survey results indicated that CPP patients were most interested in learning about the diagnosis and treatment of CPP, coping with CPP, and diet and exercise in the context of CPP; patients also indicated a preference for brief, one-time programs. Of the 164 webinar participants, 64 (39%) enrolled in the study and completed baseline measures; 20 (31%) of those returned follow-up measures 2 months after the webinars. Participants who completed follow-up measures reported significant reduction in pain-related interference; no other significant differences were observed. Participants who completed feedback surveys were positive in their evaluation of the program. CONCLUSION: Patients with CPP desire more knowledge about their complex symptoms. Addressing their specific needs through educational supports may enhance their ability to manage their symptoms independently. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Subject(s)
COVID-19 , Chronic Pain , Humans , Female , Pelvic Pain/therapy , Pelvic Pain/diagnosis , Program Development , Chronic Pain/therapy , Adaptation, PsychologicalABSTRACT
The Millon series (i.e., MCMI-II/MCMI-III) has a longstanding history of use in clinical and forensic settings. For forensic psychologists, the Millon series can serve as a unique tool in evaluations related to parental fitness due to its incorporation of DSM diagnostic categories and the use of base rate (BR) scores. There is limited research on parental fitness populations broadly, though previous research has found a common positive impression management style referred to as the normal quartet with forensic populations on the MCMI-III. It is unknown if there is a continued presence of the normal quartet in the MCMI-IV, published in 2015. With the current study, we examined parental fitness litigant response patterns on the MCMI-IV and assessed the presence of a normal quartet. The sample consisted of 330 parental fitness litigants in the northeast region of the United States. Results of the current study suggest a new normal quartet: elevations on the Desirability (Y), Histrionic (4A), Turbulent (4B), and Compulsive (7) scales. The clinical implications for the use of the MCMI-IV by forensic psychologists with parental fitness litigants are discussed including limitations and areas for future research.
