ABSTRACT
BACKGROUND: Approximately half of patients suffering from a significant drug or alcohol related disorder also match the criteria of some other psychiatric disorder. Yet, little is known about comorbidity among substance misusing pregnant women. AIMS: To estimate the prevalence of psychiatric diseases among mothers with substance misuse severe enough to end up in an assessment at a specialized addiction clinic and to compare their backgrounds to the controls. METHODS: Between 1 June 2003 and 31 December 2005, the maternity clinics in Pirkanmaa health district were asked to refer mothers with possible substance misuse to Tampere University Addiction Psychiatric Clinic, where 119/217 patients were considered misusers. Of these, 49/119 (41.2%) participated in the whole study. At baseline, the assessment was made using the International Statistical Classification of Diseases and Related Health Problems (ICD-10) and at the end of the study, 6-12 months after delivery, with the Structured Clinical Interview for DSM-IV (SCID). The comparison group (n = 74) filled a postal survey concerning their background and substance use. RESULTS: 57% of substance misusing pregnant women had psychiatric illnesses; 6-12 months after delivery the number of substance use-related diagnoses was 40%. However, the number, spectrum and severity of psychiatric diagnoses were high in this group. CONCLUSIONS: Psychiatric comorbidity is common among substance misusing mothers. Their social situation is often very difficult and support needs vary a lot. In order to offer them best possible treatment, diagnosing these disorders should be a routine part of evaluation during pregnancy.
