Contemporary management of unipolar depression in the perinatal period.

Introduction: There is increasing recognition that antenatal depression and postpartum depression are highly prevalent and have significant impact on maternal and child health.Areas Covered: In the initial part of the manuscript, the authors review the epidemiology of antenatal and postpartum depression and its impact on maternal and child health. The later part of the manuscript reviews the current status of the medical management and psychosocial interventions targeting perinatal depression.Expert Opinion: Perinatal depression is the focus of several studies with increasing interest in developing effective interventions. While several psychosocial interventions targeting maternal depressive symptoms during pregnancy and postpartum are available, more studies are needed to address the need for safe and efficacious strategies for the use of antidepressant medication during pregnancy and in the postpartum period.

Knowledge, Attitude, and Practice Regarding Contraception among Women with Schizophrenia: An Observational Study from South India.

BACKGROUND: Women with schizophrenia have needs beyond their mental health needs, such as those arising out of their gender, sexual, and reproductive functions. Very little is known about the knowledge, attitude, and practice regarding contraception among women with schizophrenia from India. MATERIALS AND METHODS: Study among women with schizophrenia (in reproductive age group, having at least one living child, and currently staying with husband) from south India explored their knowledge, attitude, and practice of contraception. Adhering to observational design and ethical principles, data were collected using a semi-structured questionnaire. Modified National Family Health Survey-3 questionnaire and Positive and Negative Symptom Scale of Schizophrenia were also used. RESULTS: Ninety-six women with schizophrenia participated. The mean age was 33.5 years [standard deviation (SD): 6.8 years], and the mean age of onset of schizophrenia was 29.2 years (SD: 6.2 years). Although nearly 90% had knowledge on at least one method of contraception, the mean total number of methods known was mere two. Out of 65 women who were practising contraception, 86.2% adopted female sterilization. The common reasons for not using contraception were wish for another child/son, lack of awareness, and fear of side effects. Unmet need for family planning was 14%. Informed choice of contraception was below 3%. There was statistically significant association between those who were currently using contraception and variables such as age 31 years and above, undifferentiated subtype of schizophrenia, and greater severity of schizophrenia. CONCLUSION: Although the majority had some knowledge about contraception, decision-making largely rested with others, and informed choice regarding contraception was poor. These could pose an obstetric risk on women with schizophrenia. Sociocultural and illness-related factors influencing contraception need to be explored.