Archives of Women's Mental Health

, Volume 17, Issue 6, pp 493–501

Decisional conflict among women considering antidepressant medication use in pregnancy

  • Georgia D. Walton
  • Lori E. Ross
  • Donna E. Stewart
  • Sophie Grigoriadis
  • Cindy-Lee Dennis
  • Simone Vigod
Original Article

DOI: 10.1007/s00737-014-0448-1

Cite this article as:
Walton, G.D., Ross, L.E., Stewart, D.E. et al. Arch Womens Ment Health (2014) 17: 493. doi:10.1007/s00737-014-0448-1

Abstract

The purpose of this study was to examine decision-making among women considering antidepressant medication use in pregnancy. Decisional conflict was assessed using the Decisional Conflict Scale (DCS) among pregnant women considering antidepressant medication treatment (N = 40). Overall DCS and subscale scores were compared between women who were antidepressant users and non-users. Semi-structured interviews (N = 10) explored barriers and facilitators of decision-making. Twenty-one women (52 %) had moderate or high decisional conflict (DCS ≥ 25). Overall DCS scores did not differ between groups, but antidepressant use was associated with feeling more adequately informed (subscale mean 17.5, SD 17.9 vs. 42.1, SD 23.8, p = 0.001) and clear about values (subscale mean 16.7, SD 15.1 vs. 29.8, SD 24.0, p = 0.043). Barriers to decision-making were (1) difficulty weighing maternal versus infant health, (2) lack of high quality information, (3) negative external influences, and (4) emotional reactions to decision-making. Facilitators were (1) interpersonal supports, (2) accessible subspecialty care, and (3) severe depressive symptoms. Many pregnant women facing decisions regarding antidepressant medication use experience decisional conflict. Interventions that provide accurate information, assistance with weighing risks and benefits of treatment, management of problematic external influences, and emotional support may reduce decisional conflict and facilitate the decision-making process.

Keywords

Antidepressant medication Decisional conflict Decision-making Pregnancy 

Supplementary material

737_2014_448_MOESM1_ESM.docx (18 kb)
ESM 1(DOCX 18 kb)

Copyright information

© Springer-Verlag Wien 2014

Authors and Affiliations

  • Georgia D. Walton
    • 1
  • Lori E. Ross
    • 2
    • 1
  • Donna E. Stewart
    • 3
    • 1
  • Sophie Grigoriadis
    • 4
    • 1
  • Cindy-Lee Dennis
    • 5
    • 1
  • Simone Vigod
    • 6
    • 1
  1. 1.Department of PsychiatryUniversity of TorontoTorontoCanada
  2. 2.Women’s College Research Institute, Centre for Addiction and Mental HealthUniversity of TorontoTorontoCanada
  3. 3.University Health NetworkUniversity of TorontoTorontoCanada
  4. 4.Sunnybrook Research InstituteUniversity of TorontoTorontoCanada
  5. 5.Faculty of Nursing, Women’s College Hospital, Women’s College Research InstituteUniversity of TorontoTorontoCanada
  6. 6.Women’s College Hospital, Women’s College Research InstituteUniversity of TorontoTorontoCanada

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