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Treatment of severe perinatal mood disorders on a specialized perinatal psychiatry inpatient unit

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Abstract

Perinatal patients with bipolar and psychotic mood disorder exacerbations are challenging to treat and often receive suboptimal care. We sought to examine the treatment patterns and outcomes on one of the only US-based Perinatal Psychiatry Inpatient Units (PPIU). Perinatal patients admitted to the PPIU completed self-report measures at admission and before discharge. Retrospective chart reviews extracted history, diagnoses (current and past), and medication treatment. Patients who had discharge diagnoses of bipolar disorder, major depression with psychotic features, or postpartum psychosis were included. Forty-seven met the diagnostic inclusion criteria. Over an average length of stay (ALOS) of 9.96 days, there was significant improvement in depressive and anxiety symptoms and daily functioning (Work and Social Adjustment Scale). Psychiatric comorbidity was common. Polypharmacy was utilized in 87 %. The most common medications prescribed at discharge were antipsychotics, alone or in combination with mood stabilizers or antidepressants. ECT was performed in 10 % of cases. The complexity of patients with severe mood disorders or psychosis admitted to the PPIU supports individualized treatment plans that address both primary diagnosis and psychiatric comorbidities. Our results provide important information that can be disseminated to others to improve clinical outcomes for severe perinatal mood disorders.

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Authors and Affiliations

  1. Department of Psychiatry, University of North Carolina-Chapel Hill, Campus Box #7160, Chapel Hill, NC, 27599-7160, USA

    Mary C. Kimmel, S. Lara-Cinisomo, K. Melvin, A. Di Florio, A. Brandon & S. Meltzer-Brody

  2. University of Illinois Urbana-Champaign, Champaign, USA

    S. Lara-Cinisomo

  3. Cardiff University, Cardiff, UK

    K. Melvin

Authors
  1. Mary C. Kimmel
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  2. S. Lara-Cinisomo
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  3. K. Melvin
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  4. A. Di Florio
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  5. A. Brandon
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  6. S. Meltzer-Brody
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Correspondence to Mary C. Kimmel.

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Conflict of interest

We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome. While not directly related to this manuscript, Dr. Meltzer-Brody discloses that she gets grant support from Sage Therapeutics and Dr. Kimmel discloses that her spouse has roughly $5400 in stock from Abbott and $7700 in stock from AbbVie as part of his financial portfolio.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Kimmel, M.C., Lara-Cinisomo, S., Melvin, K. et al. Treatment of severe perinatal mood disorders on a specialized perinatal psychiatry inpatient unit. Arch Womens Ment Health 19, 645–653 (2016). https://doi.org/10.1007/s00737-016-0599-3

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  • DOI: https://doi.org/10.1007/s00737-016-0599-3

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