PSYCHIATRIC

DISORDERS DURING
PREGNANCY

PRESENTED BY:
LAMNUNNEM HAOKIP
MSC (N) 2ND YEAR
SNSR, SU
 INTRODUCTION

• Pregnancy is generally thought to be a time of happiness

and emotional well-being for a woman. However, for
many women, pregnancy and motherhood increase their
vulnerability to psychiatric conditions such as
depression, anxiety disorders, eating disorders, and
psychosis.
 DEFINITION

Depression: Depression is a state of low mood and aversion

to activity. Classified medically as a mental and behavioural
disorder, the experience of depression affects a person's
thoughts, behaviour, motivation, feelings, and sense of well-
being.

Anxiety: Anxiety is an emotion characterized by feelings of

tension, worried thoughts and physical changes like

increased blood pressure.

 Eating disorders: Eating disorders are illnesses in which
the person experience severe disturbances in eating
behaviours and related thoughts and emotions.

Psychosis: Psychosis is a mental health problem that causes

people to perceive or interpret things differently from those
around them. This might involve hallucinations or
delusions.
TYPES OF PSYCHIATRIC
DISORDERS
IN PREGNANCY

CHART
 DEPRESSION

TYPES OF
PSYCHIATRIC ANXIETY
PSYCHOSIS DISORDERS
DISORDERS

EATING
DISORDERS
 DEPRESSION
According to The American Congress of
Obstetricians and Gynaecologists (ACOG),
between 14-23% of women will struggle with
some symptoms of depression during pregnancy.

• RISK FOR DEPRESSION: Having a history of

depression, Age at time of pregnancy, living
alone, having limited social support,
experiencing marital conflict and feeling
ambivalent about pregnancy.
 Signs of Depression
 Persistent sadness

 Difficulty concentrating

 Sleeping too little or too much

 Loss of interest in activities that you usually enjoy

 Recurring thoughts of death, suicide, or hopelessness

 Anxiety

 Feelings of guilt or worthlessness

 Change in eating habits.

 Management
Non-Pharmacological treatment

 Psychotherapy

 Behavioural Therapy

Pharmacological Treatment

• Tab. Citalopram 20mg/day, may increase to 40 mg/day.

• Tab. Sertraline 25 – 50 mg/day, may increase to 200

mg/day.
 ANXIETY DISORDERS
• Anxiety is a feeling of apprehension caused by anticipation
of an ill- defined threat or danger that is not realistically
based.
• It is the emotional reaction to a known, well defined external
threat or danger.
 Types Of Anxiety
Disorders

 Panic Disorder
 Obsessive Compulsive Disorder
 Generalized Anxiety Disorder
 Phobic disorders
 Signs And Symptoms
Palpitations

Tachycardia

Restlessness, Profuse Sweating

Irritability, Worrying thoughts, Diarrhoea,

Frequent or urgent micturition, Sweating,

Flushing or pallor, Feeling dizzy, unsteady or

fainting, Muscle tension, Tremors, Fatigue

Muscle aches, Headache.

 Management

Psychotherapy
 Supportive Psychotherapy

 Behavioural Therapy
 Cognitive-behavioural therapy

 Psychodynamic (insight-oriented) therapy

Pharmacotherapy

• Selective Serotonin Reuptake Inhibitors (SSRIs) –

Citalopram (Celexa) and Sertraline (Zoloft).

 EATING DISORDERS

Pregnancy can be a stressful and anxious time for some

women, especially those with an eating disorder. The
accompanying weight gain and change in body shape can
lead to recurrence or worsening of the eating disorder.

Pregnant women with eating disorders need enhanced

monitoring and postnatal support.
Types Of Eating Disorders
• Anorexia nervosa: Loss of appetite.
• Bulimia Nervosa: Binge eating.

Symptoms seen in high risk women who should be screened for

eating disorders

• Low body mass index.

• Concerned about weight but not overweight.

• Menstrual disturbances or amenorrhoea.

• Gastrointestinal symptoms.

• Physical signs of starvation or repeated vomiting.

• Psychological problems
 Management
• Treat the eating disorder before pregnancy.
• Nutritional advice before pregnancy.

• Educate women about nutrition and growth of the fetus.

• Refer the woman to an eating disorder service as early in
pregnancy as possible if she has an active eating disorder.
• Joint obstetric care is needed if the woman has active anorexia
nervosa or there are concerns that she is vulnerable.
• Liaise with the health visitor to monitor infant growth and
weight gain closely.
 PSYCHOSIS

• Psychosis is a mental health problem that causes people to

perceive or interpret things differently from those around
them. This might involve hallucinations or delusions.
• However, for women with a history of psychosis, particularly
psychosis in previous pregnancies, the relapse rates are high,
with the most common manifestations being bipolar illness,
followed by psychotic depression and schizophrenia.
Types of Psychotic disorders
• Bipolar mood disorder

• Schizophrenia
Signs and symptoms
 Hallucinations: Hearing voices, Seeing things which other

people do not see.

 Delusions: Being followed by secret agents or members of the

public, That people are out to get you or trying to kill you.
 Cognitive experiences: Concentration problems, Memory

problems, Unable understand new information, and,

Difficulty making decisions.
 Management

Non-Pharmacological

•Cognitive Behaviour Therapy

•Family Intervention

•Art Therapy

Pharmacological

•Olanzapine: Zyprexa, Zalasta, Zolafren, Olzapin, Rexapin 7.5 mg

– 10 mg.

•Haloperidol: Halidace, Hexidol, Dolteus, Dolsi, Helinase, Typidol

– 0.5 to 2mg orally 2 – 3 times per day. 

 NURSING RESPONSIBILITIES

 Caring for patient with acute conditions.

 Administering medications

 Helping patient to overcome stressful events

 Interacting with patient families

 Preparing and maintaining patients records, producing care

plans and risk assessments.
 Organizing group therapy sessions, including social and
artistic events, aimed at promoting patients' mental recovery.
 SUMMARY
&
CONCLUSION
 BIBLIOGRAPHY / REFERENCES
• Annamma Jabob. A comprehensive textbook of
Midwifery and Gynaecological Nursing, Fourth
edition.pp 724-741.
• Lily Podder. Fundamentals of Midwifery and Obstetrical
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• DC Dutta’s textbook of Obstetrics. Hiralal Konar 8th
Edition.Jaypee The Health Sciences Publisher.pp 440 –
457.
• DAVIS’S DRUG GUIDE for Nurses TWELFTH
EDITION. Pp 806-808,869-870.
• Mosby’s 2020. Nursing Drug Reference. Skidmore, Third
South Asia Edition. Pp 801-803,732-734.678 – 687.
• National Institute for Health and Clinical
Excellence. Eating disorders. Core interventions in
the treatment and management of anorexia nervosa,
bulimia nervosa and related eating disorders. 2004. 
www.nice.org.uk/guidance/index.jsp?action=byID&r
=true&o=10932
• Karasu TB, Docherty JP, Gelenberg A, et al. Practice
guideline for major depressive disorder in adults.
American Psychiatric Association. Am J Psychiatry
1993;150(suppl 4):1-26. PubMed Citation
• Neziroglu F, Anemone R, Yaryura-Tobias JA. Onset
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