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Review
. 2017;4(1):1-13.
doi: 10.1007/s40429-017-0132-4. Epub 2017 Mar 9.

Psychiatric Co-Morbidities in Pregnant Women with Opioid Use Disorders: Prevalence, Impact, and Implications for Treatment

Camila L Arnaudo  1 , Barbara Andraka-Christou  2 , Kacy Allgood  3
Affiliations
Review

Psychiatric Co-Morbidities in Pregnant Women with Opioid Use Disorders: Prevalence, Impact, and Implications for Treatment

Camila L Arnaudo et al. Curr Addict Rep. 2017.

Abstract

Purpose of review: This review seeks to investigate three questions: What is the prevalence of comorbid psychiatric diagnoses among pregnant women with opioid use disorder (OUD)? How do comorbid psychiatric illnesses impact pregnant women with OUD? And how do comorbid psychiatric illnesses affect the ability of pregnant women with OUD to adhere to and complete OUD treatment?

Recent findings: Based on this literature review, 25-33% of pregnant women with OUD have a psychiatric comorbidity, with depression and anxiety being especially common. However, of the 17 studies reviewed only 5 have prevalence rates of dual diagnosis in pregnant women with OUD as their primary outcome measures, their N's were typically small, methods for determining psychiatric diagnosis were variable, and many of the studies were undertaken with women presenting for treatment which carries with its implicit selection bias. Of the women enrolled in treatment programs for SUD, those with psychiatric comorbidity were more likely to have impaired psychological and family/social functioning than those without psychiatric comorbidity. Greater severity of comorbid psychiatric illness appears to predict poorer adherence to treatment, but more research is needed to clarify this relationship with the psychiatric illness is less severe.

Summary: While cooccurrence of psychiatric disorders in pregnant women with opioid use disorder appears to be common, large population-based studies with validated diagnostic tools and longitudinal assessments are needed to obtain definitive rates and characteristics of cooccurring illnesses. Integrated prenatal, addiction, and psychiatric treatment in a setting that provides social support to pregnant patients with OUD is most effective in maintaining women in treatment. More research is still needed to identify optimal treatment settings, therapy modalities, and medication management for dually diagnosed pregnant women with OUD.

Keywords: Addiction; Comorbidity; Dual diagnosis; Opioid; Pregnant; Psychiatric disorder; Substance use disorder.

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Conflict of interest statement

Conflict of Interest

Camila L. Arnaudo, Basia Andraka-Christou, and Kacy Allgood declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

    1. Krans EE, Patrick SW. Opioid use disorder in pregnancy: health policy and practice in the midst of an epidemic. Obstet Gynecol. 2016;128(1):4–10. doi: 10.1097/AOG.0000000000001446. - DOI - PMC - PubMed
    1. Maeda A, Bateman BT, Clancy CR, Creanga AA, Leffert LR. Opioid abuse and dependence during pregnancy: temporal trends and obstetrical outcomes. Anesthesiology. 2014;121(6):1158–1165. doi: 10.1097/ALN.0000000000000472. - DOI - PubMed
    1. Green TC, Grimes Serrano JM, Licari A, Budman SH, Butler SF. Women who abuse prescription opioids: findings from the addiction severity index-multimedia version connect prescription opioid database. Drug Alcohol Depend. 2009;103(1–2):65–73. doi: 10.1016/j.drugalcdep.2009.03.014. - DOI - PMC - PubMed
    1. Substance Abuse and Mental Health Services Administration, Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-48, HHS Publication No. (SMA) 14–4863. In: SERVICES USDOHAH, editor. Rockville, MD: Substance Abuse and Mental Health Services Administration 2014.
    1. Brady TM, Ashley, OS. Women in substance abuse treatment: results from the Alcohol and Drug Services Study (ADSS), (DHHS Publication No. SMA 04–3968, Analytic Series A-26).. In: Substance Abuse and Mental Health Services Administration OoAS, editor. Rockville, M.D. 2005.

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