Conference paper
CREATIVE PERSON-CENTERED PSYCHOPHARMACOTHERAPY IN THE CONTEXT OF PRENATAL PSYCHIATRY - DILEMMAS AND CHALLENGES
Dina Šmigalović
; Mental Health Care Center, Public Institution "Dom zdravlja" Kalesija, Kalesija, Bosnia and Herzegovina
Mevludin Hasanović
; Department of Psychiatry, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina ; Faculty of Medicine University of Tuzla, Tuzla, Bosnia and Herzegovina
Izet Pajević
; Department of Psychiatry, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina ; Faculty of Medicine University of Tuzla, Tuzla, Bosnia and Herzegovina
Asim Kurjak
; Department of Obstetric and Gynecology, Clinical Hospital "Sveti Duh",Medical School, University of Zagreb, Zagreb, Croatia, University of Zagreb, Zagreb, Croatia
Miro Jakovljević
; Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Aron Mulahalilović
; Mental Health Care Center, Public Institution "Dom zdravlja" Gradačac, Gradačac, Bosnia and Herzegovina Bosnia and Herzegovina
Abstract
The authors presented a psychopharmacotherapeutic approach to the treatment of women in the prenatal period that requires a
personalized, person-centered treatment plan. Treatment should include care for the mental health of women of childbearing age,
pregnancy planning, during the prenatal period, and then during the postpartum period. The authors highlighted creative
psychopharmacotherapy which is the foundation of holistic and integrative treatment of mental disorders. They emphasize the
significant role of the mother in the emotional development of the child, which begins while the child is still in the womb. Mothers
who stop taking psychotropic drugs during pregnancy have an increased risk of recurrence of the mental disorder after childbirth
because the mother's psychiatric illness is not a benign event and can cause significant morbidity for both the mother and her child,
therefore, discontinuation or denial of medication during pregnancy is not always the safest option. For more serious disorders, such as
schizophrenia, bipolar disorder, and severe depression, medications may be needed during pregnancy and lactation, despite complex
evidence based on the effects of psychotropic medications on the fetus and newborn. Perinatal mental health has become a significant
focus of interest in recent years. The randomized controlled examinations provide evidence of the effectiveness of psychological and
psychosocial interventions at the individual level. It is necessary to make a new conceptual shift in the approach to maintaining the
mental health of pregnant women and newborns, and that is to optimize the mental health of pregnant women, and not simply reduce the
symptoms of mental disorders from which they suffer before conception, during pregnancy and after childbirth. Dilemmas and
challenges of psychopharmacotherapeutic treatment in the prenatal period are intensified by the knowledge that the psychological
difficulties of mothers can significantly affect the integrity of the safe relationship between mother and child, which is essential for the
emotional, cognitive, and behavioral development of the child. Often, these problems existed before pregnancy or occurred during
pregnancy, and they are often the deterioration of the mental state due to discontinuation of pharmacotherapy during this period.
The quality of the biopsychosocial milieu in the fetal period and childhood during the early neuroplastic development phase is
one of the determinants of risk for diseases during the life cycle. For this reason, the mental health of pregnant women and mothers
must be optimized. For many of these women, health is optimized with pharmacotherapy.
Keywords
creative person-centered psychopharmacotherapy; prenatal psychiatry; mental disorders
Hrčak ID:
275076
URI
Publication date:
19.10.2021.
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