Short-term outcomes of mothers and newborn infants with comorbid psychiatric disorders and drug dependency.
OBJECTIVE
The aim of the present study was to determine the characteristics and short-term outcomes of mother-infant pairs with comorbid drug dependency and psychiatric disorders.


METHODS
A population-based retrospective chart review was carried out of 879 drug-dependent mother and infant pairs in New South Wales (NSW) and the Australian Capital Territory (ACT) who delivered between 1 January and 31 December 2004.


RESULTS
Psychiatric comorbidity (dual diagnosis, DD) was identified in 396 (45%) of the 879 drug-dependent women. DSM-IV depression (79%), followed by anxiety (20%), was most prevalent. DD women were more likely to use amphetamines (29% vs 18%, p < 0.05), less likely to use opiates (42% vs 51%, p < 0.05) and to have had no antenatal care (24% vs 8%, p < 0.05). They also had more previous pregnancies (4, range = 2-5 vs 3, range = 2-5, p < 0.05) and domestic violence (29% vs 14%, p < 0.05) was more common. DD infants were less likely to be admitted to a nursery (47% vs 55%, p < 0.05). Withdrawal scores were similar (maximum median Finnegan scores = 4 (interquartile range = 3-8) vs 10 (interquartile range = 7-12, p = 0.30) but fewer needed withdrawal medication (19% vs 27%, p < 0.05). Maternal psychotropic agents did not worsen the severity of neonatal withdrawal.


CONCLUSIONS
Psychiatric comorbidity, especially depression, is common and affects almost half of drug-using mothers. Antenatal care, drug use and social outcomes are worse for DD mothers and their infants. It is recommended that all drug-using women be assessed antenatally for psychosocial disorders so that timely mental health intervention can be offered, if required.
Oei
Ju Lee
JL
Department of Newborn Care, Royal Hospital for Women, NSW, Australia. ju.oei@sesiahs.health.nsw.gov.au
Abdel-Latif
Mohamed E
ME
Craig
Fiona
F
Kee
Aivy
A
Austin
Marie-Paule
MP
Lui
Kei
K
D000662:Amphetamines / Q000009:adverse effects; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D017579:Domestic Violence / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008427:Maternal Health Services / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000188:drug therapy* / Q000453:epidemiology*; D009035:Mothers; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology / Q000209:etiology*; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012720:Severity of Illness Index; D013375:Substance Withdrawal Syndrome / Q000209:etiology* / Q000517:prevention & control*; D019966:Substance-Related Disorders / Q000188:drug therapy / Q000453:epidemiology*; D016896:Treatment Outcome
D000662:Amphetamines; D011619:Psychotropic Drugs