title: Maternal mental health and integrated programs for mothers with substance abuse issues.
abstract: To examine the impact of integrated treatment programs (those with substance use treatment and pregnancy-, parenting-, or child-related services) on maternal mental health, we compiled a database of studies of integrated programs published between 1990 and 2007 with outcome data on maternal mental health. There were 18 cohort studies, 3 randomized trials, and 2 quasi-experimental studies. Of the five studies comparing integrated to nonintegrated programs, three studies provided enough information to allow for them to be combined in a meta-analysis. The average effect size was 0.23 (95% CI = 0.15 to 0.31, SE = 0.04), p < .001. There was no statistically significant heterogeneity among the studies, Q = 5.66, p = .059. This meta-analysis is the first systematic quantitative review of studies evaluating the impact of integrated programs on maternal mental health. Findings suggest that integrated programs may be associated with a small advantage over nonintegrated programs in improving maternal mental health. This review highlights the need for further research with improved methodology, study quality, and reporting to improve our understanding of how best to meet the mental health needs of mothers with substance abuse issues.
authors.affiliation: Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada. niccols@hhsc.ca
authors.forename: Alison
authors.initials: A
authors.lastname: Niccols
authors.forename: Karen
authors.initials: K
authors.lastname: Milligan
authors.forename: Wendy
authors.initials: W
authors.lastname: Sword
authors.forename: Lehana
authors.initials: L
authors.lastname: Thabane
authors.forename: Joanna
authors.initials: J
authors.lastname: Henderson
authors.forename: Ainsley
authors.initials: A
authors.lastname: Smith
authors.forename: Jennifer
authors.initials: J
authors.lastname: Liu
authors.forename: Susan
authors.initials: S
authors.lastname: Jack
mesh_terms: D002986:Clinical Trials as Topic; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008429:Maternal Welfare / Q000523:psychology*; D008603:Mental Health; D009035:Mothers / Q000523:psychology*; D011247:Pregnancy / Q000523:psychology; D019966:Substance-Related Disorders / Q000523:psychology / Q000628:therapy*