Short-Term Outcomes of Mothers and Newborn Infants with Comorbid Psychiatric Disorders and Drug Dependency

• Published in: Australian and New Zealand journal of psychiatry 2009-04, Vol.43 (4), p.323-331
• Main Authors: Oei, Ju Lee, Abdel-Latif, Mohamed E, Craig, Fiona, Kee, Aivy, Austin, Marie-Paule, Lui, Kei
• Format: Article
• Language: English
• Subjects: Addictive behaviors; Adult and adolescent clinical studies; Amphetamines - adverse effects; Biological and medical sciences; Comorbidity; Diagnostic and Statistical Manual of Mental Disorders; Domestic Violence - statistics & numerical data; Drug addiction; Drug use; Effect of drugs on; Female; Humans; Infant, Newborn; Maternal Health Services - utilization; Medical sciences; Mental Disorders - drug therapy; Mental Disorders - epidemiology; Miscellaneous; Mother and infant; Mothers; Newborn infants; Pregnancy; Prenatal Exposure Delayed Effects - epidemiology; Prenatal Exposure Delayed Effects - etiology; Psychology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychotropic Drugs - therapeutic use; Severity of Illness Index; Substance Withdrawal Syndrome - etiology; Substance Withdrawal Syndrome - prevention & control; Substance-Related Disorders - drug therapy; Substance-Related Disorders - epidemiology; Treatment Outcome
• ISSN: 0004-8674; 1440-1614
• DOI: 10.1080/00048670902721087

Objectives: 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.