A Peer-to-Peer, Longitudinal Reproductive Psychiatry Educational Curriculum for Obstetrics/Gynecology Residents.
Perinatal psychiatry
Pregnancy
Psychiatric medications
Resident education
Women’s mental health
Journal
Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry
ISSN: 1545-7230
Titre abrégé: Acad Psychiatry
Pays: United States
ID NLM: 8917200
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
received:
21
03
2022
accepted:
09
09
2022
pubmed:
21
9
2022
medline:
1
2
2023
entrez:
20
9
2022
Statut:
ppublish
Résumé
Pregnant patients with psychiatric diagnoses are commonly advised to stop their psychiatric medications. Few studies assess the knowledge of, attitude toward, or comfort levels of obstetrics and gynecology (OB/GYN) residents in managing psychiatric conditions, which carry adverse and potentially life-threatening risks to mother and fetus. A gap remains between evidence advocating for active psychopharmacological treatment during pregnancy and implementation of curricula targeting OB/GYN physicians in mental health. The authors' goals are to assess the knowledge, attitude, and comfort that OB/GYN residents have toward assessing and managing active psychiatric conditions in pregnant/postpartum women and to develop an educational, case-based intervention targeting these conditions in the perinatal/postpartum period. Eight perinatal/postpartum psychiatric topics were developed into interactive cases designed for OB/GYN residents. Two weeks before the curriculum administration, OB/GYN residents were surveyed on prior knowledge in, attitudes toward, and comfort levels in assessing and discussing psychiatric conditions in pregnant patients. The assessment was administered again after the intervention to assess its effectiveness. Pre- (N = 19) and post-intervention (N = 15) surveys of residents were analyzed. Most residents (94%) felt it was both important and their responsibility to discuss mental health conditions with pregnant patients. Comfort levels with counseling psychiatric patients increased for all eight topics after the educational intervention was implemented, with statistically significant increases (p < 0.05) for five of the topics. OB/GYN residents feel responsible for caring for pregnant patients with psychiatric illness, and case-based interventions offer an interactive, helpful tool for increasing residents' knowledge and comfort level in treating this patient population.
Identifiants
pubmed: 36127485
doi: 10.1007/s40596-022-01710-4
pii: 10.1007/s40596-022-01710-4
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
43-47Informations de copyright
© 2022. The Author(s), under exclusive licence to American Association of Chairs of Departments of Psychiatry, American Association of Directors of Psychiatric Residency Training, Association for Academic Psychiatry and Association of Directors of Medical Student Education in Psychiatry.
Références
Rodriguez-Cabezas L, Clark C. Psychiatric emergencies in pregnancy and postpartum. Clin Obstet Gynecol. 2018;61(3):615–27.
doi: 10.1097/GRF.0000000000000377
Gentile S. Untreated depression during pregnancy: short- and long-term effects in offspring. A systematic review. Neuroscience. 2017;342:154–66.
doi: 10.1016/j.neuroscience.2015.09.001
Bhat A, Hadley A. The management of alcohol withdrawal in pregnancy—case report, literature review and preliminary recommendations. Gen Hosp Psychiatry. 2015;37(3):273.e1-3. https://doi.org/10.1016/j.genhosppsych.2015.02.001 .
doi: 10.1016/j.genhosppsych.2015.02.001
Keough L, Fantasia HC. Pharmacologic treatment of opioid addiction during pregnancy. Nurs Womens Health. 2017;21(1):34–44.
doi: 10.1016/j.nwh.2016.12.010
Hardy LT, Reichenbacker OL. A practical guide to the use of psychotropic medications during pregnancy and lactation. Arch Psychiatr Nursing. 2019;33(3):254–66.
doi: 10.1016/j.apnu.2019.04.001
Weiner S. Addressing the escalating psychiatrist shortage. 2018. https://www.aamc.org/news-insights/addressing-escalating-psychiatrist-shortage . Accessed 17 March 2022.
Garbarino AH, Kohn JR, Coverdale JH, Kilpatrick CC. Current trends in psychiatric education among obstetrics and gynecology residency programs. Acad Psychiatry. 2019;43(3):294–9.
doi: 10.1007/s40596-019-01018-w
Becker M, Weinberger T, Chandy A, Schmukler S. Depression during pregnancy and postpartum. Curr Psychiatry Rep. 2016;18(3):32. https://doi.org/10.1007/s11920-016-0664-7 .
doi: 10.1007/s11920-016-0664-7
Jones I, Chandra PS, Dazzan P, Howard LM. Bipolar disorder, affective psychosis, and schizophrenia in pregnancy and the post-partum period. Lancet. 2014;384(9956):1789–99.
doi: 10.1016/S0140-6736(14)61278-2
Forray A, Foster D. Substance use in the perinatal period. Curr Psychiatry Rep. 2015;17(11):91. https://doi.org/10.1007/s11920-015-0626-5 .
doi: 10.1007/s11920-015-0626-5
Khoramroudi R. The prevalence of posttraumatic stress disorder during pregnancy and postpartum period. J Family Med Prim Care. 2018;7(1):220–3.
doi: 10.4103/jfmpc.jfmpc_272_17
LaPlante L, Gopalan P, Glance J. Addressing intimate partner violence: reducing barriers and improving residents’ attitudes, knowledge, and practices. Acad Psychiatry. 2016;40(5):825–8.
doi: 10.1007/s40596-016-0529-8
Stevens NR, Holmgreen L, Hobfoll SE, Cvengros JA. Assessing trauma history in pregnant patients: a didactic module and role-play for obstetrics and gynecology residents. MedEdPORTAL. 2020;16:10925. https://doi.org/10.15766/mep_2374-8265.10925 .
doi: 10.15766/mep_2374-8265.10925
Boud D, Cohen R, Sampson J. Peer learning in higher education: learning from and with each other. Routledge; 2016.
Morrison EH, Rucker L, Boker JR, Gabbert CC, Hubbell FA, Hitchcock MA, et al. The effect of a 13-hour curriculum to improve residents’ teaching skills. Ann Intern Med. 2004;141(4):257–63.
doi: 10.7326/0003-4819-141-4-200408170-00005
Gaba ND, Blatt B, Macri CJ, Greenberg L. Improving teaching skills in obstetrics and gynecology residents: evaluation of a residents-as-teachers program. Am J Obstet Gynecol. 2007;196(1):87.e1-7. https://doi.org/10.1016/j.ajog.2006.08.037 .
doi: 10.1016/j.ajog.2006.08.037
Brand MW, Ekambaram V, Tucker P, Aggarwal R. Residents as teachers: psychiatry and family medicine residents’ self-assessment of teaching knowledge, skills, and attitudes. Acad Psychiatry. 2013;37(5):313–6.
doi: 10.1176/appi.ap.12050086
Hoffman MC, Wisner KL. Psychiatry and obstetrics: an imperative for collaboration. Am J Psychiatry. 2017;174(3):205–7.
doi: 10.1176/appi.ajp.2016.16111233
Hutner LA, Yeaton-Massey A, Toscano M, Coulehan J, Hage B, Gopalan P, et al. Cultivating mental health education in obstetrics and gynecology: a call to action. Am J Obstet Gynecol MFM. 2021;3(6): 100459. https://doi.org/10.1016/j.ajogmf.2021.100459 .
doi: 10.1016/j.ajogmf.2021.100459