Antenatal and Postnatal Mental Health

Excerpt

The guideline makes recommendations for the use of pharmacological, psychological and service-level interventions. It aims to:

• evaluate the role of specific pharmacological agents in the treatment and management mental health problems in pregnancy and the postnatal period
• evaluate the role of specific psychological interventions in the treatment and management of mental health problems in pregnancy and the postnatal period
• evaluate the role of specific service-delivery systems and service-level interventions in the management of mental health problems in pregnancy and the postnatal period
• to provide best-practice advice on the care of women with a mental health problem in pregnancy or the postnatal period through the different phases of illness, including the initiation of treatment, the treatment of acute episodes and the promotion of recovery
• consider economic aspects of various standard treatments of mental health problems in pregnancy and the postnatal period
• promote the implementation of best clinical practice through the development of recommendations tailored to the requirements of the NHS in England and Wales.

Contents

• GUIDELINE DEVELOPMENT GROUP MEMBERS AND NATIONAL COLLABORATING CENTRE FOR MENTAL HEALTH REVIEW (NCCMH) TEAM
• ACKNOWLEDGEMENTS
• GUIDELINE DEVELOPMENT GROUP MEMBERS 2007
• 1. PREFACE
  • 1.1. NATIONAL CLINICAL GUIDELINES
  • 1.2. THE NATIONAL ANTENATAL AND POSTNATAL MENTAL HEALTH GUIDELINE
• 2. ANTENATAL AND POSTNATAL MENTAL HEALTH
  • 2.1. SCOPE OF THE GUIDELINE
  • 2.2. MENTAL HEALTH PROBLEMS IN PREGNANCY AND THE POSTNATAL PERIOD
  • 2.3. INCIDENCE AND PREVALENCE OF MENTAL HEALTH PROBLEMS IN PREGNANCY AND THE POSTNATAL PERIOD
  • 2.4. AETIOLOGY OF MENTAL HEALTH PROBLEMS IN PREGNANCY AND THE POSTNATAL PERIOD
  • 2.5. TREATMENT IN THE NHS
  • 2.6. THE ECONOMIC COSTS OF MENTAL HEALTH PROBLEMS IN PREGNANCY AND THE POSTNATAL PERIOD
• 3. METHODS USED TO DEVELOP THIS GUIDELINE
  • 3.1. OVERVIEW
  • 3.2. THE SCOPE
  • 3.3. THE GUIDELINE DEVELOPMENT GROUP
  • 3.4. REVIEW PROTOCOLS
  • 3.5. CLINICAL REVIEW METHODS
  • 3.6. HEALTH ECONOMICS METHODS
  • 3.7. USING NICE EVIDENCE REVIEWS AND RECOMMENDATIONS FROM EXISTING NICE CLINICAL GUIDELINES
  • 3.8. LINKING EVIDENCE TO RECOMMENDATIONS
  • 3.9. STAKEHOLDER CONTRIBUTIONS
  • 3.10. VALIDATION OF THE GUIDELINE
• 4. THE ORGANISATION OF PERINATAL MENTAL SERVICES
  • 4.1. THE 2007 STRUCTURE OF SERVICES
  • 4.2. ESTIMATING THE NEED FOR SERVICES
  • 4.3. THE FUNCTIONS OF SERVICES FOR WOMEN, THEIR PARTNERS AND CARERS IN PREGNANCY AND THE POSTNATAL PERIOD
  • 4.4. MANAGED CLINICAL NETWORKS
  • 4.5. RECOMMENDATIONS
• 5. CASE IDENTIFICATION AND ASSESSMENT
  • 5.1. INTRODUCTION
  • 5.2. CLINICAL REVIEW PROTOCOL (CASE IDENTIFICATION AND ASSESSMENT)
  • 5.3. CASE IDENTIFICATION
  • 5.4. ASSESSMENT
• 6. EXPERIENCE OF CARE
  • 6.1. INTRODUCTION
  • 6.2. REVIEW OF THE PRIMARY EVIDENCE
  • 6.3. LINKING EVIDENCE TO RECOMMENDATIONS
  • 6.4. RECOMMENDATIONS
• 7. PSYCHOLOGICAL AND PSYCHOSOCIAL INTERVENTIONS FOR THE PREVENTION OR TREATMENT OF MENTAL HEALTH PROBLEMS
  • 7.1. INTRODUCTION
  • 7.2. FACTORS TO CONSIDER IN THE EVALUATION OF PSYCHOLOGICAL AND PSYCHOSOCIAL TREATMENT
  • 7.3. DEFINITIONS OF PSYCHOLOGICAL AND PSYCHOSOCIAL INTERVENTIONS
  • 7.4. PSYCHOLOGICAL AND PSYCHOSOCIAL INTERVENTIONS FOR THE PREVENTION OF MENTAL HEALTH PROBLEMS
  • 7.5. PSYCHOLOGICAL AND PSYCHOSOCIAL INTERVENTIONS FOR THE TREATMENT OF MENTAL HEALTH PROBLEMS
  • 7.6. LINKING EVIDENCE TO RECOMMENDATIONS
  • 7.7. RECOMMENDATIONS
• 8. PHARMACOLOGICAL AND PHYSICAL INTERVENTIONS
  • 8.1. INTRODUCTION
  • 8.2. PHARMACOLOGICAL INTERVENTIONS FOR THE PREVENTION OF MENTAL HEALTH PROBLEMS IN PREGNANCY AND THE POSTNATAL PERIOD
  • 8.3. PHARMACOLOGICAL INTERVENTIONS FOR THE TREATMENT OF MENTAL HEALTH PROBLEMS IN PREGNANCY AND THE POSTNATAL PERIOD
  • 8.4. HARMS ASSOCIATED WITH SPECIFIC DRUGS IN PREGNANCY AND THE POSTNATAL PERIOD
  • 8.5. PHYSICAL INTERVENTIONS FOR THE PREVENTION OF MENTAL HEALTH PROBLEMS IN PREGNANCY AND THE POSTNATAL PERIOD
  • 8.6. PHYSICAL INTERVENTIONS FOR THE TREATMENT OF MENTAL HEALTH PROBLEMS IN PREGNANCY AND THE POSTNATAL PERIOD
  • 8.7. ELECTROCONVULSIVE THERAPY FOR MENTAL HEALTH PROBLEMS IN PREGNANCY AND THE POSTNATAL PERIOD
  • 8.8. LINKING EVIDENCE TO RECOMMENDATIONS
  • 8.9. RECOMMENDATIONS
• 9. SUMMARY OF RECOMMENDATIONS
  • 9.1. USING THIS GUIDELINE IN CONJUNCTION WITH OTHER NICE GUIDELINES
  • 9.2. CONSIDERATIONS FOR WOMEN OF CHILDBEARING POTENTIAL
  • 9.3. PRINCIPLES OF CARE IN PREGNANCY AND THE POSTNATAL PERIOD
  • 9.4. TREATMENT DECISIONS, ADVICE AND MONITORING FOR WOMEN WHO ARE PLANNING A PREGNANCY, PREGNANT OR IN THE POSTNATAL PERIOD
  • 9.5. RECOGNISING MENTAL HEALTH PROBLEMS IN PREGNANCY AND THE POSTNATAL PERIOD AND REFERRAL
  • 9.6. ASSESSMENT AND CARE PLANNING IN PREGNANCY AND THE POSTNATAL PERIOD
  • 9.7. PROVIDING INTERVENTIONS IN PREGNANCY AND THE POSTNATAL PERIOD
  • 9.8. TREATING SPECIFIC MENTAL HEALTH PROBLEMS IN PREGNANCY AND THE POSTNATAL PERIOD
  • 9.9. CONSIDERATIONS FOR WOMEN AND THEIR BABIES IN THE POSTNATAL PERIOD
  • 9.10. THE ORGANISATION OF SERVICES
• APPENDICES
  • APPENDIX 1. SCOPE FOR THE DEVELOPMENT OF THE CLINICAL GUIDELINE
  • APPENDIX 2. DECLARATIONS OF INTERESTS BY GUIDELINE DEVELOPMENT GROUP MEMBERS
  • APPENDIX 3. SPECIAL ADVISORS TO THE GUIDELINE DEVELOPMENT GROUP
  • APPENDIX 4. STAKEHOLDERS WHO RESPONDED TO EARLY REQUESTS FOR EVIDENCE
  • APPENDIX 5. RESEARCHERS CONTACTED TO REQUEST FURTHER INFORMATION FROM PUBLISHED STUDIES
  • APPENDIX 6. EXPERT REVIEWERS WHO SUBMITTED COMMENTS IN RESPONSE TO THE CONSULATION DRAFT OF THE GUIDELINE
  • APPENDIX 7. STAKEHOLDERS WHO SUBMITTED COMMENTS IN RESPONSE TO THE CONSULTATION DRAFT OF THE GUIDELINE
  • APPENDIX 8. ANALYTIC FRAMEWORK AND REVIEW QUESTIONS
  • APPENDIX 9. REVIEW PROTOCOLS
  • APPENDIX 10. SEARCH STRATEGIES FOR THE IDENTIFICATION OF CLINICAL STUDIES
  • APPENDIX 11. SEARCH STRATEGIES FOR THE IDENTIFICATION OF HEALTH ECONOMICS EVIDENCE
  • APPENDIX 12. EVIDENCE SYNTHESIS METHODS
  • APPENDIX 13. METHODOLOGY CHECKLIST FOR CLINICAL STUDIES AND REVIEWS
  • APPENDIX 14. METHODOLOGY CHECKLIST TEMPLATE FOR ECONOMIC STUDIES
  • APPENDIX 15. RESEARCH RECOMMENDATIONS
  • APPENDIX 16. CHANGES MADE TO THE 2007 FULL GUIDELINE
  • APPENDIX 17. CLINICAL EVIDENCE – COMPLETED METHODOLOGY CHECKLISTS
  • APPENDIX 18. CLINICAL EVIDENCE – STUDY CHARACTERISTICS TABLES
  • APPENDIX 19. CLINICAL EVIDENCE – FOREST PLOTS
  • APPENDIX 20. ECONOMIC EVIDENCE – COMPLETED METHODOLOGY CHECKLISTS
  • APPENDIX 21. EVIDENCE TABLES – EVIDENCE TABLES OF PUBLISHED STUDIES
  • APPENDIX 22. CLINICAL AND ECONOMIC EVIDENCE PROFILES
  • APPENDIX 23. 2007 METHODS CHAPTER
  • APPENDIX 24. 2007 HEALTH ECONOMICS EVIDENCE ON MOTHER AND BABY UNITS
  • APPENDIX 25. 2007 SURVEY OF ANTENATAL AND POSTNATAL MENTAL HEALTH PRIMARY CARE SERVICES IN ENGLAND AND WALES – QUESTIONNAIRE
  • APPENDIX 26. 2007 RESULTS OF SURVEY OF ANTENATAL AND POSTNATAL MENTAL HEALTH PRIMARY CARE SERVICES IN ENGLAND AND WALES
  • APPENDIX 27. 2007 CHAPTER 4 (POPULATION, DISORDERS AND SERVICES)
• REFERENCES
• ABBREVIATIONS

This guideline should be read in conjunction with ‘Service User Experience in Adult Mental Health’, NICE Clinical Guidance 136 and ‘Patient experience in adult NHS services’, NICE Clinical Guidance 138.