Background: There are few studies concerning the family planning needs of female chronic psychiatric patients. We aimed to determine the contraceptive needs and sexually transmitted disease (STD) risk-behaviours of female psychiatric out-patients.
Method: Sixty-six female out-patients with major psychiatric disorders, including schizophrenia, bipolar disorder and mood disorders, completed a semi-structured interview (response rate = 63%) and were individually matched for age and ethnicity with 66 women who had never been treated for psychiatric illness. They answered questions on child-rearing and on their methods of contraception in relation to their attitudes towards pregnancy, as well as on their risk for STDs.
Results: Compared with controls, the female patients reported having had significantly more induced abortions and were significantly more likely to have given up their own children for others to raise. Heterosexually active psychiatric patients were significantly more likely than controls to have had more than one male sexual partner, to have been pressured into unwanted sexual intercourse, and to report having had sexual intercourse with a suspected bisexual over the preceding year.
Conclusions: These results underscore the priority for developing programmes that reduce female psychiatric patients' risk for unwanted pregnancies and STDs.
PIP: 66 patients 18-50 years of age with chronic psychiatric disorders were interviewed using semistructured interviews at a community mental health center in Auckland, New Zealand, resulting in a response rate of 62.9%. Each patient was matched with a control for ethnicity and age. The psychiatric patients also completed the Mini-Mental State Examination. The interview covered demographic, obstetric, and gynecologic information and information on women's risk for unwanted pregnancies and STDs. The mean age of cases was 36.03 years and that of the controls was 36.20 years. The mean age of leaving school was around 16 years. The mean duration of psychiatric illness was 12.5 years. 24.2% of patients vs. 50.0% of controls were currently married or living with a male partner (p 0.005); 24.2% of patients vs. 54.5% of controls had a job (p 0.001); and 92.3% of patients vs. 36.4% of controls were receiving social welfare (p 0.001). 43 (65.1%) of the patients reported having been pregnant at least once, the total number of completed pregnancies being 80. 9 of the pregnancies ended in miscarriages, 17 in induced abortions, 2 in stillbirths, and 52 in live births. 58 (87.9%) controls had been pregnant at least once. 17 patients (39.5%) and 8 controls (13.8%) had had one or more induced abortions (p 0.01). There was no significant difference between the two groups with regard to miscarriages or stillbirths. 19 children of the patients were under 16 years of age and 8 of them were not living with their mothers. A significantly greater percentage of children of patients (42%), compared with the children of controls (3.8%), were not being reared by their biological mothers (p 0.001). 35 patients (55.4%) had had heterosexual intercourse within the past year. Only one patient had not used birth control. Heterosexually active patients (n = 35) were significantly more likely than heterosexually active controls (n = 52) to have had more than one male sexual partner, to report having been pressured into unwanted intercourse, and to have had intercourse with a bisexual person.