Clinical Needs of In-treatment Pregnant Women with Co-occurring Disorders: Implications for Primary Care
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We investigated social vulnerability and behavioral health clinical profiles (symptom severity) of pregnant women with co-occurring disorders, defined as substance abuse, mental illness, and trauma at treatment entry compared to their nonpregnant counterparts and the role of interpersonal abuse in clinical presentation among pregnant women. Our objective was to provide primary health care providers with insight into the needs of pregnant patients with high behavioral health risks to serve them better during the critical window of opportunity for long-term impact. We conducted cross-sectional secondary analysis of baseline data from women enrolled in treatment programs in the Women, Co-occurring Disorders and Violence Study from nine sites across the United States. We used analysis of variance and Cochran–Mantel–Haenszel statistical analyses to compare means and frequencies of social vulnerability indicators and baseline Addiction Severity Index, Brief Symptom Inventory of mental health, and Posttraumatic Stress Diagnostic Scale scores between 152 pregnant and 2,577 nonpregnant women, and between pregnant women with and without current interpersonal abuse. Compared to nonpregnant women, pregnant women evidenced more social vulnerability but better behavioral health clinical profiles at treatment entry. Current interpersonal abuse was associated with increased mental health and trauma symptomatology but not with alcohol or drug abuse severity among pregnant women. The prenatal period is an important time for screening and intervention for factors such as social vulnerability and co-occurring disorders, known to affect pregnancy and infant outcomes; social and behavioral health services are particularly essential among pregnant women with co-occurring disorders.
KeywordsCo-occurring disorders Trauma Women Primary care Clinical profiles
The authors would like to thank the Women, Co-occurring Disorders and Violence Study participants, study site personnel, and funder—the Department of Health and Human Services, Public Health Service, and Substance Abuse and Mental Health Services Administration (GFA No. TI 00-003). The work on this manuscript was funded by the University of Southern California School of Social Work’s Postdoctoral Scholars program. The authors also acknowledge Vivian Brown, Julie Cederbaum, and Kathleen Ell for their feedback during the development of this manuscript and Eric Lindberg for his editorial review of the final manuscript.
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