Treatments for mothers with schizophrenia

Why do mothers with schizophrenia need specialised treatments?

Mothers who have been diagnosed with schizophrenia face challenges in accessing and maintaining treatment programs, particularly when inpatient care is required. Mothers with dependent children may be less likely to seek treatments for their illness due to a fear of losing custody of their children, or due to difficulties in finding alternative care should hospitalisation be required. They may also find it difficult to properly adhere to any treatment programs due to the demands of childcare. Mothers have been shown to be particularly at risk of relapse in the months immediately following child birth and specialised programs could help to support them and their babies during this time.

What is the evidence for treatments tailored to mothers with schizophrenia?

Low quality evidence is unclear as to the benefits of specialised programs tailored to mothers with schizophrenia who have dependent children. Review authors conclude that such interventions are lacking and that flexible treatment approaches that incorporate support networks including childcare and family involvement are highly recommended.

Also see the parenthood topic and the pharmaceutical treatments during pregnancy and breastfeeding topic.

April 2016

Treatments during pregnancy and breastfeeding

What are the issues regarding antipsychotic treatment during pregnancy and motherhood? 

Antipsychotic use during pregnancy requires careful consideration of the mother’s risk of illness relapse, against the risk of harm or complications for the developing infant if medication is to be continued.

What is the evidence for the use of antipsychotics during pregnancy and breastfeeding?

Moderate to low quality evidence suggests a small increased risk of heart defect or lower birth weight in infants, and a small increased risk of preterm delivery, but not stillbirth, with exposure to antipsychotics (first or second generation). Low quality evidence is unsure about the risk of termination or spontaneous abortion, and the size and malformation in infants.

Review authors report that the studies did not routinely adjust for potential confounding factors, such as other medication use.

Also see the Course and Outcome parenthood topic and the psychosocial treatments for mothers with schizophrenia topic.

 

December 2017

Parenthood

What are the issues concerning parenthood for people with schizophrenia? 

People with schizophrenia have reduced fertility rates compared to general population rates. There is interest in determining how genetic factors predisposing people to schizophrenia are maintained in the face of these reduced fertility rates and this could be explained by increased fertility rates in unaffected relatives. Antipsychotic use in pregnant women requires careful consideration of the mother’s risk of illness relapse, against the risk of harm or complications for the developing infant (including congenital malformation, or poor obstetric outcomes) if medication is to be continued. However, there is currently very little evidence regarding the use of antipsychotics for schizophrenia during pregnancy and the postpartum period.

What is the evidence regarding parenthood?

Moderate to high quality evidence suggests people with schizophrenia, particularly men, have fewer offspring than people without schizophrenia. Siblings of people with schizophrenia, particularly brothers, also have fewer offspring than people without schizophrenia, although to a lesser degree.

Moderate to low quality evidence suggests a small increased risk of heart defect or lower birth weight in newborn infants, and a small increased risk of preterm delivery, but not stillbirth, with exposure to antipsychotics (first or second generation). Low quality evidence is unsure about the risk of termination or spontaneous abortion, and size or malformation in newborn infants.

Also see pharmaceutical treatments during pregnancy and breastfeeding.

 

March 2019