Psychopathology, Psychosocial Problems and Substance Use During Pregnancy: screening and referral towards care

Abstract

The overall aim of the present thesis is to demonstrate the feasibility of an innovative screenand- advice instrument, for routine screening and subsequent referral to tailored care of pregnant women with psychopathology, psychosocial problems and substance use. Firstly, this dissertation addresses how and by whom PPS risk management should be performed, with regard to screening and subsequent guidance to specialised care, if indicated. Secondly, this dissertation outlines recommendations for a targeted prevention of poor perinatal health related to PPS, by investigating the role of PPS in the pathway to the preterm birth, birth weight and small for gestational age. To that purpose fi ve research questions are answered: 1. What is the prevalence of psychopathology, psychosocial problems and substance use during pregnancy in a large Dutch urban area? (chapter 2) 2. Is the Mind2Care screen-and-advice instrument a reliable and valid instrument for routine use in obstetric care? (chapters 2, 3, and 4) 3. Is the antenatal screening for depressive and/or anxiety symptoms biased by worries surrounding the fi rst ultrasound examination? (chapter 5) 4. How many pregnant women identifi ed as being at risk for PPS after screening eventually receive specialized treatment? (chapter 6) 5. What is the role of psychopathology, psychosocial problems and substance use in the pathway to adverse pregnancy outcomes? (chapters 7 and 8).