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Pseudocyesis In Women

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Pseudocyesis or false pregnancy, a case report for educational purpose

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October 24, Screening for depression and suicide also should include screening for nonsuicidal self-injury. Misuse was defined as use without a prescription; use in greater amounts, more often, or longer than the respondent was told to take them; or use in any other way a doctor did not direct the respondent to use them. Use of psychopharmacologic agents in adolescents depends on accurate diagnosis and typically is an adjunct to nonpharmacological treatment.

The best role for the obstetrician—gynecologist is to address the obstetric and gynecologic implications of these agents. Table 1 includes details about psychopharmacologic medications often prescribed for adolescents. Obstetrician—gynecologists should recognize the complexity of prescribing for an adolescent and young adult population, and that they differ from the adult population. The complexity of prescribing for adolescents is well-reviewed elsewhere 21 An adolescent should be managed by a health care provider with experience and training treating adolescents with mental health disorders. Additionally, narcotics should not be prescribed for underlying pain or dysmenorrhea. Obstetrician—gynecologists should be familiar with local and state rules regarding the medical use of controlled substances, including stimulants and sedatives.

Obstetrician—gynecologists should know that some medications can affect menses and that selective serotonin reuptake inhibitors SSRIs may be associated with sexual dysfunction Table 1. Antiepileptic drugs used for bipolar disorder may affect circulating levels of oral contraceptives and also can affect the efficacy of the medication being prescribed eg, lamotrigine and valproic acid During pregnancy, close collaboration between the obstetrician and the prescribing psychiatrist is essential to provide adequate treatment to balance the benefits with potential maternal and fetal harms The U.

Food and Drug Administration is phasing out the use of product letter categories—A, B, C, D, and X—to classify the risks of using prescription drugs during pregnancy. These categories are being replaced with three detailed subsections that describe risks within the real-world context of caring for pregnant women who may need medication. For more information, see www. The obstetrician—gynecologist, when reviewing current medications, may be the first health care provider to learn that a patient is no longer taking her medication and, therefore, has the opportunity to refer the patient back to her mental health care professional.

Additionally, some data report higher rates of contraceptive nonuse, misuse, and discontinuation among women with symptoms of mental health disorders eg, depression and anxiety compared with asymptomatic women Proactive counseling about long-acting, highly effective contraceptive methods may be beneficial in this population. Obstetrician—gynecologists who care for minors should be aware of federal and state laws that affect confidentiality, state statutes on the rights of minors to consent to health care services, and the regulations that apply to their practice.

During preventive care visits, all adolescents should be screened for any mental health disorder in a confidential setting if allowed by the laws of that locality by asking questions such as those listed in Box 3. This can be self-completed by the patient or administered by the obstetrician—gynecologist or office staff. The last question screens for suicidal thinking. Many institutions use the PHQ-2, the first two questions, as the initial screen. Bright Futures: guidelines for health supervision of infants, children, and adolescents. Instructions: How often have you been bothered by each of the following symptoms during the past 2 weeks?

Adapted from patient health questionnaire PHQ screeners. Retrieved February 2, Positive responses to screening questions should be investigated further and the patient should be referred to a mental health care specialist or agency for further evaluation and treatment. A list of appropriate health care providers and resources should be made available and can include child and adolescent psychiatrists, adolescent-friendly psychologists or other psychotherapists, adolescent medicine specialists, and behavioral pediatricians. Adolescents, especially minors, may benefit from having a parent or guardian as part of the process of accessing mental health services.

Where it is not possible to involve a parent, an alternative adult relative, family friend, or counselor may be an option. Short-term follow-up with a visit or telephone call can determine if recommendations have been followed, provide an opportunity for the obstetrician—gynecologist to offer assistance with any barriers to the referral, and provide support to the patient and her family.

Mental health disorders in adolescence are a significant problem, relatively common, and amenable to treatment or intervention. An understanding of the obstetric and gynecologic implications of mental health disorders and their treatment is critical. Although mental health disorders should be managed by mental health care professionals or appropriately trained primary care providers, the obstetrician—gynecologist can assist by managing the gynecologic adverse effects of psychiatric medications and by providing effective contraception and regular screening for STIs. The American College of Obstetricians and Gynecologists has identified additional resources on topics related to this document that may be helpful for ob-gyns, other health care providers, and patients.

You may view these resources at www. These resources are for information only and are not meant to be comprehensive. The resources may change without notice. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, posted on the Internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher. Mental health disorders in adolescents. Committee Opinion No. American College of Obstetricians and Gynecologists. Obstet Gynecol ;e32— This information is designed as an educational resource to aid clinicians in providing obstetric and gynecologic care, and use of this information is voluntary.

This information should not be considered as inclusive of all proper treatments or methods of care or as a statement of the standard of care. It is not intended to substitute for the independent professional judgment of the treating clinician. Variations in practice may be warranted when, in the reasonable judgment of the treating clinician, such course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology. The American College of Obstetricians and Gynecologists reviews its publications regularly; however, its publications may not reflect the most recent evidence. Any updates to this document can be found on www. ACOG does not guarantee, warrant, or endorse the products or services of any firm, organization, or person.

Neither ACOG nor its officers, directors, members, employees, or agents will be liable for any loss, damage, or claim with respect to any liabilities, including direct, special, indirect, or consequential damages, incurred in connection with this publication or reliance on the information presented. Bulk pricing was not found for item. Please try reloading page. For additional quantities, please contact sales acog. Patient Education Materials For Patients. Featured Clinical Topics. Jump to Jump to Close. Search Page. Resources Close. Recommendations and Conclusions The American College of Obstetricians and Gynecologists makes the following recommendations and conclusions: At least one in five youth aged 9—17 years currently has a diagnosable mental health disorder that causes some degree of impairment; one in 10 has a disorder that causes significant impairment.

Suicide is the second leading cause of death in young people aged 15—24 years. Introduction At least one in five youth aged 9—17 years currently has a diagnosable mental health disorder that causes some degree of impairment; one in 10 has a disorder that causes significant impairment 1 2. Box 1. Panic Disorder: Recurrent unexpected panic attacks. Mood Disorders Adjustment Disorder With Depressed Mood: The development of emotional or behavioral symptoms in response to an identifiable stressor s that occur within 3 months of the onset of the stressor s in which low mood, tearfulness, or feelings of hopelessness are predominant. Attention Deficit Hyperactivity Disorder Symptoms of inattention and hyperactivity or impulsivity present for at least 6 months to a degree that is maladaptive and inconsistent with developmental level.

Disruptive Behavior Disorders Conduct Disorder: Repetitive and persistent pattern of behavior that violates the basic rights of others or the age-appropriate societal norms, including aggression to people and animals, destruction of property, deceitfulness or theft, or serious violation of rules such as running away, truancy, curfew violations. The changes in the uterine endometrium is dependent on the hormones secreted by the ovaries. If pregnancy occurs, the corpus luteum continues to increase in size and the level of progesterone continues to rise and support the early embryo.

The corpus lutuem maintains the pregnancy until the placenta is mature enough to take over its function - this occurs at around the 12 week of pregnancy. The corpus luteum becomes much smaller at this time and eventually atrophies. If pregnancy does not occur, the corpus luteum decreases in size during the luteal phase and eventually atrophies at the time of menstruation..

The progesterone level also falls in tandem with the decreasing action of the corpus luteum. When it reaches a minimum critical level, the endometrium that had been primed by the estrogen and the progesterone to receive an embryo, sheds from the inner wall of the uterus. This shedding of the endometrium with the consequent bleeding is termed menstruation. As soon as the menstruation starts, it denotes the beginning of another menstrual cycle. The estrogen and progesterone secreted by the changes in the ovary during the ovarian cycle acts on the endometrium to produce the uterine cycle. Also Read- Bleeding in Pregnancy. Different Types of Abortion. Vaginal Discharge with Itching. Different Birth Control Methods.

D o you have a gynecological or obstetrical problem? Would you like to discuss it in private? Consult our online gynecologist Dr.

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