Contemporary Topics in Women's Mental Health (eBook)

Contemporary Topics in Women’s Mental Health 3
Contents 7
Foreword 17
Preface 19
List of Contributors 21
SECTION 1 Current themes in psychiatric disorders among women 27
1. Psychotic disorders and bipolar affective disorder 35
1.1 Psychotic disorders in women 35
1.2 Schizophrenia 36
1.3 Bipolar disorder 43
1.4 Other psychoses 51
1.5 Special issues in women with severe mental illness 53
2. Depression and anxiety among women 63
2.1 Introduction 63
2.2 Epidemiology 63
2.3 Transcultural aspects of affective disturbances in sub-Saharan Africa 67
2.4 Treatment effects 68
2.5 Sex differences in depression and anxiety disorders: Biological determinants 70
2.6 Sex differences in depression and anxiety disorders: Social factors 72
2.7 Mood and anxiety disorders across lifespan in women 76
2.8 Pregnancy 78
2.9 Motherhood 79
2.10 Conclusion 81
3. Somatisation and dissociation 91
3.1 Introduction 91
3.2 Somatisation – definitions and concept 92
3.3 Dissociation – definitions and concept 92
3.4 The diagnosis and classification of somatoform and dissociative disorders 94
3.5 The neurobiology of somatisation and dissociation 96
3.6 Psychosocial factors 100
3.7 Conversion disorder 107
3.8 Hypochondriasis 109
3.9 Dissociative disorders 111
3.10 Conclusions 114
4. Eating disorders 123
4.1 Introduction 123
4.2 Risk factors and pathogenesis 124
4.3 Distribution 126
4.4 Presentation, assessment, diagnosis and engagement 126
4.5 Treatment and management 130
4.6 Conclusion 137
5. Suicidality in women 143
5.1 Definitions 143
5.2 Epidemiology 144
5.3 Suicidality and mental disorders and risk 152
5.4 Suicide prevention 155
6. Alcohol and substance abuse 165
6.1 Introduction 165
6.2 Genetics of alcohol and drug abuse 166
6.3 Burden of the problem and patterns of drinking 166
6.4 Alcohol and drug abuse, risky sexual behaviour and HIV vulnerability 167
6.5 Stigma, women and alcohol and drug abuse 169
6.6 Health consequences 169
6.7 Social and economic consequences 169
6.8 Interventions 170
6.9 Challenges 171
6.10 Research 171
6.11 Recommendations 171
6.12 Conclusions 172
7. Psychiatric consequences of trauma in women 175
7.1 Introduction 175
7.2 What types of traumata are more common among women? 176
7.3 How do women respond to trauma? 180
7.4 What are the trauma related risk factors? 182
7.5 Which mental disorders are related to trauma? 185
7.6 Future directions 190
8. Voices of consumers – women with mental illness share their experiences 195
8.1 ‘Ni Tagibebu’ – ‘I will change my lifestyle’ 195
8.2 Determined to go against the odds 199
8.3 Brilliant madness – a narrative by a young woman from India who is recovering from mental illness 203
8.4 From illness to purpose and recovery . . . 206
8.5 Conclusions 212
SECTION 2 The interface between reproductive health and psychiatry 215
9. Mental health aspects of pregnancy, childbirth and the postpartum period 223
9.1 Mental health and maternal mortality 224
9.2 Mental health and antenatal morbidity 226
9.3 Depression in pregnancy 226
9.4 Anxiety in pregnancy 227
9.5 Cultural preferences and mental health in pregnancy 228
9.6 Inflicted violence and mental health in pregnancy 229
9.7 Mental health and postpartum morbidity 229
9.8 Postpartum blues or mild transient mood disturbance 230
9.9 Postpartum psychotic illness 230
9.10 Postpartum depression 231
9.11 Psychosocial risk factors for postpartum depression 232
9.12 Infant factors and maternal mental health 234
9.13 Cultural specificity of postpartum mood disturbance 234
9.14 Maternal mental health, infant development and the mother-infant relationship 236
9.15 Prevention and treatment of maternal mental health problems 238
9.16 Summary 239
10. Psychosocial issues and reproductive health conditions: An interface 253
10.1 Introduction 253
10.2 Infertility – a psychosocial appraisal 254
10.3 The psychological implications of hysterectomy 261
10.4 Gynaecological infections 264
10.5 Conclusions 271
11. Menopause and women’s mental health: The need for a multidimensional approach 285
11.1 Introduction 285
11.2 Social, cultural and contextual factors 286
11.3 Variation in symptoms and symptom patterns 286
11.4 The research evidence 290
11.5 Is menopause a time of increased risk for women’s mental health? 290
11.6 The relationship between menopause and depression in midlife 290
11.7 The need for a life course perspective 293
11.8 Methodological difficulties 296
11.9 Therapeutic approaches in mid life 297
11.10 Conclusion 301
SECTION 3 Service delivery and ethics 307
12. Ethics in psychiatric research among women 313
12.1 The scientific imperative to include women in psychiatric research 313
12.2 The ethical challenges of psychiatric research 315
12.3 Unique challenges of psychiatric research in women 317
12.4 Summary 321
13. Integrating mental health into women’s health and primary healthcare: The case of Chile 327
13.1 Introduction 327
13.2 Integrating mental health into primary healthcare 328
13.3 Integrating mental health into women’s health 333
14. Gender sensitive psychiatric care for children and adolescents 343
14.1 Mental health services for children and adolescents 343
14.2 Barriers to service use 345
14.3 Recommendations for gender sensitive psychiatric care of children and adolescents 345
15. Gender sensitive care for adult women 349
15.1 Introduction 349
15.2 Gender sensitive and informed mental healthcare: Basic strategies 351
15.3 Principles of gender sensitive care 353
15.4 Characteristics of gender sensitive services 354
16. Psychopharmacology 363
16.1 History of psychopharmacology 363
16.2 Ethics 364
16.3 Sources and interpretation of data 366
16.4 Women in clinical trials 367
16.5 Pharmacodynamics and pharmacokinetics in women 368
16.6 Psychotropic treatments in women 369
16.7 Treatment of postpartum disorders 377
SECTION 4 Impact of violence, disasters, migration and work 385
17. Women and disasters 395
17.1 Wars and women’s mental health 396
17.2 Natural disasters and women 403
18. Intimate partner violence interventions 413
18.1 Mental health consequences of intimate partner violence on women 413
18.2 Victim focused interventions 414
18.3 Interventions with batterers of violence 417
18.4 Other intervention approaches 422
18.5 Conclusion 424
19. Migration and mental health in women: Mental health action plan as a tool to increase communication between clinicians and policy makers 431
19.1 Definitions: Mental health and health 431
19.2 Introduction 432
19.3 Risk factors 434
19.4 Resilience and coping 435
19.5 The impact of domestic violence on immigrant women’s mental health 436
19.6 Access to mental healthcare services 437
19.7 The ADAPT model (Adaptation and Development after Persecution and Trauma) 438
19.8 The case of Mrs Aba, her family and the community 439
19.9 Theory of change logic: Mental health action planning 441
20. Work and women’s mental health 449
20.1 Introduction: A late but growing awareness 449
20.2 The job burnout 450
20.3 A higher risk for burnout 454
20.4 Work and women’s mental health issues 460
20.5 Management issues 464
20.6 Conclusion 465
21. Globalisation and women’s mental health: Cutting edge information 469
21.1 Concept and process of globalisation 469
21.2 Gendered effects of globalisation 470
21.3 The impact of globalisation and liberalisation on women’s health 471
21.4 Education and empowerment in women 472
21.5 The United Nations’ and World Bank’s approach to women’s education 473
21.6 The global and local intersection of feminism in muslim societies 474
21.7 Other impacts of globalisation 477
21.8 Internet addiction 481
21.9 Mental health issues related to the use of internet and mobile phones in the developing countries 482
21.10 Recommendations to counteract negative effects of globalisation 484
22. The impact of culture on women’s mental health 489
22.1 Introduction 489
22.2 Definitions 490
22.3 Epidemiological perspectives 492
22.4 Cultural aspects of stress 492
22.5 Diagnostic considerations 495
22.6 Cultural and social practices and their impact on mental health 499
22.7 Therapeutic issues 503
22.8 Perspectives 504
23. Female mutilation 511
23.1 Definition 511
23.2 Introduction 511
23.3 Historical background 512
23.4 Classification 513
23.5 Epidemiology of FGM 514
23.6 Physical complications of FGM 515
23.7 Psychological complications 516
23.8 Posttraumatic stress disorder and memory problems after FGM 517
23.9 Obstacles facing changing harmful social convention: Female genital mutilation/cutting 517
23.10 The basic concept for FGM elimination (The mental map for FGM) 520
23.11 Recommendations in countries where FGM is commonly practised 521
SECTION 5 Gender, social policy and implications for promoting women’s mental health 525
24. Women’s mental health in the context of broad global policies 533
24.1 Introduction 533
24.2 Definitions of health and the right to health made by the United Nations 534
24.3 The Fourth World Conference on Women: Platform for Action (1995) 535
24.4 Conventions 536
24.5 Other international tools 538
24.6 New aid environment: Sector wide approaches and the poverty reduction strategy paper 539
24.7 Conclusion 540
25. Families of origin as agents determining women’s mental health 543
25.1 Introduction 543
25.2 The impact of the family of origin’s perspectives about females on the growth of women 544
25.3 Impact of parenthood on women’s mental health 545
25.4 Families, social change and women’s mental health 547
25.5 Conclusion 548
26. The unpaid workload: Gender discrimination in conceptualisation and its impact on maternal wellbeing 551
26.1 Introduction 551
26.2 Maternal desire 552
26.3 Disenfranchised grief and motherhood 552
26.4 Fantasies of motherhood 553
26.5 Fantasies about the workload 553
26.6 Workload of motherhood 554
26.7 Occupational fatigue as a determinant of maternal mood? 555
26.8 Recognition and valuing of work and occupational satisfaction 557
26.9 Training and education for mothering 558
26.10 Presumptions about the contributions of others to the workload 560
26.11 Collegial relationships 560
26.12 Honouring the work of motherhood in practice and policy 561
26.13 Conclusion 563
27. Foundations of human development: Maternal care in the early years 565
27.1 Child development and human culture 565
27.2 Interactions and relationships 567
27.3 Maternal mental health and children’s development 568
27.4 Maternal care 569
27.5 Implications for mental healthcare 570
27.6 Increased choices for women 570
27.7 Conclusion 571
28. The adverse impact of psychological aggression, coercion and violence in the intimate partner relationship on women’s mental health 575
28.1 Introduction 575
28.2 Prevalence and nature of intimate partner violence 575
28.3 Impact of intimate partner violence on general health 577
28.4 Mental health problems among women affected by intimate partner violence 577
28.5 Intimate partner violence, children and intergenerational patterns of abuse 581
28.6 Conclusion 582
Index 585

"The book does a service in pointing out its importance as a major
issue in women's mental health ... There is much more here than
mental and reproduction health." (World Federation for Mental
Health, 1 August 2011)

"Given the vital importance of social factors to the development
of mental disorders in the women of the world and mainstream
psychiatry's predominant focus on the biological, this
book's devotion to highlighting the impact of how cultural,
political and economic conditions affect women's mental
health is noteworthy and a major strength. The book also delivers
on its promise to examine this area from a global perspective, and
the reader is richer for it. Each inhabited continent is
represented in the book's list of contributors, and this
ensures that relevant social factors are not overlooked. Not
surprisingly, the product of this international focus is a book
that is unparalleled in terms of the breadth of the social factors
that are examined for their relevance to women's mental
health." (Archives of Womens Mental Health, 2011)

"The really interesting feature of the book is its emphasis on
the role of cultural and social circumstances on the presentation,
perceptions and treatment of mental health in women. The chapters
on somatization and the impact of culture on women's mental health
are essential reading for all health practitioners who have women
among their patients." (Occupational Medicine, December
2010)

"This book is a goldmine of information on the challenges for
gender-focused research and clinical treatment of mental health
problems. The editors have done a remarkable job of identifying and
summarizing the available literature on women's mental health... It
would be a valuable asset for academic psychiatrists and
psychologists teaching courses or researching women's mental health
issues, as well as psychotherapists." (Indian Journal of
Psychiatry, October 2010)