Prevalence of Psychiatric Disorders During Pregnancy at 2nd Trimester Ultrasound: a Feasibility Study in the General Population

Young women represent a population at risk of psychiatric disorders, the first signs of which often appear between the ages of 15 and 25. Psychiatric disorders are a major source of disability and healthcare costs. They are often comorbid, and can be complicated by suicidal behaviour. Delays in diagnosis are common, significantly worsening the prognosis and increasing the societal cost of these disorders.

The perinatal period is an additional period of psychological vulnerability, during which women are at increased risk of developing or worsening psychiatric disorders. Unfortunately, these disorders seem to be largely under-diagnosed during this period, and therefore under-treated.

To date, psychiatric diagnoses are exclusively clinical. They can be facilitated by screening questionnaires, the sensitivity and specificity of which are highly heterogeneous and sometimes poorly understood in the perinatal period and in the general population of pregnant women. What's more, several studies have shown that clinical diagnosis in everyday practice often lacks sensitivity when compared with standardized assessments, i.e. those based on a structured and reproducible diagnostic approach, which is longer and more costly, such as the MINI (Mini International Neuropsychiatric Interview).

The state of knowledge on the epidemiology of psychiatric disorders in the perinatal period suffers from many imperfections. The vast majority of studies focus exclusively on postpartum depression. This project, on the other hand, focuses on the diagnosis of any psychiatric disorder characterized by a standardized diagnostic interview (validated and reproducible, like the MINI) carried out by a professional trained in the clinical management of psychiatric disorders.

Biomarkers, in particular to aid differential diagnosis, are being developed and are a source of hope for improving the quality of screening; but the results are rarely replicated in independent cohorts or from biological banks associated with quality clinical data.

Our hypothesis is that the prevalence of psychiatric disorders (current or in remission), in this population, is at least 20% and that more than half of these disorders are unknown.

From a practical point of view, it aims to improve assessments of psychiatric vulnerabilities within the two main public maternity hospitals in the Hérault department in France.

From a scientific point of view, it will provide an opportunity to create a highly original bank of biological samples, opening up interesting research prospects in psychiatry, but also well beyond, given the specific nature of the population concerned.

• To determine the prevalence of each psychiatric disorder characterized during pregnancy at the time of the second-trimester ultrasound, based on a standardized clinical assessment. [Срок оценки: Baseline (T2 ultrasound)]
• Determine comorbidity profiles across all pathologies, describing whether there are patient groups based on these profiles. [Срок оценки: Baseline (T2 ultrasound) and 2 months postpartum]
• Compare the prevalence of psychiatric disorders unknown to the obstetrics team with the prevalence of known psychiatric disorders in pregnant patients at the time of T2 ultrasound. [Срок оценки: Baseline (T2 ultrasound)]
• Compare the prevalence of psychiatric disorders unknown to the patient with the prevalence of known psychiatric disorders in pregnant patients at the time of T2 ultrasound. [Срок оценки: Baseline (T2 ultrasound)]
• Compare the prevalence of psychiatric disorders unknown to the general practitioner with the prevalence of known psychiatric disorders in pregnant patients at the time of T2 ultrasound. [Срок оценки: Baseline (T2 ultrasound)]
• Assess patients' medication compliance using self-administered questionnaires (MARS). [Срок оценки: Baseline (T2 ultrasound) and 2 months post partum]
• Assess patients' treatment beliefs using self-administered questionnaires (BMQ). [Срок оценки: Baseline (T2 ultrasound) and 2 months post partum]
• Determine the sociodemographic, psychological, psychiatric, medical and obstetric factors, as well as those associated with access to care and the care pathway associated with known or unknown diagnoses during pregnancy. [Срок оценки: Baseline (T2 ultrasound) and 2 months post partum]
• Determine the properties (sensitivity) of screening questionnaires (EPDS) for psychiatric disorders in this population. [Срок оценки: Baseline (T2 ultrasound) and 2 months post partum]
• Determine the properties (specificity) of screening questionnaires (EPDS) for psychiatric disorders in this population. [Срок оценки: Baseline (T2 ultrasound) and 2 months post partum]
• Determine the properties (positive predictive value) of screening questionnaires (EPDS) for psychiatric disorders in this population. [Срок оценки: Baseline (T2 ultrasound) and 2 months post partum]
• Determine the properties (negative predictive value) of screening questionnaires (EPDS) for psychiatric disorders in this population. [Срок оценки: Baseline (T2 ultrasound) and 2 months post partum]