Neurodevelopmental Disorders in Adult Women: Special Considerations in the Perinatal Period
Médecine, Psychologie
Audio avec voix de synthèse, Braille automatisé
Résumé
This book elaborates on Neurodevelopmental Disorders (NDD) and their treatment in adult women with a special focus on the unique clinical presentation of these problems during the Perinatal period. Problems related to chronic, untreated NDD during adulthood are viewed through… the lens of pregnant and postpartum mothers to highlight unique struggles as their family unit expands after having children. The content is based on the author&’s clinical experience with mothers under her psychiatric care between 2017-2024 at an outpatient practice, affiliated with Brown University. Comorbid psychiatric problems such as anxiety, mood disorders, trauma and substance use disorders are also reviewed. In addition to sharing clinical anecdotes, the author presents a consolidated review of scientific literature on the subject. I believe that this book can be an important addition to scientific literature at this time, when Neurodiversity is being explored and accepted more in society and we are more receptive to improving women&’s mental health. Afflicted mothers as well as their treatment providers have conveyed to me the profound relief on finally getting accurate diagnosis and treatment for NDDs. Several books have been published documenting the unique presentation and treatment interventions for ADHD and Autism in women, however, this will be the only book addressing symptomology and treatment interventions for NDD specifically during the perinatal period. I have seen how successful long-term treatment with a specialized team of mental health professionals can significantly improve the quality of life not just for the mother but also, for the entire family unit. The book will be divided into two parts: Part 1- Clinical Manifestations and Symptomology in Adult Women with NDD In the first part of the book, I plan to discuss the approach to diagnosis of Neurodevelopmental Disorders in General Adult Psychiatry and understand reasons for missed diagnosis, especially in females. I will outline my diagnostic and therapeutic approach, conceptualizing NDDsymptomology as variations of higher brain functioning rather than categorization of these symptoms as a &“disorder,&” and contemplating potential evolutionary advantages to neurodiversity. Based on my clinical practice, I will discuss tools for clinical assessment, including referral for neuropsychological testing and its utility in adults. In addition to the DSM-5 diagnoses, I will also propose conceptualizing difficulties in functioning and subjective distress in terms of symptom domains (executive dysfunction, hyperactivity/impulsivity, sensory overload and emotional regulation) as reflected in day-to-day functioning and social interactions in the adult life of women. Also, differential diagnoses including Obsessive Compulsive Disorder, Bipolar disorder, Post Traumatic Stress Disorder (PTSD), and personality disorders will be discussed, addressing the puzzling symptom overlap as well as genetic predisposition between these psychiatric illnesses and neurodevelopmental disorders. I will describe this association using clinical case examples and, later in the book, propose the inclusion of trauma-based interventions in treatment of Neurodevelopmental Illnesses in adult women. Lastly, comorbid substance use will be addressed. I will highlight struggles related to complex psychopathology and dual diagnosis. Given my training in Addiction Psychiatry, one of my goals is also to reduce stigma and apprehension about prescribing controlled medications in patients with history of substance use disorders. Part 2- Perinatal perspective on NDD Part 2 will have a specific perinatal focus starting with a detailed description of predisposing factors (Behavioral/Social, Psychological and Biological factors) for distress in Mothers with