Women's Mental Health and Lessons Learnt from the COVID-19 Pandemic.

Women are at the highest risk of pandemic adversities as they represent the majority of health and frontline workers in addition to their essential roles at home. We review gender differences during the COVID-19 pandemic by demonstrating risk-exposure during specific situations such as pregnancy, women's mental health fallouts, COVID-19 disease itself and exposure to different forms of violence. We discuss the particularities that women face in developing countries with depicted examples from some countries in Africa and the Middle East. Women mental health care service stands out as an essential component of the national response to pandemics. Women's integration and leadership in the national pandemic response planning is crucial.

Perinatal Psychoactive Substances Use: A Rising Perinatal Mental Health Concern.

INTRODUCTION: A significant increase in psychoactive drugs use was observed in women of childbearing age and during the perinatal period worldwide. Yet, the use of illicit drugs, alcohol and tobacco during pregnancy is a serious health risk for the mother, developing fetus and newborn. METHODS: This review of current trends and consequences of psychoactive substance use in the general population and in pregnant women was conducted using the English and French literature published during the years 2000 to 2022, supplemented by guidelines, meta-analyses and reviews. RESULTS: According to current rates of prenatal substances use, it was calculated that 380,000 offspring were exposed to illicit substances, more than 500,000 to alcohol and over one million to tobacco during uterine life. Alarmingly, drug-related pregnancy-associated mortality has shown a staggering 190% rise between 2010 and 2019 in the USA. Different drugs of abuse, when used during pregnancy, increase the risk of stillbirth, neonatal abstinence syndrome and sudden infant death. Adverse effects on pregnancy include premature rupture of membranes, placental abruption, preterm birth, low birth space? weight and small-for-gestational-age infants. There is also an increased risk of morbidity and mortality for the pregnant women. Long-term negative adverse effects of perinatal exposure to substances also include a number of neurocognitive, behavioral and emotional dysfunctions in infants. Each type of substance has its own specificities, which will be briefly summarized. CONCLUSION: All childbearing age women must be informed about the potential harm of the prenatal use of psychoactive substances and should be encouraged to stop their use when pregnancy is planned and, at least, when pregnancy is known. Questioning women about their alcohol consumption should be systematic at the first prenatal visit and then at every prenatal visit until delivery. Multidisciplinary prevention approaches as well as intervention measures targeted to each type of psychoactive substance can save mothers' lives and mitigate serious adversities to the offspring.

Beyond antipsychotics: the role of medication and nonmedication factors in female sexual dysfunctions in schizophrenia.

To date, few studies have investigated male sexual dysfunctions (FSDs) in schizophrenia in non-Western countries, with most studies focusing on the sexual side effects of antipsychotic medications. Therefore, we aimed to screen for FSD in a sample of Egyptian females with schizophrenia, compare them to controls and to investigate demographic and clinical parameters associated with FSD. We conducted a cross-sectional study of 72 medicated and unmedicated females with schizophrenia (27 unmedicated and 45 medicated) and 24 controls. They were assessed using the Female Sexual Function Index (FSFI) and data were collected for demographic and clinical parameters. We found that females with schizophrenia had significantly lower scores on the FSFI compared to controls and that 93.1% of females with schizophrenia reached the threshold for FSD (FSFI score ≤26), compared to 87.5% of controls. Medicated and unmedicated subjects did not differ significantly in most domains of the FSFI. Age, duration of illness, positive and negative syndrome Scale total, positive and negative symptom scores correlated significantly with the majority of domains of the FSFI. Rates of FSD are very high in both schizophrenia and controls and correlate in schizophrenia with a number of demographic and clinical parameters, suggesting that FSDs are not restricted to the side effects of medications. There is a need to screen for sexual function in routine practice, and for developing active strategies to tackle sexual dysfunctions.

Impact of a culturally adapted behavioural family psychoeducational programme in patients with schizophrenia in Egypt.

OBJECTIVE: To study the effect of a culturally adapted, structured family intervention on symptom severity, medication attitudes and knowledge, social functioning and quality of life in patients with schizophrenia. METHODS: Thirty subjects with schizophrenia were selected to receive 14 sessions of a culturally adapted behavioural family psychoeducational programme (BFPEP). Another 30 subjects received standard treatment as usual (STU) for 6 months. Pre- and post-intervention outcomes were assessed using the Positive and Negative Syndrome Scale (PANSS), Drug Attitude Inventory 10-item scale (DAI-10), Quality of Life Scale (QLS) and Social Functioning Questionnaire (SFQ). RESULTS: There was a no significant difference between BFPEP and STU at baseline on all measures. There was a significant difference (p < .05) between pre- and post-treatment scores for BFPEP on all measures, a significant difference (p < .05) between pre- and post-treatment scores for STU on all measures (favouring pre-treatment scores) and a significant difference (p < .05) favouring BFPEP over STU on all measures post-treatment. CONCLUSIONS: These results demonstrate the feasibility and effectiveness of implementing family therapy psychoeducational interventions in different cultural settings, with relatively minor modifications. This may have implications for mental health policy makers to make available such programmes for patients and mental health professionals.