Perinatal Psychiatry Top-up masterclass resources

Please note that these resources are for your information only and should not be used or duplicated elsewhere.

Themes

12 September 2022 - Day 1- Compassionate leadership and perinatal mental health teams and ADHD - assessment and treatment in the perinatal context and implications for parenting

4 October 2022 - Day 2 - Eating Disorders, Obstetrics and contraception and y our role as a trainer and educator

11 November 2022 - Day 3 - Infertility and fertility treatment

22 November 2022 - Day 4 - Premenstrual syndrome and menopause , autistic Spectrum Disorders in Women and applying learning to complex cases

9 December 2022 - Day 5 - Couple and family interventions and progress with The NHS Long Term Plan implementation

Aims of this masterclass programme

  • enable and support consultants in perinatal psychiatry in their assessment, understanding and management of complex clinical work
  • encourage participants to integrate current evidence into clinical practice
  • develop self-reflection skills
  • support leadership development
  • emphasise the importance of the perspectives of women, infants, partners and families throughout the perinatal pathway
  • improve patient safety
  • improve the experience of women and families in perinatal mental health services
  • develop knowledge and understanding relevant to implementing the recommendations of the NHS Long Term Plan for perinatal mental health services.

Programme

The full programme for the Top-up Masterclass is available online.

Learning objectives and reading lists are provided before each day.

All session will run on zoom and the link will be sent to participants in advance

Each session will have a didactic component and small group work/discussion.

All 5 days are facilitated by Dr Liz McDonald and Dr Lucinda Green.

Speakers: Dr Nic Horley,  Dr Lucinda Green , Dr Sally Cubbin and Dr Amanda Elkin

Intended learning objectives

At the end of day 1 participants will be able to:

  1. Understand the advantages of compassionate leadership approaches for leaders and teams
  2. Recognise the importance of self-compassion
  3. Be familiar with compassion focussed activities that can be used with their teams
  4. Recognise how ADHD presents in adults, with a particular focus on women.
  5. Understand how untreated ADHD may affect women in the perinatal period.
  6. Consider medication treatment options for ADHD in the perinatal period.
  7. Feel confident in writing a CD prescription.

Essential reading

  1. West, M., Eckert, R., Collins, B., &Chowla, R. (2017) Caring to Change. How compassionate leadership can stimulate innovation in health care. The King’s Fund
  2. Cubbin, S., Leaver, L., & Parry, A. (2020). Attention deficit hyperactivity disorder in adults: common in primary care, misdiagnosed, and impairing, but highly responsive to treatment. The British journal of general practice: The journal of the Royal College of General Practitioners, 70(698), 465– 466.

Recommended reading

  1. Conversano, C., Ciacchini, R., Orrù, G., Di Giuseppe, M., Gemignani, A., & Poli, A. (2020). Mindfulness, Compassion, and Self-Compassion Among Health Care Professionals: What's New? A Systematic Review. Frontiers in psychology, 11, 1683. https://doi.org/10.3389/fpsyg.2020.01683.
  2. Cortese, S., Adamo, N., Del Giovane, C., et al. (2018). Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis. The Lancet. Psychiatry, 5(9), 727–738.
  3. De Zulueta P. C. (2015). Developing compassionate leadership in health care: an integrative review. Journal of healthcare leadership, 8, 1–10.
  4. Gilbert, P.l & Basran, J. (2018). Imagining One’s Compassionate Self and Coping with Life Difficulties. EC Psychology and Psychiatry, 7, 971-978.
  5. Kooij, J., Bijlenga, D., Salerno, L., (2019). Updated European Consensus Statement on diagnosis and treatment of adult ADHD. European Psychiatry: The Journal of the Association of European Psychiatrists, 56, 14–34.
  6. Li, L., Sujan, A. C., Butwicka, A., Chang, Z., Cortese, S., Quinn, P., Viktorin, A., Öberg, A. S., D'Onofrio, B. M., & Larsson, H. (2020). Associations of Prescribed ADHD Medication in Pregnancy with Pregnancy-Related and Offspring Outcomes: A Systematic Review. CNS drugs, 34(7), 731–747.
  7. Neff, KD, Knox, MC, Long, P, Gregory, K. (2020) Caring for others without losing yourself: An adaptation of the Mindful Self‐Compassion Program for
    • Healthcare Communities. J Clin Psychol. 76, 1543– 1562.
  8. NHS England (2014) Building and Strengthening Leadership: Leading with Compassion
  9. Steer S (2021) Understanding ADHD in Girls & Women. London: Jessica Kingsley Publishers.
  10. West MA (2021) Compassionate Leadership: Sustaining wisdom, humanity and presence in health and social care. London: Swirling Leaf Press.
  11. Young, S., Adamo, N., Ásgeirsdóttir, B. B., Branney, P., et al. (2020) Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women. BMC psychiatry, 20(1), 404.

Speakers: Dr Catia Acosta, Miss Shankari Arulkumaran , Dr Roch Cantwell and Dr Liz McDonald

Intended learning objectives

At the end of day 2 participants will be able to:

  1. Screen for and identify women who have a diagnosis of an eating disorder in the perinatal period.
  2. Assess women who have eating disorders in the perinatal period, including assessment of the risk to the woman, the foetus and the infant, requesting physical investigations and discussing risk concerns with women.
  3. Devise a perinatal mental health care plan for a woman who has an eating disorder in the perinatal period, in partnership with the woman, the eating disorder service and other relevant professionals.
  4. Understand the physiological changes that occur in pregnancy and how they may impact on common obstetric complications.
  5. Learn more about the range of safe and effective contraceptive technologies and interventions available to both women and men. Particular emphasis is given to UK practice, with consideration of relevant legal and ethical issues and factors that may influence an individual's choice of method.
  6. Understand which are the most important aspects of perinatal mental illness and perinatal mental health care to include in training for professionals in a range of disciplines and services.
  7. Recognise the challenges in training and educating professionals who are involved in the care of women who have, or who are at risk of, perinatal mental health problems.

Essential reading

  1. Acosta, C., Treasure, J. (2015) Eating Disorders: Overview and Management in Women. Current progress in obstetrics and gynaecology, volume 3. Ed:
  2. FSRH UK Medical Eligibility Criteria for Contraceptive Use (UK MEC). https://www.fsrh.org/ukmec/
  3. MBRRACE-UK: Saving Lives, Improving Mothers’ Care. Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2017-19. https://www.npeu.ox.ac.uk/mbrrace-uk/reports
  4. NICE (2017). Eating disorders: recognition and treatment. NICE guidelines [NG69] https://www.nice.org.uk/guidance/ng69

Recommended reading

  1. Bye, A., Shawe, J., Bick, D., Easter, A., Kash-Macdonald, M., & Micali, N. (2018). Barriers to identifying eating disorders in pregnancy and in the postnatal period: a qualitative approach. BMC pregnancy and childbirth, 18(1), 114
  2. Easter, A., Treasure, J., & Micali, N. (2011). Fertility and prenatal attitudes towards pregnancy in women with eating disorders: results from the Avon Longitudinal Study of Parents and Children. BJOG : an international journal of obstetrics and gynaecology, 118(12), 1491–1498.
  3. Fogarty, S., Elmir, R., Hay, P. et al. (2018).The experience of women with an eating disorder in the perinatal period: a meta-ethnographic study. BMC Pregnancy Childbirth 18, 121.
  4. Janas-Kozik, M., Żmijowska, A., Zasada, I., Jelonek, I., Cichoń, L., Siwiec, A., & Wilczyński, K. M. (2021). Systematic Review of Literature on Eating Disorders During Pregnancy-Risk and Consequences for Mother and Child. Frontiers in psychiatry, 12, 777529.
  5. Mah, B., Cibralic, S., Hanna, J., Hart, M., Loughland, C., & Cosh, S. (2021). Outcomes for infants whose mothers had an eating disorder in the perinatal period: A systematic review of the evidence. The International journal of eating disorders, 54(12), 2077–2094.
  6. NICE (2019) Intrapartum care for women with existing medical conditions or obstetric complications and their babies. NICE guideline [NG121] https://www.nice.org.uk/guidance/ng121
  7. NICE (2019) 3. Hypertension in pregnancy: diagnosis and management. NICE guideline [NG133] https://www.nice.org.uk/guidance/ng133
  8. Royal College of Obstetricians and Gynaecologists. Reducing the Risk of Thrombosis and Embolism During Pregnancy and the Puerperium. Green-top Guideline No. 37a. London: RCOG; 2015 https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/reducing-the- risk-of-thrombosis-and-embolism-during-pregnancy-and-the-puerperium-green-top-guideline-no-37a/

Speakers: Dr Suzanne Dark  and Dr Lucinda Green

Intended learning objectives

At the end of day 3 participants will be able to:

  1. Describe and recognise the psychological consequences of infertility and fertility treatment
  2. Understand the role of the counsellor in the infertility clinic and the other care and support available for women having fertility treatment.
  3. Discuss the risk of mental health problems associated with infertility and fertility treatment

Essential reading

  1. Bhat, A., & Byatt, N. (2016). Infertility and perinatal loss: when the bough breaks. Current psychiatry reports, 18(3), 31

Recommended reading

  1. Bronya Hi-Kwan Luk & Alice Yuen Loke (2015) The Impact of Infertility on the Psychological Well-Being, Marital Relationships, Sexual Relationships, and Quality of Life of Couples: A Systematic Review, Journal of Sex & Marital Therapy, 41:6, 610-625,
  2. Doyle, M., & Carballedo, A. (2014). Infertility and mental health. Advances in Psychiatric Treatment, 20(5), 297-303.
  3. Golombok, S. (2015) Modern families: Parenting and children in new family forms. Cambridge University Press.
  4. McCluskey G & Gilbert P. Implications counselling for people considering donor-assisted treatment. Fully updated version. British Infertility Counselling Association: 2015.
  5. Ebdrup, N. H., Assens, M., Hougaard, C. O., Pinborg, A., Hageman, I., & Schmidt, L. (2014). Assisted reproductive technology (ART) treatment in women with schizophrenia or related psychotic disorder: a national cohort study. European journal of obstetrics, gynecology, and reproductive biology, 177, 115–120.
  6. Pasch, L. A., Holley, S. R., Bleil, M. E., Shehab, D., Katz, P. P., & Adler, N. E. (2016). Addressing the needs of fertility treatment patients and their partners: are they informed of and do they receive mental health services?. Fertility and sterility, 106(1), 209–215.e2.
  7. Patel, A., Sharma, P., & Kumar, P. (2018). Role of Mental Health Practitioner in Infertility Clinics: A Review on Past, Present and Future Directions. Journal of Human Reproductive sciences, 11(3), 219–228.
  8. Szkodziak, F., Krzyżanowski, J., & Szkodziak, P. (2020). Psychological aspects of infertility. A systematic review. The Journal of international medical research, 48(6), 300060520932403.
  9. Vikström, J., Josefsson, A., Bladh, M., & Sydsjö, G. (2015). Mental health in women 20-23 years after IVF treatment: a Swedish cross-sectional study. BMJ open, 5(10), e009426.

Speakers: Prof Michael Craig, Dr Lucinda Green and Dr Liz McDonald

Intended learning objectives

At the end of day 4 participants will be able to:

  1. Discuss the management of Premenstrual Syndrome with women who have co-existing mental health problems.
  2. Describe the impact of the menopause on women’s mental health.
  3. Understand the management of menopause related mood symptoms.
  4. Identify how Autism can present in women
  5. Demonstrate a clear understanding of common comorbidities with Autism and how these can be evaluated
  6. Describe the support that may benefit women who have Autism in the perinatal period.

Essential reading

  1. Green LJ, O’Brien PMS, Panay N, Craig M on behalf of the Royal College of Obstetricians and Gynaecologists. Management of premenstrual syndrome (2016) BJOG ; DOI: 10.1111/1471-0528.14260.
  2. Lockwood Estrin, G., Milner, V., Spain, D., Happé, F., & Colvert, E. (2021). Barriers to Autism Spectrum Disorder Diagnosis for Young Women and Girls: a Systematic Review. Review journal of autism and developmental disorders, 8(4), 454–470.

Recommended reading

  1. Craig, M. C., Sadler, C., & Panay, N. (2019). Diagnosis and management of premenstrual syndrome. Practitioner, 263(1824), 15-19.
  2. Clow A & Smyth N (2020). Stress and Brain Health: Across the Life Course. International Review of Neurobiology Volume 150, 2-246
  3. Eaton, J. (2017) A Guide to Mental Health Issues in Girls and Young Women on the Autism Spectrum: Diagnosis, Intervention and Family Support. London: Jessica Kingsley Publishers.
  4. Hampton, S., Man, J., Allison, C., Aydin, E., Baron-Cohen, S., & Holt, R. (2022). A qualitative exploration of autistic mothers' experiences II: Childbirth and postnatal experiences. Autism : the international journal of research and practice, 26(5), 1165–1175.
  5. Pohl, A. L., Crockford, S. K., Blakemore, M., Allison, C., & Baron-Cohen, S. (2020). A comparative study of autistic and non-autistic women's experience of motherhood. Molecular autism, 11(1), 3.
  6. Samuel, P., Yew, R. Y., Hooley, M., Hickey, M., & Stokes, M. A. (2022). Sensory challenges experienced by autistic women during pregnancy and childbirth: a systematic review. Archives of gynecology and obstetrics, 305(2), 299–311.

Speakers: Dr Phil Arthrington and Dr Giles Berrisford

Intended learning objectives

At the end of day 5 participants will be able to:

  1. Describe the contribution that couple and family interventions can make to perinatal mental health services.
  2. Identify key challenges faced by families during the perinatal period and how key systemic concepts can aid in making sense of these difficulties.
  3. Discuss some of the main barriers to working with families in the perinatal period and how these may be overcome in your service.
  4. Define potential criteria for women who will be eligible for perinatal mental health services once the NHS Long Term Plan is fully implemented.
  5. Describe approaches to implementing the NHS Long Term plan in perinatal mental health services.

Essential reading

  1. Hunt, C. (2006). When baby brings the blues: Family therapy and postnatal depression. Australian and New Zealand Journal of Family Therapy, 27(4), 214-220.

Recommended reading

  1. Arthington, P. (in press). Mighty oaks from little acorns grow: Why beginnings matter. Context, 172, pp.xxxxx. Warrington: AFT.
  2. Barker, S. (2019). Perinatal mental health and working with families. In N. Evans (Ed), Family Work in Mental Health: A Skills Approach. Keswick: M&K Publishing. pp. 67-82.
  3. Cluxton-Keller, F., & Bruce, M.L. (2018). Clinical effectiveness of family therapeutic interventions in the prevention and treatment of perinatal depression: A systematic review and meta-analysis. PLoS ONE, 13(6): e0198730.
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