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Court-Mandated Outpatient Psychiatric Care for a Pregnant Woman with Psychosis: A Unique Bridge to Alliance

DRAGATSI, DIANNA MD; MEJIA, BEATRIZ R. LCSW; POLANIA, LAURA M MD; SIRULNIK, LAURA MD; KAHN, DAVID A. MD

Journal of Psychiatric Practice®: May 2013 - Volume 19 - Issue 3 - p 247–253
doi: 10.1097/01.pra.0000430510.82885.04
Clinical Case Discussion

We describe the case of a young pregnant woman with refractory schizoaffective disorder and how we reached a decision to apply for court-mandated outpatient psychiatric treatment (Assisted Outpatient Treatment or AOT). The patient was stable when we made this application as a preventive measure, given her serious prior episodes of illness. While there has been court-mandated outpatient obstetrical treatment, as far as we know this is the first report of mandated outpatient psychiatric treatment in connection with pregnancy. The ultimate benefit of this AOT application was the development of a therapeutic alliance and improved voluntary adherence to treatment, and a safe outcome to the pregnancy. (Journal of Psychiatric Practice 2013;19:247–253)

DRAGATSI, MEJIA, POLANIA, and SIRULNIK: New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York; KAHN: Columbia University College of Physicians and Surgeons, New York.

The authors declare no conflicts of interest.

© 2013 by Lippincott Williams & Wilkins, Inc.