Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Depression, Postpartum/diagnosis , Depression, Postpartum/etiology , Depression, Postpartum/physiopathology , Depression, Postpartum/psychology , Depression, Postpartum/drug therapy , Breast Feeding/psychology , Postpartum Period/psychology , Mother-Child Relations/psychology , Antidepressive Agents/therapeutic useABSTRACT
A depressão pós-parto é uma condição clínica séria no puerpério, atingindo aproximadamente 10 a 20% das mulheres nos seis primeiros meses após o parto, sendo muitas vezes não-investigada nem diagnosticada, com impacto negativo para a mãe e a criança. Fatores de risco biológicos e psicossociais têm sido descritos na literatura, relacionados com a depressão pós-parto, porém, seu mecanismo fisiopatológico ainda não é totalmente esclarecido. Objetivou-se com este trabalho avaliar criticamente a literatura científica quanto ao tratamento da depressão pós-parto, com base na literatura disponível. Há evidência de eficácia de algumas intervenções terapêuticas como psicoterapia, antidepressivos e exercício físico no tratamento entre 1 e 12 semanas de duração. Dificuldades para a adesão e continuidade da terapia envolvem o temor de efeitos indesejáveis das medicações sobre os lactentes no início do uso destas e sobre as crianças no longo prazo, além da dificuldade de acesso ao acompanhamento psicológico.
Postpartum depression is a serious clinical condition during the postnatal period, affecting from 10 to 20% of women during the first six months after delivery, being most of the time underscored and undiagnosed, with negative impact on the mother and the infant. Biological and psychosocial risk factors have been described in the literature, but its physiopathology is still unclear. The objective of this article was to critically appraise the literature in regards to the treatment of postpartum depression, based on evidence. There is evidence of some therapeutic interventions efficacy such as psychotherapy, antidepressant medications and physical activity between 1 and 12 weeks of treatment. Barriers to the treatment include fear of adverse effects on the infants at the beginning of the treatment and in the long term and low access to psychotherapy.
Subject(s)
Humans , Female , Antidepressive Agents/therapeutic use , Depression, Postpartum/physiopathology , Depression, Postpartum/psychology , Depression, Postpartum/therapy , Evidence-Based Medicine , Mass Screening/methods , Psychotherapy/methods , Risk Factors , Exercise Therapy/methods , WalkingABSTRACT
Introduction : La depression du post-partum occupe une place importante parmi les accidents psychiatriques de la puerperalite. Les auteurs rapportent les differents aspects cliniques; therapeutiques et evolutifs de la depression du post-partum dans une serie de onze cas senegalais. Materiel et methode : Il s'agit d'un travail mene a partir des observations medicales et des registres d'hospitalisation d'une serie de 11 patientes appartenant a un echantillon de 52 femmes presentant des troubles psychiques de la puerperalite. Le diagnostic a ete fait en utilisant la classification internationale des maladies. Resultats : Sur le plan clinique les symptomes de depression etaient constitues principalement d'irritabilite; de troubles de la concentration; de plaintes somatiques multiples; d'insomnie d'endormissement; de perte des interets habituels. Pour la prise en charge; toutes nos patientes ont beneficie d'une psychotherapie de soutien et d'un traitement antidepresseur; associes a un traitement tranquillisant dans six cas. L'evolution a ete favorable au bout de 29 a 43 jours d'hospitalisation. Conclusion : Le vecu de la grossesse et de l'accouchement; la parite; l'histoire personnelle de la patiente; son environnement et les representations culturelles de la maternite sont des facteurs de depression du postpartum. Le traitement antidepresseur est dans tous les cas indispensable
Subject(s)
Depression, Postpartum , Depression, Postpartum/diagnosis , Depression, Postpartum/physiopathology , Depression, Postpartum/psychologySubject(s)
Humans , Female , Pregnancy , Infant, Newborn , Carbamazepine/adverse effects , Depression, Postpartum/physiopathology , Phenytoin/adverse effects , Hyperthyroidism/complications , Hypothyroidism/complications , Pregnancy Complications/drug therapy , Psychotropic Drugs/adverse effects , Puerperal Disorders/diagnosis , Puerperal Disorders/physiopathology , Psychotic Disorders/diagnosis , Antidepressive Agents, Tricyclic/adverse effects , Anti-Anxiety Agents/adverse effects , Antidepressive Agents/adverse effects , Breast Feeding/adverse effects , Embryonic Structures , Fetus/drug effects , Haloperidol/adverse effects , Mice , Smoking/adverse effects , Psychotic Disorders/physiopathology , Psychotic Disorders/drug therapyABSTRACT
Mother's depression during pregnancy and postpartum is a risk factor that can adversely affect mother's relationship with her infant. As breast feeding is an important situation for early mother-child interaction the effect of mother's depression on her breast feeding attitude and practice was decided to be studied prospectively. In this study, 158 primigravidae attending antenatal clinics in two MCH centres were interviewed at third trimester. The interview data covered social background, attitudes to breast feeding as well, as self rating of depression using the Edinburgh postnatal depression Scale [EPDS]. At postnatal interview 72 mother-infant pairs could be reached between 6-16 weeks- after birth. They were subjected again to EPDS along with inquiry about type of infant feeding and breast feeding practices. Findings revealed that the prevalence of antepartum depression was 25.32%. Antepartum depression was significantly linked to postpartum depression and negative attitudes to breast feeding. Persistent maternal depression [ante- and postpartum] was a risk factor for early resorting to mixed infant feeding, retarded infant growth as well as some adverse maternal and infant health outcomes. Logistic analysis indicated that negative mothers' attitudes to breast feeding and postpartum depressive scores taken together predicted mixed infant feeding. Hence, preventive programs should be directed specifically towards modifying the mother's psychological. status and her attitude on behalf of her infant