Mother-to-Infant Bonding in Women with Postpartum Psychosis and Severe Postpartum Depression: A Clinical Cohort Study

Mother-to-infant bonding is important for long-term child development. The aim of this study was to investigate bonding in women admitted to a Mother and Baby Unit with postpartum depression (PD, n = 64) and postpartum psychosis (PP, n = 91). Participants completed the Postpartum Bonding Questionnaire (PBQ), the Edinburgh Postnatal Depression Scale (EPDS) and the Young Mania Rating Scale (YMRS) weekly during admission. At admission, 57.1% of women with PD had impaired bonding, compared to only 17.6% of women with PP (p-value < 0.001). At discharge, only 18.2% of women with PD and 5.9% of women with PP still experienced impaired bonding (p-value = 0.02). There was a strong association between decrease of depressive and manic symptoms and improved bonding over an eight-week admission period. In a small group of women (5.7%) impaired bonding persisted despite being in remission of their psychiatric disorder. The results from our study show that impaired bonding is a more present and evidently severe problem in postpartum depression but not so much in postpartum psychosis. Treatment of depressive symptoms will improve bonding in almost all women, but clinicians should assess if impaired bonding is still present after remission because for a small group special care and treatment focused on bonding might be required.

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Is there a relationship between gestational diabetes and postpartum depression?

Current Women s Health Reviews ◽

10.2174/1573404816999200918115133 ◽

2020 ◽

Vol 16 ◽

Author(s):

Salman Khazaei ◽

Erfan Ayubi ◽

Saeid Bashirian ◽

Ronak Hamzehei ◽

Ensiyeh Jenabi

Keyword(s):

Gestational Diabetes ◽

Postpartum Depression ◽

Odds Ratio ◽

Depression Scale ◽

Binary Logistic Regression ◽

Cross Sectional Study ◽

University Education ◽

P Value ◽

Cross Sectional ◽

The Relationship

Background: The relationship between gestational diabetes and postpartum depression (PPD) is poorly understood and seldom studied. Objective: In an effort to explore this issue, the present study investigated the relationship between gestational diabetes and PPD. Methods: The present cross-sectional study was performed with 342 women who were referred to four urban health centers of Hamadan city, west of Iran. We used convenience sampling as a method to recruit women in each health center. We used a researcher-made checklist for gathering data on socio-demographic characteristics and potential risk factors of PPD. The Persian validated version of the Edinburgh Postnatal Depression Scale (EPDS) was used to assess PPD. Univariate and multivariable binary logistic regression was applied to estimate the odds ratio (OR) (95% confidence interval [CI]). Results: Gestational diabetes was identified as the most important risk factor for PPD with OR (95% CI) of 2.19 (1.11, 4.31); P-value=0.02 after adjusting for other variables. Moreover, the adjusted odds ratio showed that PPD among lesseducated women (primary school) was 3.5 times higher compared to women with a university education (OR=3.54, 95% CI: 1.27, 9.84; P-value=0.01). Conclusion: Our findings suggested that PPD is more likely among women with gestational diabetes and those who were less educated. Interventional and educational activities for reducing the risk of PPD can be targeted for use with this population.

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Violence and depression among pregnant women in Egypt

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03932-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hanan M. Ghoneim ◽

Mohamed Elprince ◽

Tamer Yehia M. Ali ◽

Waleed F. Gharieb ◽

Amal A. Ahmed

Keyword(s):

Intimate Partner Violence ◽

Sexual Violence ◽

Partner Violence ◽

Strong Association ◽

Depression Scale ◽

Intimate Partner ◽

University Hospital ◽

P Value ◽

Significant Difference ◽

History Of

Abstract Background Depression is a serious mental health disorder that might affect women in the childbearing period. Incidences increase during pregnancy as well as after delivery. Its association with intimate partner violence (defined as physical, sexual, or psychological harm by a current or former partner) has been reported in many countries. Data about this sensitive issue are lacking in Egypt. The aim of the study was to determine the relation between intimate partner violence and depression during pregnancy. Methods This was a case control study conducted at the outpatient clinics in Suez Canal University hospital, from January 2019 to March 2020. The study included two groups, the study group included women exposed to violence during the current pregnancy and a control one included women with no history of violence. Both groups were recruited according to the predetermined inclusion criteria (women aged 18-45 years, continuous marital relationship, no history of depression in current or previous pregnancies, and singleton pregnancy). Women were asked to complete the Arabic validated NorVold Domestic Abuse Questionnaire (measuring four types of abuse: emotional, physical, sexual, and violence in the health care system, the last one being excluded). Depression was evaluated using the Arabic validated form of the Edinburgh Postnatal Depression Scale (comprises 10 questions that represent patients’ feelings in the last 7 days). The main outcome measure was to assess the association between intimate partner violence and depression. Results We recruited 158 women in each group. Both groups were matched in their demographic characters. Although emotional violence was reported prominently among women exposed to IPV 87.9% (139/158), it was not significantly reported in depressed women (P value 0.084). Physical and sexual violence were significantly reported among depressed women (P value 0.022 and 0.001, respectively). There was a significant difference between women exposed to violence and those who were not exposed to violence in the total depression scores (13.63 ± 5.47 and 10.65 ± 5.44, respectively with a p value < 0.001). Emotional (p value < 0.001) and sexual violence (mild and severe with p value of 0.026 and 0.002 respectively) had significant roles as risk factors for depression during pregnancy in single regression and after control of other confounders. Conclusion There was a strong association between intimate partner violence and depression during pregnancy.

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Effectiveness of Acupuncture in Postpartum Depression: A Systematic Review and Meta-Analysis

Acupuncture in Medicine ◽

10.1136/acupmed-2017-011530 ◽

2018 ◽

Vol 36 (5) ◽

pp. 295-301 ◽

Cited By ~ 13

Author(s):

Shanshan Li ◽

Weiqiang Zhong ◽

Wen Peng ◽

Gaofeng Jiang

Keyword(s):

Postpartum Depression ◽

Rating Scale ◽

Meta Analysis ◽

Depression Scale ◽

Cochrane Collaboration ◽

Clinical Effectiveness ◽

Effective Rate ◽

Cochrane Library ◽

Secondary Outcome ◽

Control Group

Objective To assess the clinical effectiveness of acupuncture in the treatment of postpartum depression (PPD). Methods The following electronic databases were systematically searched: PubMed, Cochrane Library, SCI, Elsevier SDOL, China National Knowledge, Wan Fang database and Chinese Science and Technology Periodical Database. Only randomised controlled trials (RCTs) of acupuncture for PPD were considered. Primary outcomes were the Hamilton Rating Scale for Depression (HAMD) or the Edinburgh Postnatal Depression Scale (EPDS) scores and effective rate. Our secondary outcome was the level of oestradiol. The quality of all included trials was evaluated according to the Cochrane Collaboration. This protocol was registered in PROSPERO (CRD42016048528). Results Nine trials involving 653 women were selected. The result of this meta-analysis demonstrated that the acupuncture group had a significantly greater overall effective rate compared with the control group (seven trials, n=576, I2=24%; relative risk (RR) 1.15, 95% CI 1.06 to 1.24; P<0.001). Moreover, acupuncture significantly increased oestradiol levels compared with the control group (mean difference (MD) 36.92, 95% CI 23.14 to 50.71, P<0.001). Regarding the HAMD and EPDS scores, no difference was found between the two groups (five trials, n=276, I2=82%; MD−1.38, 95% CI −3.40 to 0.64; P=0.18; two trials, n=60, I2=16%; MD 1.08, 95% CI −1.09 to 3.26; P=0.33). Conclusions Acupuncture appears to be effective for postpartum depression with respect to certain outcomes. However, the evidence thus far is inconclusive. Further high-quality RCTs following standardised guidelines with a low risk of bias are needed to confirm the effectiveness of acupuncture for postpartum depression.

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the differences of intrapartum types to the risk of postpartum depression on primiparous mother in public hospital of yogyakarta municipality

Jurnal Formil (Forum Ilmiah) Kesmas Respati ◽

10.35842/formil.v4i2.264 ◽

2019 ◽

Vol 4 (2) ◽

pp. 107

Author(s):

Chici Riansih ◽

Sri Nabawiyati nurul Makiyah ◽

Farida Kartini

Keyword(s):

Postpartum Depression ◽

Public Hospital ◽

Depression Scale ◽

Observational Research ◽

Sectio Caesarea ◽

Bivariate Analysis ◽

P Value ◽

Depression Symptoms ◽

Vacuum Extraction ◽

Postpartum Mothers

Postpartum depression is one of serious problems that women experience after giving birth. Depression symptoms found in postpartum mothers include sadness, anxiety, crying, temperament, lack of appetite, insomnia, and inattentive to the baby. It is a part of the symptoms of maternal psychological disorders that lead to the postpartum depression. This study used quantitative research with analytic observational research design. The population of primiparous postpartum mothers is 60 people consisting of 20 postpartum mothers of Sectio Caesarea, 20 spontaneous postpartum mothers, and 20 vacuum extraction postpartum mothers in the Public Hospital of Yogyakarta Municipality. The sampling teachnique used consecutive sampling. The study utilized Edinburgh Postnatal Depression Scale (EPDS) questionnaire. Bivariate analysis used ANOVA statistical test followed by post hoc test and Chi-Square test with 95% of confidence level. The results of the analysis show Respondents data who were at risk of postpartum depression in Sectio Caesarea intrapartum (16 or 80%) compared to vacuum extraction intrapartum (5 or 13%) and spontaneous intrapartum (7 or 35%). There was a difference on the type of Sectio Caesarea intrapartum with spontaneous intrapartum and vacuum extraction with the risk of postpartum depression of p-value = 0.001 (p <0.05). The difference of the risk was significant on the type of Sectio Caesarea intrapartum when compared with vacuum extraction and spontaneous intrapartum, while between vacuum extraction and spontaneous intrapartum was not significantly different. The conclusion of this study is that there are differences in the type of Sectio Caesarea intrapartum with spontaneous intrapartum and vacuum extraction on the risk of postpartum depression among primiparous mothers in Public Hospital of Yogyakarta Municipality.

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The Relationship Between Social Support and Postpartum Depression

Journal of Holistic Nursing and Midwifery ◽

10.32598/jhnm.31.2.1099 ◽

2021 ◽

Vol 31 (2) ◽

pp. 93-103

Author(s):

Sayareh Hajipoor ◽

◽

Sedigheh Pakseresht ◽

Maryam Niknami ◽

Zahra Atrkar Roshan ◽

...

Keyword(s):

Social Support ◽

Postpartum Depression ◽

Health Care Providers ◽

Significant Risk ◽

Depression Scale ◽

Care Providers ◽

Severe Problem ◽

Comprehensive Health ◽

The Relationship ◽

Support Score

Introduction: Postpartum depression is a common and severe problem that has adverse effects on maternal and family health. Social support is one of the determinants of health, and in recent years has received increasing attention, and its overlook is a significant risk factor for postpartum depression. Objective: This study aimed to determine the relationship between social support and postpartum depression in women referring to comprehensive health centers in Rasht City, Iran. Materials and Methods: The present study is a cross-sectional, analytical study performed on 300 mothers referred to the comprehensive health service centers in Rasht 2-4 weeks after their deliveries. They were selected by cluster sampling method, which was done systematically within each cluster. The study data were collected using a three-part questionnaire of demographic characteristics, Edinburgh Postpartum Depression Scale (EPDS), and Hopkins social support. The obtained data were analyzed using descriptive and inferential statistics (t-test, Friedman, Mann-Whitney, Kruskal-Wallis, Spearman correlation coefficient, and rank logistic regression). Results: The results showed that the mean±SD age of the study mothers was 29±5.3 years. About 63.7% of mothers had low postpartum depression, and their mean±SD total score of social support was 64.03±16.92. The most support received from the spauses and parents. There was a statistically significant relationship between social support received by mothers after childbirth with education level (P=0.003), job (P=0.001), spauses’ job (P=0.001), income (P=0.001), residence status (P=0.043), number of deliveries (P=0.05) and pregnancy desire (P=0.047) and there was a significant inverse correlation between depression score and social support score by spauses (P=0.004, r=-0.167), parents (P=0.002, r=-0.176) and total social support score (P=0.024, r =-0.130). After adjusting for individual social variables, the effect of social support score on the part of the spauses (P=0.001), parents (P=0.006), friends, and relatives (P=0.033) continued to be associated with the severity of depression. Also, the number of deliveries (P=0.05) and h spauses’ jobs (self-employed) were significant compared to the unemployed ones (P=0.049). Conclusion: The results showed a significant and inverse relationship between social support and symptoms of postpartum depression. Although these results show the most support from spauses and parents, the amount of support received in the area of spauses’ parents, friends, and relatives were low. It is necessary to draw the attention of midwives and health care providers to mothers and inform them about the importance of social support and its prominent role in reducing postpartum depression.

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Role of Age at Onset in the Clinical Presentation of Bipolar Disorder

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/24770.14692 ◽

2021 ◽

Author(s):

Ajitabh Soni ◽

Paramjeet Singh ◽

Raghav Shah ◽

Sunil Kumar ◽

Lalit Batra

Keyword(s):

Bipolar Disorder ◽

Family History ◽

Rating Scale ◽

Clinical Presentation ◽

Late Onset ◽

Age At Onset ◽

P Value ◽

Young Mania ◽

Thought Disorders ◽

History Of

Introduction: There is considerable evidence to suggest that the clinical expression of Bipolar Disorder (BD) differs according to Age at Onset (AAO) that has therefore been identified as a potential specifier of interest. Aim: To compare the clinical presentation of BD and also to compare the presence of family history of illness in three subgroups made on the basis of AAO. Materials and Methods: A cross-sectional hospital based observational study was carried out on 162 patients having a diagnosis of BD current episode manic. Three subgroups were made according to AAO viz., Early Onset Bipolar Disorder (EOBD; AAO ≤21 years; 67 patients), Intermediate Onset Bipolar Disorder (IOBD; AAO=22-34 years; 59 patients) and Late Onset Bipolar Disorder (LOBD; AAO ≥35 years; 36 patients). The subgroups were compared on clinical variables, items of the Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HAM-D) and Scale for Assessment of Positive Symptoms (SAPS) scales and family history of illness. Results: The EOBD subgroup had significantly more episodes per year (p-value <0.001 and partial eta squared value=0.17) than IOBD and LOBD subgroups (mean episodes per year, respectively in EOBD, IOBD and LOBD were 1.8, 0.8 and 0.6). The prevalence of family history of mood disorder was also significantly higher in the EOBD (present in 35 out of 67; χ2 value=22.8 and p-value <0.001) than both the other subgroups (present in 10 out of 59 in IOBD and 6 out of 36 in LOBD). Significant differences were found on different items of YMRS, HAM-D and SAPS scales among the subgroups EOBD subgroup had higher rating on irritability, motor activity energy, sexual interest, depressed mood, delusions, thought disorders, while LOBD subgroup had higher rating on elevated mood. Conclusion: EOBD subgroup can be considered as a specific phenotype of BD patients, which is more homogenous, severe and heritable form of illness.

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Association of Plasma Level of Lithium with Clinical Effect in Bipolar Disorder at a Tertiary Center in Eastern Nepal

Journal of Psychiatrists Association of Nepal ◽

10.3126/jpan.v9i2.36281 ◽

2020 ◽

Vol 9 (2) ◽

pp. 23-29

Author(s):

S Nepal ◽

DP Sarraf ◽

DD Baral ◽

SK Mishra ◽

RK Chaudhari ◽

...

Keyword(s):

Serum Concentration ◽

Clinical Effect ◽

Rating Scale ◽

Objective Assessment ◽

Bipolar Affective Disorder ◽

P Value ◽

Young Mania ◽

Cross Sectional ◽

Therapeutic Benefits ◽

Tertiary Center

Introduction: Lithium is widely used as the gold standard for the treatment of acute and maintenance treatment of Bipolar Affective Disorder (BPAD). Its therapeutic benefits are restricted by several adverse drug reactions (ADR). Therefore, it is necessary to measure its serum concentration for optimal dosing and clinical response and to minimize toxicity. The objectives of the study were to correlate dose of Lithium with its serum concentration and serum concentration of lithium with clinical effect. Material And Method: A cross sectional study was conducted in 213 patients presenting to psychiatric OPD, diagnosed with BPAD and taking Lithium monotherapy at least for 3 months. Data collection was done from 15th December 2018 to14th December 2019. Sociodemographic profile and relevant laboratory investigations were recorded on a self-designed proforma. Young Mania Rating Scale and Hamilton Rating Scale for Depression were applied for objective assessment of remission. Chi square test was used to correlate categorical data and ANOVA test was used for continuous data using SPSS at P-value of 0.05. Results: Majority of patients were male (51.6%), married (62.4%), Hindu (86.9%) and in remission phase (92%). Dose of lithium was 300-1200 mg/day; serum concentration was 0.26 to 1.51mmol/L, was in therapeutic range in majority of the patients (82.6%) and was positively correlated with the dose of lithium (P-value <0.0001). Conclusion: Lithium is very effective for maintenance therapy in BPAD with wide variation in dose and serum concentration. The dose of lithium should be guided both on the basis of clinical assessment and serum concentration.

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Healthy Habits and Emotional Balance in Women during the Postpartum Period: Differences between Term and Preterm Delivery

Children ◽

10.3390/children8100937 ◽

2021 ◽

Vol 8 (10) ◽

pp. 937

Author(s):

Andrea Gila-Díaz ◽

Gloria Herranz Carrillo ◽

Silvia M. Arribas ◽

David Ramiro-Cortijo

Keyword(s):

Postpartum Depression ◽

Preterm Delivery ◽

Postpartum Period ◽

Depression Scale ◽

Healthy Food ◽

P Value ◽

Healthy Habits ◽

Food Pyramid ◽

Term Delivery ◽

The Impact

Breastfeeding could be considered as a vulnerable period, rising the risk to shift from optimism to pessimism. Preterm delivery is an event that increases postpartum maternal stress and depression, which can have a negative impact on breastfeeding and maternal–filial wellbeing. The adherence to healthy habits may have a positive influence on this vulnerable population. We aimed to analyze the impact of prematurity on maternal psychological aspects during postpartum and to study if adherence to the Healthy Food Pyramid influences psychological variables. Fifty-five breastfeeding women being attended in the Hospital Clínico San Carlos (Madrid, Spain) were recruited during the first day postpartum. The medical data were collected from the obstetrical records. The women answered an auto-administered questionnaire with several sections: sociodemographic characteristics, Perceived Stress Scale (PSS), and Life Orientation Test (LOT), at 14 days and 6 months postpartum, Adherence to the Healthy Food Pyramid Questionnaire (AP-Q) at 28 days postpartum and the Edinburgh Postpartum Depression Scale (EPDS) at 6 months postpartum. The PSS and LOT scores were not statistically different in mothers with preterm compared to term delivery either at 14 days or at 6 months postpartum. Longitudinally, the PSS did not show significant differences, but the LOT score was lower at 6 months compared to 14 days postpartum (p-Value = 0.046). A higher EPDS score was significantly found in mothers with preterm delivery (9.0 ± 4.7) than those with a term delivery (5.4 ± 4.2; p-value = 0.040). A significant and positive correlation was observed between the AP-Q score and LOT both at 14 days and 6 months postpartum. Conclusively, maternal optimism decreases during the postpartum period, women with preterm delivery being at risk of postpartum depression. Furthermore, there is a relationship between optimism and adherence to healthy habits. Healthcare professional counseling is essential during the entire breastfeeding period, particularly in vulnerable mothers with preterm delivery.

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Συχνότητα των ήπιων νευρολογικών σημείων σε ασθενείς με σχιζοφρενικού τύπου ψύχωση

10.12681/eadd/35462 ◽

2012 ◽

Author(s):

Παναγιώτης Παναγιωτίδης

Keyword(s):

Trait Anxiety ◽

Rating Scale ◽

Depression Scale ◽

Hand Preference ◽

T Test ◽

State Trait Anxiety Inventory ◽

Greek Version ◽

Young Mania ◽

Syndrome Scale ◽

Negative Syndrome

Η παρά τη κλίνη εξέταση των νευρολογικών διαταραχών, μέσω μίας τυπικής νευρολογικής κλινικής εξέτασης θεωρείται ως μία άμεση και ανέξοδη μέθοδος για την αξιολόγηση της εγκεφαλικής δυσλειτουργίας στη σχιζοφρένεια. Κατά τη διάρκεια των τελευταίων σαράντα ετών οι ερευνητικές εργασίες αναφέρουν συστηματικά την αυξημένη παρουσία των ήπιων νευρολογικών σημείων (ΗΝΣ) στους ασθενείς με σχιζοφρένεια, σε σύγκριση με τον υγιή πληθυσμό ή τους μη-ψυχωτικούς ψυχιατρικούς ασθενείς. Ωστόσο, η λειτουργική τους συσχέτιση παραμένει ασαφής και η ειδικότητά τους έχει συχνά αμφισβητηθεί, αν και υπάρχουν ενδείξεις μίας σχετικής ειδικότητας ως προς τη διάγνωση ή τη συμπτωματολογία. Παράγοντες όπως οι ανεπιθύμητες ενέργειες των νευροληπτικών φαρμάκων, το φύλο, η ηλικία ή το οικογενειακό ψυχιατρικό ιστορικό, θεωρείται ότι επηρεάζουν τα αποτελέσματα της νευρολογικής εκτίμησης, ενώ μόνο ένας σχετικά μικρός αριθμός ερευνών αναφέρει δεδομένα μίας μακροχρόνιας παρακολούθησης των ΗΝΣ σε έναν επαρκή αριθμό ατόμων προκειμένου να αξιολογηθεί μία πιθανή έκπτωση των νευρολογικών λειτουργιών. Η παρούσα μελέτη προσπάθησε να διερευνήσει τη συχνότητα και τη φύση των ΗΝΣ σε ασθενείς με σχιζοφρένεια, καθώς και σε μία ομάδα υγιών μαρτύρων. Στοχεύσαμε στη διερεύνηση των διαφορών μεταξύ των μελετώμενων πληθυσμών και των συσχετίσεων μεταξύ συγκεκριμένων ομάδων νευρολογικών σημείων και κλινικών, κοινωνικοδημογραφικών και θεραπευτικών χαρακτηριστικών του πληθυσμού των ασθενών, κατά την αρχική εκτίμηση, καθώς και μετά την πάροδο δώδεκα μηνών. Συνολικά εντάχθηκαν στη μελέτη 133 νοσηλευόμενοι και εξωτερικοί ασθενείς. Οι διαγνώσεις τέθηκαν βάση της ελληνικής έκδοσης 5.0.0. της σύντομης διεθνούς νευροψυχιατρικής συνέντευξης (Mini International Neuropsychiatric Interview, MINI Greek version 5.0.0.). Επιπλέον, 122 υγιείς μάρτυρες συμπεριλήφθηκαν στη μελέτη και αντιστοιχήθηκαν ως προς το φύλο και την ηλικία με τον πληθυσμό των ασθενών. Όλοι οι ενταχθέντες στη μελέτη υποβλήθηκαν αρχικά σε νευρολογική εξέταση εστιασμένη στη διερεύνηση των ΗΝΣ, βάση της Neurological Evaluation Scale (NES) κλίμακας. Τα εξωπυραμιδικά συμπτώματα εκτιμήθηκαν με τις κλίμακες Simpson-Angus Rating Scale (SARS) και Extrapyramidal Symptoms Rating Scale (ESRS). Τα ανευρεθέντα κλινικά συμπτώματα του πληθυσμού της μελέτης αξιολογήθηκαν με τις κλίμακες Positive And Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), State-Trait Anxiety Inventory form Y (STAI-T and STAI-S) και Young Mania Rating Scale (YMRS). Τέλος, η εκτίμηση της γενικής λειτουργικότητας έγινε βάση των οδηγιών της Αμερικάνικης Ψυχιατρικής Εταιρείας (κλίμακα GAF), ενώ η προτίμηση χρήσης των χεριών εκτιμήθηκε με την κλίμακα Annett Hand Preference Questionnaire (AHPQ). Για λόγους στατιστικής ανάλυσης υιοθετήθηκε τιμή p τέτοια ώστε να είναι επαρκής για πολλαπλές συγκρίσεις και ορίστηκε σε επίπεδο p<0.001. Για την ανάλυση των δεδομένων χρησιμοποιήθηκε το t-test για ένα δείγμα, η δοκιμασία x2, η δοκιμασία t-test για ανεξάρτητα δείγματα και ο συντελεστής συσχέτισης Pearson, όπου αυτό απαιτείτο. Συμπεράσματα: Τα ήπια νευρολογικά σημεία είναι εξαιρετικά συχνά σε ασθενείς με σχιζοφρένεια (90%), ενώ μάλλον σπάνια σε υγιείς μάρτυρες (12%), εύρημα κοινό σε όλες τις υποομάδες στις οποίες κατηγοριοποιούνται. Η παρουσία τους έχει μορφή δομικών χαρακτηριστικών (trait-like), με σταθερότητα στο χρόνο, και είναι ανεξάρτητα από κοινωνικοδημογραφικούς παράγοντες, κλινικά χαρακτηριστικά της νόσου και την υπάρχουσα φαρμακοθεραπεία, αν και η ύπαρξή τους ενδεχομένως υποδεικνύει νόσο με φτωχότερη έκβαση. Δε φαίνεται να επιδεινώνονται με το πέρασμα της ηλικίας, τουλάχιστον μέχρι την ηλικία των 65 ετών.

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Barriers to access to treatment for mothers with postpartum depression in primary health care centers: a predictive model

Revista Latino-Americana de Enfermagem ◽

10.1590/1518-8345.0982.2675 ◽

2016 ◽

Vol 24 (0) ◽

Cited By ~ 4

Author(s):

Pablo Martínez ◽

Paul A. Vöhringer ◽

Graciela Rojas

Keyword(s):

Postpartum Depression ◽

Predictive Model ◽

Short Form ◽

Previous History ◽

Depression Scale ◽

Initial Assessment ◽

P Value ◽

Access To Treatment ◽

History Of ◽

History Of Depression

Objective to develop a predictive model to evaluate the factors that modify the access to treatment for Postpartum Depression (PPD). Methods prospective study with mothers who participated in the monitoring of child health in primary care centers. For the initial assessment and during 3 months, it was considered: sociodemographic data, gyneco-obstetric data, data on the services provided, depressive symptoms according to the Edinburgh Postpartum Depression Scale (EPDS) and quality of life according to the Short Form-36 Health Status Questionnaire (SF-36). The diagnosis of depression was made based on MINI. Mothers diagnosed with PPD in the initial evaluation, were followed-up. Results a statistical model was constructed to determine the factors that prevented access to treatment, which consisted of: item 2 of EPDS (OR 0.43, 95%CI: 0.20-0.93) and item 5 (OR 0.48, 95%CI: 0.21-1.09), and previous history of depression treatment (OR 0.26, 95%CI: 0.61-1.06). Area under the ROC curve for the model=0.79; p-value for the Hosmer-Lemershow=0.73. Conclusion it was elaborated a simple, well standardized and accurate profile, which advises that nurses should pay attention to those mothers diagnosed with PPD, presenting low/no anhedonia (item 2 of EPDS), scarce/no panic/fear (item 5 of EPDS), and no history of depression, as it is likely that these women do not initiate treatment.

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