Yıl: 2014 Cilt: 45 Sayı: 2 Sayfa Aralığı: 71 - 77 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Gebelık ve Postpartum Dönemde Sık Görülen Ruhsal Bozukluklar

Öz:
Psikiyatrik hastalıkların görülme sıklığı, kadınların doğurganlık çağında diğer yaşam dönemlerine oranla kısmen artmaktadır. Gebelik ve postpartum döneminse,ruhsal hastalık görülme sıklığındaartıştan çok, hastalığın alevlenmesi ile ilişkili olduğu düşünülmektedir. Buna göre, gebelik ve postpartum dönem pek çok kadın için anksiyete bozukluğu, depresyon, yeme bozukluğu ve psikoz gibi psikiyatrik hastalıklara yatkınlığın arttığı bir dönem olabilmektedir. Gebelik sürecinde bedendeki fizyolojik değişiklikler, cinsel ilgideki değişiklikler ve doğumla ilgili anksiyete, duygudurum değişikliğine katkı sağlayabilir. Bunun yanında gebelikte görülen somatik yakınmalar, depresyon ve anksiyete belirtileri hekimlerce genellikle gebelikle ilgili hormonal ve fiziksel değişikliklere bağlanmakta ve sıklıkla daha az teşhis edilebilmekte ve buna bağlı olarak da tedavileri aksamaktadır. Daha önceden hastalık öyküsü bulunan kadınların hamilelik ya da postpartum döneminde bu hastalıkların alevlenme riski bulunmaktadır. Ayrıca bu dönemlerde bazı psikiyatrik bozuklukların tedavileri değişebilmekte veya ilaç dozlarında değişikliğe gidilmesi gerekliliği ortaya çıkabilmektedir. Bu dönemdeki psikiyatrik hastalıklarla ilgili çalışmalarınçoğunun son yıllarda gerçekleşmesinden dolayı klinisyenlerin bu dönemdeki bireylere yaklaşımına yönelik bilgi oldukça sınırlıdır.Tedavisi ihmal edilen bu ruhsal bozuklukların anne-çocuk ilişkisinin ciddi olarak bozulması ile sonuçlandığı göz önüne alındığında, bu konuya duyarlılık ile yaklaşılmasının gerektiği açıktır.Bu derlemede gebelik ve postpartum dönemde sık karşılaşılan psikiyatrikhastalıklar konusunda makaleler gözden geçirilerek, bu hastalıkların tanısı, müdahale yöntemleri ve tedavi konularında klinisyenlere önerilerde bulunulmaktadır
Anahtar Kelime:

Konular: Kadın Hastalıkları ve Doğum Kadın Araştırmaları Psikoloji Psikiyatri

Common Psychiatric Disorders in Pregnancy and Postpartum Period

Öz:
Psychiatric disorders are common at women during particularly their reproductive years, when compared to other life periods. It is believed that, pregnancy and postpartum period is not associated with increased incidence of any mental disorder, but the severity of the disorder. Accordingly, pregnancy and postpartum periods may be a time of increased susceptibility to psychiatric disorders such as anxiety disorder, depression, eating disorder and psychosis. Physiological changes in the body during pregnancy, changes in sexual interest and birth-related anxiety might contribute to mood changes. Besides, somatic complaints, depression and anxiety symptoms seen in pregnancy are frequently linked to pregnancy-related hormonal and physical changes and can be less commonly diagnosed by physicians, consequently therapies are being delayed. During the pregnancy or postpartum periods of women with a prior history of disease, there is an increased risk of exacerbation of these diseases. Additionally during these periods, the treatment of certain psychiatric disorders may change or the necessity of amendment in drug doses may arise.Because studies about the psychiatric disorders in this period have been done in recent years, clinicians have limited data about approaching to the individuals in this period. Given that the neglected therapy of these disorders results in severe impairment of the mother-baby relationship, it is clear that the issue should be approached with sensitivity. In this review, articles about common psychiatric disorders during pregnancy and postpartum period have been reviewed and suggestions to clinicians about identifying, interventionsand treatments of these disorders are being made
Anahtar Kelime:

Konular: Kadın Hastalıkları ve Doğum Kadın Araştırmaları Psikoloji Psikiyatri
Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık
0
0
0
  • Cantwell R, Cox JL. Psychiatric disorders in preg- nancy and the puerperium. Current Obstetrics & Gy- naecology, 2006; 16(1): 14-20.
  • Carter D, Kostaras X. Psychiatric disorders in preg- nancy. BCMJ 2005; 47(3): 96-9.
  • Hendrick V. General Considerations in Treating Ps- ychiatric Disorders During Pregnancy and Following Delivery, in Psychiatric Disorders in Pregnancy and the Postpartum, 1st ed. Humana Press,Totowa, New Jersey, 2006, p.1-12.
  • Lancaster CA, Gold KJ, Flynn HA, Yoo H, Marcus SM, Davis MM. Risk factors for depressive symptoms during pregnancy: a systematic review. Am J Obstet Gynecol 2010;202(1): 5-14.
  • Bennett HA, Einarson A, Taddio A, Koren G, Einar- son TR. Prevalence of depression during pregnan- cy: systematic review. Obstet. Gynecol 2004;103(4): -709.
  • Klein M, Essex M. Pregnant or depressed? The effects of overlap between symptoms of depressi- on and somatic complaints of pregnancy on rates of major depression in the second trimester. Depression ;2(6):308-14. Spitzer RL, Williams JB, Kroenke K, Hornyak R, McMurray J. Validity and utility of the PRIME-MD pa- tient health questionnaire in assessment of 3000 obs- tetric-gynecologic patients: the PRIME-MD patient health questionnaire obstetrics-gynecology study. Am
  • J Obstet Gynecol 2000;183(3):759-69.
  • Murray L, Carothers AD. The validation of the Edin- burgh Post-Natal Depression Scale on a community sample. Br J Psychiatry 1990;157: 288-90.
  • Dossett EC. Perinatal Depression. Obstet Gynecol Clin N Am 2008; 35(3); 419-34.
  • O'Hara MW. Postpartum depression: Causes and Consequences. New York, NY: Springer-Verlag. ;168-94. Melville JL, Gavin A, Guo Y, Fan MY, Kayon WJ. Depressive disorders during pregnancy. Obstet Gy- necol 2010;116(5): 1064-70.
  • Sungur MZ. Kadında psikiyatrik problemler[Psy- chiatric problems in women]. Nöroloji Nöroşirürji Psi- kiyatri Dergisi. 1986; 2(1): 11-14.
  • Haeri S, Baker MA, Ruano R. Do pregnant wo- men with depression have a pro-inflammatory profi- le? J Obstet Gynaecol Res 2013; 39(5): 948-52.
  • Engineer N, Darwin L, Nishigandh D, Ngian- ga-Bakwin K, Smith SC, Grammatopoulos DK. Asso- ciation of glucocorticoid and type 1 corticotropin-re- leasing hormone receptors gene variants and risk for depression during pregnancy and post-partum. J Psychiatric Res 2013;47(9):1166-73.
  • Lundy BL, Jones NA, Field T, Nearing G, Davalos M, Pietro PA, et al. Prenatal depression effects on ne- onates. Infant Behav Dev 1999;22(1): 119-29.
  • O'Hara M, Swain A. Rates and risk of postpar- tum depression - a meta-analysis. Int Rev Psychiatry ; 8(1): 37-54. Milgrom J, Gemmill AW, Bilstza JL, Hayes B, Bar- nett B, Brooks J, et al. Antenatal risk factors for post- natal depression: a large prospective study. J Affect Disord 2008; 108(1-2): 147-57.
  • Akman C, Uguz F, Kaya N. Postpartum-onset major depression is associated with personality disor- ders. Compr Psychiatry 2007; 48(4): 343-7.
  • Toohey J. Depression During Pregnancy and Postpartum. Clin Obstet Gynecol 2012;55(3): 788-97.
  • Cunningham FG, Gant FN, Leveno KJ, Gilstrap CL, Hauth JC, Wenstrom K. Neurologic and psyc- hiatric disorders. In: Cunningham FG, Gant FN, Le- veno KJ, Gilstrap CL, Hauth JC, Wenstrom K, eds. Williams Obstetrics. 23rd ed. New York: McGraw Hill, , pp.1420-32.
  • American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th ed. DSM- IV. Washington, DC; 1994, pp.429.
  • Stuart S, Couser G, Schilder K, O'Hara MW, Gor- man L. Postpartum anxiety and depression: onset and comorbidity in a community sample. J Nerv Ment Dis 1998; 186(7); 420-4.
  • Uguz F, Gezginc K, Kayhan F, Sarı S, Büyüköz D. Is pregnancy associated with mood and anxiety disorders? A cross-sectional study. Gen Hosp Psyc- hiatry 2010; 32(2): 213-5.
  • Bandelow B, Sojka F, Broocks A, Hajak G, Blei- ch S, Rüther E. Panic disorder during pregnancy and postpartum period. Eur Psychiatry 2006; 21(7): 495
  • Guler O, Koken NG, Emul M, Ozbulut O, Geci- ci O, Uguz F, et al. Course of panic disorder during the early postpartum period: a prospective analysis. Compr Psychiatry 2008;49(1): 30-4.
  • Rambelli C, Montagnani MS, Oppo A, Banti S, Borri C, Cortopassi C, et al. Panic disorder as a risk factor for post-partum depression. Results from the Perinatal Depression-Research & Screening Unit (PND-ReScU) study. J Affect Disord 2010;122(1- ):139-43.
  • 27. Okanlı A, Tortumluoğlu G, Kırpınar İ. Gebe kadın-ların ailelerinden aldıkları sosyal destek ile problem çözme becerileri arasındaki ilişki[The relationship between the pregnant women's social support they received from their families and the problem solving skills]. Anadolu Psikiyatri Dergisi 2003; 4(2): 98-105.
  • 28. Chen HY, Lin CH, Lee HC. Pregnancy outcomes among women with panic disorder - Do panic atta-cks during pregnancy matter? J Affect Disord 2010; 120(1-3): 258-62.
  • 29. Arch JJ. Pregnancy-specific anxiety: Which wo-men are highest and what are the alcohol-related ris-ks? Compr Psychiatry 2013; 54(3): 217-28.
  • 30. Littleton HL, Breitkopf CR, Berenson AB. Correla-tes of anxiety symptoms during pregnancy and asso-ciation with perinatal outcomes: a meta-analysis. Am J Obstet Gynecol 2007;196(5): 424-32.
  • 31. Rasmussen SA, Tsuang MT. Clinical characteris-tics and family history in DSM III obsessive-compul-sive disorder. Am J Psychiatry 1986;143(3):317-22.
  • 32. Yüksel N. Psikofarmakoloji. Bilimsel Tıp Yayınevi, Ankara: 1998:348-71.
  • 33. Buttolph ML, Holland AD. Obsessive-compulsi-ve disorders in pregnancy and childbirth. In: Jenike MA, Baer L, Minichiello WE, eds. Obsessive-compul-sive disorder: theory and management, 2nd ed. Chi-cago: Yearbook Medical Publishers, 1990,pp.89-95.
  • 34. Easter A, Bye A, Taborelli E, Corfield F, Schmidt U, Treasure J, et al. Recognising the symptoms: how common are eating disorders in pregnancy?Eur Eat Disord Rev 2013;21(4):340-4.
  • 35. Turton P, Hughes P, Bolton H, Sedgwick P. Inci-dence and demographic correlates of eating disorder symptoms in a pregnant population. Int J Eat Disord 1999; 26(4): 448-52.
  • 36. Watson HJ, Von Holle A, Hamer RM, Knoph Berg C, Torgensen L, Magnus P, et al. Remission, continu-ation and incidence of eating disorders during early pregnancy: a validation study in a population-based birth cohort. Psychol Med. 2013;43(8):1723-34.
  • 37. Blais MA, Becker AE, Burwell RA, Flores AT, Nussbaum KM, Greenwood DN, et al. Pregnancy: Outcome and impact on symptomatology in a co-hort of eating disordered women. Int J Eat Disord 2000;27(2):140-9.
  • 38. Brinch M, Isager T, Tolstrup K. Anorexia and mo-therhood: Reproduction pattern and mothering be-haviour of 50 women. Acta Psychiatr Scand 1988; 77(5): 611-7.
  • 39. Knoph C, Von Holle A, Zerwas S, Torgensen L, Tambs K, Stoltenberg C, et al. Course and predictors of maternal eating disorders in the postpartum period. Int J Eat Disord 2013;46(4):355-68.
  • 40. Mitchell-Gieleghem A, Mittelstaedt ME, Bulik CM. Eating disorders and childbearing: concealment and consequences. Birth 2002;29(3):182-91.
  • 41. McNeil TF. A prospective study of postpartum psychoses in a high-risk group. Relationships to de-mographic and psychiatric history characteristics. Acta Psychiatr Scand 1987;75(1):35-43.
  • 42. Lier L, Kastrup M, Rafaelsen OJ. Psychiatric ill-ness in relation to childbirth and pregnancy: diagnos-tic profiles, psychosocial and perinatal aspects. Nor-disk Psykiatrisk Tidsskrift 1989;43(6):535-42.
  • 43. McNeil TF, Malmquist-Larsson A. Women with non-organic psychosis: mental disturbance during pregnancy. Acta Psychiatr Scand. 1984;70(2):140-8.
  • 44. Bergink V, Bouvy PF, Vervoort JSP, Koorengevel KM, Steegers EAP, Kushner SA. Prevention of post-partum psychosis and mania in women at high risk. Am J Psychiatry 2012;169(6): 609-15.
  • 45. Grof P, Robbins W, Alda M, Berghoefer A, Vojte-chovsky M, Nilsson A, Robertson C. Protective effect of pregnancy in women with lithium-responsive bipo-lar disorder. J Affect Disord 2000;61(1-2):31-9.
  • 46. Freeman MP, Wosnitzer-Smith K, Freeman SA, McElroy SL, Kmetz GF, Wright R, et al. The impact of reproductive events on the course of bipolar disorder in women. J. Clin Psychiatry 2002;63(4): 284-7.
  • 47. Rhode A, Marneros A. Bipolar disorders during pregnancy, postpartum, and in menopause. In: Mar-ners A and Angst J, eds. Bipolar Disorders: 100 Ye-ars After Manic-Depressive Insanity. 1st ed. London: Kluwer Academic Publishers, 2000,pp.127-37.
  • 48. Kruger S, Braunig P. Clinical issues in bipolar di-sorder during pregnancy and the pospartum period. Clin Appr Bipol Disord 2002;1(2):65-71.
  • 49. Çetin M. Gebelikte psikotrop ilaç kullanımı: Bir güncelleme[Psychotropic drug use in pregnan-cy: An update]. Klinik Psikofarmakoloji Bülteni, 2011;2(21):161-73.
APA Özdamar Ö, YILMAZ O, BEYCA H, MUHCU M (2014). Gebelık ve Postpartum Dönemde Sık Görülen Ruhsal Bozukluklar. , 71 - 77.
Chicago Özdamar Özkan,YILMAZ Onat,BEYCA Hacer Hicran,MUHCU Murat Gebelık ve Postpartum Dönemde Sık Görülen Ruhsal Bozukluklar. (2014): 71 - 77.
MLA Özdamar Özkan,YILMAZ Onat,BEYCA Hacer Hicran,MUHCU Murat Gebelık ve Postpartum Dönemde Sık Görülen Ruhsal Bozukluklar. , 2014, ss.71 - 77.
AMA Özdamar Ö,YILMAZ O,BEYCA H,MUHCU M Gebelık ve Postpartum Dönemde Sık Görülen Ruhsal Bozukluklar. . 2014; 71 - 77.
Vancouver Özdamar Ö,YILMAZ O,BEYCA H,MUHCU M Gebelık ve Postpartum Dönemde Sık Görülen Ruhsal Bozukluklar. . 2014; 71 - 77.
IEEE Özdamar Ö,YILMAZ O,BEYCA H,MUHCU M "Gebelık ve Postpartum Dönemde Sık Görülen Ruhsal Bozukluklar." , ss.71 - 77, 2014.
ISNAD Özdamar, Özkan vd. "Gebelık ve Postpartum Dönemde Sık Görülen Ruhsal Bozukluklar". (2014), 71-77.
APA Özdamar Ö, YILMAZ O, BEYCA H, MUHCU M (2014). Gebelık ve Postpartum Dönemde Sık Görülen Ruhsal Bozukluklar. Zeynep Kamil Tıp Bülteni, 45(2), 71 - 77.
Chicago Özdamar Özkan,YILMAZ Onat,BEYCA Hacer Hicran,MUHCU Murat Gebelık ve Postpartum Dönemde Sık Görülen Ruhsal Bozukluklar. Zeynep Kamil Tıp Bülteni 45, no.2 (2014): 71 - 77.
MLA Özdamar Özkan,YILMAZ Onat,BEYCA Hacer Hicran,MUHCU Murat Gebelık ve Postpartum Dönemde Sık Görülen Ruhsal Bozukluklar. Zeynep Kamil Tıp Bülteni, vol.45, no.2, 2014, ss.71 - 77.
AMA Özdamar Ö,YILMAZ O,BEYCA H,MUHCU M Gebelık ve Postpartum Dönemde Sık Görülen Ruhsal Bozukluklar. Zeynep Kamil Tıp Bülteni. 2014; 45(2): 71 - 77.
Vancouver Özdamar Ö,YILMAZ O,BEYCA H,MUHCU M Gebelık ve Postpartum Dönemde Sık Görülen Ruhsal Bozukluklar. Zeynep Kamil Tıp Bülteni. 2014; 45(2): 71 - 77.
IEEE Özdamar Ö,YILMAZ O,BEYCA H,MUHCU M "Gebelık ve Postpartum Dönemde Sık Görülen Ruhsal Bozukluklar." Zeynep Kamil Tıp Bülteni, 45, ss.71 - 77, 2014.
ISNAD Özdamar, Özkan vd. "Gebelık ve Postpartum Dönemde Sık Görülen Ruhsal Bozukluklar". Zeynep Kamil Tıp Bülteni 45/2 (2014), 71-77.