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Midwifery Apr 2013to conduct a systematic review of randomised controlled trials investigating the efficacy of treatments used to manage postnatal psychological morbidity. (Review)
Review
OBJECTIVE
to conduct a systematic review of randomised controlled trials investigating the efficacy of treatments used to manage postnatal psychological morbidity.
DESIGN
a systematic review was conducted of studies in English published from 1995 to 2011. Studies were included in the review if they were randomised controlled trials and had extractable data on symptoms of psychological morbidity after an intervention designed to manage the disorders in postnatal women. Eight studies met the criteria and were included in the review.
FINDINGS
the number of participants ranged from 58 to 1745. The interventions included group and individual counselling, debriefing and expressive writing. Authors of only three studies reported fewer symptoms of PTSD after the intervention. Those that appeared to be helpful were counselling and expressive writing. However most authors did not assess pre-existing PTSD.
KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE
the review revealed that there was no standardised scale used for diagnosis of post-traumatic stress disorder across the studies and no single efficacious treatment. A universal instrument for diagnosis of postnatal post-traumatic stress disorder is required. The intrapartum relationship with midwives appears to be an important contributor to prevention of PTSD and this requires further investigation.
Topics: Comparative Effectiveness Research; Crisis Intervention; Directive Counseling; Female; Humans; Needs Assessment; Outcome Assessment, Health Care; Psychiatric Status Rating Scales; Psychological Techniques; Puerperal Disorders; Randomized Controlled Trials as Topic; Stress Disorders, Post-Traumatic; Treatment Outcome
PubMed: 23177594
DOI: 10.1016/j.midw.2012.03.004 -
Australasian Psychiatry : Bulletin of... Dec 2015This study examines pregnancy and early infant outcomes of pregnant women with a clinical diagnosis of Borderline Personality Disorder presenting for obstetric services...
OBJECTIVE
This study examines pregnancy and early infant outcomes of pregnant women with a clinical diagnosis of Borderline Personality Disorder presenting for obstetric services to a major metropolitan maternity hospital in Victoria, Australia.
METHOD
A retrospective case review of pregnancy and early infant outcomes on 42 women who had been diagnosed with Borderline Personality Disorder via psychiatric assessment using DSM-IV-R criteria was undertaken. Outcomes were compared with a control group of 14,313 consisting of women and infants of non-affected women from the same hospital over the same period of time.
RESULTS
Women presenting for obstetric services with a clinical diagnosis of Borderline Personality Disorder experienced considerable psychosocial impairment. They anticipated birth as traumatic and frequently requested early delivery. High comorbidity with substance abuse was found and high rates of referral to child protective services. Mothers with Borderline Personality Disorder were significantly more likely to have negative birth outcomes such as lowered Apgar scores, prematurity and special care nursery referral when compared with controls.
CONCLUSIONS
These findings offer preliminary evidence to be considered by clinicians in developing treatments and services for the perinatal care of women with Borderline Personality Disorder and their infants. Further research is required in order to develop evidence informed clinical guidelines for the management of women with Borderline Personality Disorder and their infants.
Topics: Adult; Australia; Borderline Personality Disorder; Diagnostic and Statistical Manual of Mental Disorders; Female; Hospitals, Maternity; Humans; Infant; Mental Health; Mothers; Outcome Assessment, Health Care; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Psychiatric Status Rating Scales; Puerperal Disorders; Retrospective Studies
PubMed: 26133812
DOI: 10.1177/1039856215590254 -
Canadian Journal of Psychiatry. Revue... Oct 1980
Topics: Adult; Affective Disorders, Psychotic; Bipolar Disorder; Female; Humans; Pregnancy; Pregnancy Complications; Puerperal Disorders
PubMed: 7417929
DOI: 10.1177/070674378002500620 -
Clinical Obstetrics and Gynecology Sep 2004
Review
Topics: Delivery, Obstetric; Female; Humans; Pregnancy; Prevalence; Puerperal Disorders; Risk Factors; Stress Disorders, Post-Traumatic
PubMed: 15326418
DOI: 10.1097/01.grf.0000129919.00756.9c -
Cephalalgia : An International Journal... Jul 2004Hemicrania continua is a common, but unrecognized headache disorder. We describe two patients with hemicrania continua whose symptoms started in the postpartum period,...
Hemicrania continua is a common, but unrecognized headache disorder. We describe two patients with hemicrania continua whose symptoms started in the postpartum period, coined as hemicrania continua postpartum.
Topics: Adult; Female; Humans; Indomethacin; Migraine Disorders; Postpartum Period; Puerperal Disorders
PubMed: 15196303
DOI: 10.1111/j.1468-2982.2004.00733.x -
The Journal of Clinical Psychiatry 1998Mood disturbance occurs commonly during the postpartum period. The symptoms may be transient and relatively mild (as in postpartum blues) or may be associated with... (Review)
Review
Mood disturbance occurs commonly during the postpartum period. The symptoms may be transient and relatively mild (as in postpartum blues) or may be associated with significant impairment of functioning (as in postpartum depression and puerperal psychosis). Despite the prevalence of postpartum mood disorders, depressive symptoms that emerge during the puerperium are often overlooked. Puerperal affective illness places the mother at risk for the development of recurrent depression and has also been associated with significant long-term effects on child development and behavior. Therefore, the prompt recognition and efficacious treatment of puerperal mood disorders are essential in order to avoid adverse outcomes for both mother and infant. This article discusses the evaluation of postpartum mood disturbance and offers guidelines for the treatment of affective illness during the puerperium.
Topics: Depression, Postpartum; Depressive Disorder; Female; Humans; Mood Disorders; Practice Guidelines as Topic; Psychotherapy; Puerperal Disorders; Risk Assessment; Risk Factors; Selective Serotonin Reuptake Inhibitors
PubMed: 9559758
DOI: No ID Found -
Tijdschrift Voor Psychiatrie 2015Although anxiety disorders are more prevalent during the perinatal period, little attention has been given so far to the influence that pregnancy and the post-partum... (Review)
Review
BACKGROUND
Although anxiety disorders are more prevalent during the perinatal period, little attention has been given so far to the influence that pregnancy and the post-partum period can have on anxiety disorders.
AIM
To review the literature concerning the prevalence, presentation and treatment of anxiety disorders during pregnancy and the post-partum period and to identify the risk factors involved.
METHOD
We reviewed the literature in order to find articles concerning the influence of the post-partum period on various types of anxiety disorders.
RESULTS
Having selected the most relevant articles, we discuss the findings in relation to specific types of anxiety disorder.
CONCLUSION
Women are more vulnerable to anxiety disorders during the perinatal period. Because anxiety disorders can have a significant impact on the mother and her foetus/infant it is important that anxiety disorders are identified and treated at the earliest opportunity.
Topics: Anxiety Disorders; Female; Humans; Postpartum Period; Pregnancy; Pregnant Women; Prevalence; Puerperal Disorders
PubMed: 26073835
DOI: No ID Found -
Archives of Women's Mental Health Feb 2017Despite perinatal depression (PND) being a common mental disorder affecting pregnant women and new mothers, limited attention has been paid to the heterogeneous nature... (Review)
Review
Despite perinatal depression (PND) being a common mental disorder affecting pregnant women and new mothers, limited attention has been paid to the heterogeneous nature of this disorder. We examined heterogeneity in PND symptom profiles and symptom trajectories. Literature searches revealed 247 studies, 23 of which were included in the final review. The most common statistical approaches used to explore symptom and trajectory heterogeneity were latent class model and growth mixture model. All but one study examined PND symptom trajectories and provided collective evidence of at least three heterogeneous patterns: low, medium, or chronic-high symptom levels. Social and psychological risk factors were the most common group of predictors related to a higher burden (high sum of score) of depressive symptoms. These studies were consistent in reporting poorer health outcomes for children of mothers assigned to high burden symptom trajectories. Only one study explored heterogeneity in symptom profile and was the only one to describe the specific constellations of depressive symptoms related to the PND heterogeneous patterns identified. Therefore, there is limited evidence on the specific symptoms and symptom configurations that make up PND heterogeneity. We suggest directions for future research to further clarify the PND heterogeneity and its related mechanisms.
Topics: Adult; Depression; Female; Humans; Mothers; Pregnancy; Pregnancy Complications; Puerperal Disorders
PubMed: 27796597
DOI: 10.1007/s00737-016-0691-8 -
Social Psychiatry and Psychiatric... Nov 1994The three main conditions that are associated with childbirth are the maternity blues, postnatal depression and post-partum psychosis. The prevalence of the blues, which... (Review)
Review
The three main conditions that are associated with childbirth are the maternity blues, postnatal depression and post-partum psychosis. The prevalence of the blues, which are mild, transient and very common disturbances of postnatal mood, does not appear in a major way to be related to environmental, social or cultural factors. Postnatal depression, which has a predominantly psychosocial etiology, surprisingly does not appear to vary in incidence across different cultures in the few studies reported that permit direct comparisons. There is also no good evidence for or against the theory that postnatal depression is partly the consequence of the customs and rituals that traditionally mark the transition to parenthood being stripped away in developed Western societies. However, the lack of relevant research and limitations of method severely restrict any conclusions that can be drawn. There is much firmer evidence for a consistent incidence of post-partum psychosis across cultural and ethnic divides; this observation, together with clinical data and historical evidence of an unchanging incidence rate during the past 150 years, points to a primarily endogenous etiology for the psychoses, which may be triggered by the physiology of childbirth. The transcultural approach to postnatal psychiatric disorders provides a unique opportunity not only to test hypotheses about social and cultural contributions to the etiology of psychotic and non-psychotic reactions to childbirth, but also an opportunity to study the ways in which social factors can influence the evolution of psychopathology. It is also possible that in some cultures the family and social milieu may play a major part in buffering infants from the adverse effects of maternal postnatal illness, but the evidence is anecdotal. Systematic research across cultures will lead to better recognition of maternal illness as well as to better prevention and management.
Topics: Cross-Cultural Comparison; Depression; Depressive Disorder; Female; Humans; Incidence; Maternal Mortality; Psychotic Disorders; Puerperal Disorders
PubMed: 7825036
DOI: 10.1007/BF00802048 -
American Journal of Obstetrics and... Aug 1995There is considerable evidence that the childbearing years represent a time when women are highly vulnerable to developing mood disorders. Prospective, cross-sectional,... (Review)
Review
There is considerable evidence that the childbearing years represent a time when women are highly vulnerable to developing mood disorders. Prospective, cross-sectional, and retrospective studies have demonstrated that more than 10% of new adult mothers will experience a major depressive episode during the first postpartum year. Changes in the health care delivery system will result in increased pressure on the obstetrician/gynecologist to identify and treat women with postpartum-onset depression. Despite shortcomings in the available literature, prospective studies have identified risk factors for developing postpartum depression. Furthermore, the clear overlap between the normal sequelae of childbirth and the symptoms of major depression, including alterations in sleep, energy, libido, appetite, and body weight, underscores the need to develop guidelines for early identification. We furnish a brief overview of postpartum mood disorders with a primary focus on the antenatal and postnatal risk factors for developing postpartum depression. Based on the extent literature and our clinical experience, a set of recommendations for early identification and treatment is provided.
Topics: Depressive Disorder; Female; Humans; Puerperal Disorders; Risk Factors
PubMed: 7645646
DOI: 10.1016/0002-9378(95)90296-1