Επιλόχειος κατάθλιψη

Postgraduate Thesis uoadl:1317342 582 Read counter

Unit:
Τομέας Βιολογίας Κυττάρου Και Βιοφυσικής
Library of the School of Science
Deposit date:
2011-10-26
Year:
2011
Author:
Γραμμένου Μαρία
Supervisors info:
Θεόδωρος Κατσώρχης Καθηγητής Επιβλέπων, Γεώργιος Τσίτσας ΕΕΔΙΠ Χαροκοπείου, Ευαγγελία Μαυρικάκη Λέκτορας
Original Title:
Επιλόχειος κατάθλιψη
Languages:
Greek
Summary:
Postpartum depression is the definition of a major depressive episode that
occurs within the first 4 weeks postpartum but the total expression of the
disease happens during the 4th-5th month after delivery. Medically, the patient
exhibits mild to moderate symptoms which include gloominess, loss of interest,
anxiety, irritability, distress, loss or gain of body weight, insomnia,
exhaustion, psychomotor stimulation or deterioration, reduced mental ability,
guilt feelings, headaches, dizziness, diminished libido and suicidal ideation.
Postpartum depression requires differentiation from other diseases because of
their similar symptoms. The prevalence of postpartum depression is estimated at
10%-20% and it is more dominant in cases of the financially challenge mothers
of one child, the adolescents and the women with previous history of
depression. Etiologically, postpartum depression is related to a variety of
psychosocial and neurobiological factors. With regard to the psychosocial
background, the risk factors for the occurrence of postpartum depression can be
presented the prenatal depression, the prenatal anxiety, the personal and
family history of mental disorders, the negative life events during the
pregnancy and postpartum, the infant temperament, the poor socioeconomic
status, the age of the woman, the poor social support, the premenstrual
syndrome, the obstetric complications as well as the childhood experiences and
the vulnerability of women’s personality. On the other hand, the
neurobiological background of postpartum depression is related with the brain
structure disorders, the neuroendocrinal dysfunctions of the
hypothalamic-pituitary-adrenal axis and the hypothalamic-pituitary-thyroid axis
as well as with the neurotransmitter disorders. During the pregnancy and the
period after delivery the changes in the levels of ovary hormones, b-endorphins
and GRH are seemed to be relevant with the etiology of postpartum depression.
It is also well known that, the ovary hormones have significant impact on the
serotonin system, effecting changes in the central nervous system and thus
change the new mother’s mood. Prevention and early diagnosis of postpartum
depression aim to halt progression in early stages and in combination with the
correct treatment can accomplish the avoidance of negative effects of the
disease in the cognitive and physical health of the new mother and the newborn,
and in the relationship with the rest of the family members. The treatment of
postpartum depression can vary depending on the specific needs of the mother
and includes psychotherapy for mild cases or combination of psychotherapy and
medicinal treatments (antidepressant drugs) for more severe cases, as well as
electroconclusive therapy (ECT).
“Baby blues” is the name of a time–limited and self–limited disorder that has
its onset between the 3rd and the 5th day after delivery and persists for
several days. The symptoms include tearfulness, mood lability, irritability,
general anxiety, lack of concentration and clarity, exhaustion, headache and
insomnia. The prevalence of “baby blues” ranges from 8%-84%. The etiology of
“baby blues” is related to both biological and psychosocial factors. The main
biological factors that have been proposed as the etiology of that disorder are
the rapid fluctuation on the levels of estrogen and progesterone, as well as
the hypersensitivity to GABA receptors. With regard to the psychosocial risk
factors, the list includes mood disorders and anxiety at the third trimester of
pregnancy, any personal previous history of depression, premenstrual syndrome,
poor social support and specific character traits. Baby blues does not require
treatment, since it is not regarded as an illness but rather a normal reaction
of the new mother.
Finally, a mother can be regarded as suffering from postpartum psychosis when
she exhibits symptoms of mania, bipolar disorder, schizophrenia, psychosis and
psychotic depression during the first two weeks after delivery. The clinical
onset is rapid, with escalating symptoms between the 2nd and 14th day after
delivery and lasts for a few weeks, if diagnosed promptly. The occurrence of
the disease measures at 1-2 cases per 1000 deliveries. Its etiology is mainly
neuroendocrinal, since the hypersensitivity of dopamine receptors seems to be
involved. Risk factors of the onset of postpartum psychosis include personal or
family history of psychosis or any other serious mental disorder, being
first-born, poor social support, as well as obsessive-compulsive personality.
The therapeutic treatment includes admission to mental clinic, psychotherapy,
administering of anti-psychotic cocktails or anti-depressants and mood
stabilizers as well as electroconclusive therapy (ECT).
Keywords:
Postpartum depression, Baby blues, Bostpartum psychosis, Depression, Antidepressants
Index:
No
Number of index pages:
0
Contains images:
Yes
Number of references:
199
Number of pages:
134
File:
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