Abstract
Objective: to analyze the psychopathological structure, risk factors and tretment of depressive disorders in women in the postpartum period.Patients and methods. A prospective cohort study included 150 women in the postpartum period (0-3 days after birth), aged 18 to 41 years, with follow-up every two weeks for six months. The evaluation included clinical interviews, Montgomery-Asberg Depression Rating Scale, and the 17-item Hamilton Anxiety Rating Scale.Results and discussion. 11.3% of women developed depression within six weeks after childbirth. Among them, 94.2% presented with mild depression, and 5.8% - moderate. Risk factors associated with postpartum depression included: periods of low mood and anxiety before and during the current pregnancy, traumatic situations during pregnancy, unwanted pregnancy, pathology of pregnancy and childbirth, cesarean section, perinatal status, lack of breastfeeding. All women with postpartum depression were treated with rational-emotive and cognitive-behavioral therapy. A short course of pharmacotherapy was prescribed to 17.6% of them to correct insomnia and anxiety symptoms. Psychotherapy was highly efficient in the treatment of postpartum affective disorders.Conclusion. The postpartum depression prevalence was 11.3%. The severity of postpartum depression was predominantly mild, and the symptoms regressed during treatment within five months in all women.
Highlights
Objective: to analyze the psychopathological structure, risk factors and tretment of depressive disorders in women in the postpartum period
Psychotherapy was highly efficient in the treatment of postpartum affective disorders
The severity of postpartum depression was predominantly mild, and the symptoms regressed during treatment within five months in all women
Summary
Послеродовая депрессия – факторы риска развития, клинические и терапевтические аспекты. В когортное проспективное исследование включено 150 женщин в возрасте от 18 лет до 41 года в послеродовом периоде (0–3-й день после родов), с катамнестическим прослеживанием каждые 2 нед в течение 6 мес. В течение 6 нед после родов депрессия развилась у 11,3% женщин, из них у 94,2% – легкой степени тяжести, у 5,8% – средней степени. Для обследования применялись клинико-психопатологический и клинико-катамнестический, психометрический методы с использованием Шкалы оценки депрессии Монтгомери–Асберг (Montgomery–Asberg Depression Rating Scale, MADRS), Шкалы общего клинического впечатления (Clinical Global Impression Scale, CGI), Шкалы тревоги Гамильтона (HAM-A). В группе женщин без аффективной патологии при оценке с помощью MADRS наиболее высокие баллы получены для симптомов тревоги (1,28±0,56) и нарушений сна (1,34±0,74). Для оценки влияния различных факторов на риск развития послеродовой депрессии был проведен сравнительный анализ групп с развившейся депрессией и без аффективной патологии General characteristics of women with postpartum depression and without affective disorders, n (%)
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