Systemic Solutions for Addressing Early Recognition and Treatment of Antenatal and Postpartum/Postnatal Depression in Psychiatry Clinic in Skopje, North Macedonia

Abstract

Background: It is considered that depressive disorder most often begins in the reproductive period, around 20 years of age. Introduction: The greatest risk or danger for the young depressed mother is suicide, which is being considered the second cause of death in the young during the reproductive years. Unfortunately, it happens usually at the end of the pregnancy or during the first postpartum year. Materials and methods: The investigation comprised 69 patients at the age between 18 and 44 years, with postpartum depression. Patients were diagnosed and treated during their pregnancy and postpartum period. Patients were analyzed by using a structured clinically diagnostic psychiatric interview, psychodiagnostic instruments for assessment of anxiety and depression, HAM-A and HAM-D. Depression and anxiety were evaluated in the beginning of the treatment and after three months of treatment. Patients were treated with psychological interventions and pharmacological treatment, SSRI or SNRI antidepressant therapy, during pregnancy or postpartum period. Results: Cross-sectional study was conducted in a 3-month-period and comprised 69 patients, of which 71.0% were at the age older than 30 years, and 29.0% younger than 30 years. Of these, 81.5% of patients received antidepressants, 24.6% received antipsychotics and anxiolytics, alone or in combination. Discussion: The results have shown a statistically significant presence of risk factors in patients with antenatal or postpartum depression. The results have shown a significant reduction of anxiety and depression after application of SSRI therapy and psychological individual and group interventions by empowering the mother to care for herself and her child. Conclusion: Proper care for the mental health of the mother is the care for the entire society, healthy mother, healthy children and healthy society. Early recognition of the risk factors for development of antenatal depression leads to prevention of onset of antenatal or postpartum depression.