Postpartum-depression

Abstract

Introduction. Pregnancy, childbirth and the postpartum period are some of the most important periods in a woman's life, in which physical and mental health changes take place. Systems and organs changes occur (uterus involution, wound healing, changes in the cardiovascular, urinary, respiratory, and muscular systems). Risk factors that predispose to postnatal depression include: previous depressive episodes, feeling of despair, anxiety in pregnancy, low self-esteem, poor relationships with the partner, low socio-cultural status and loneliness. Also, women at risk of perinatal complications, hospitalization during pregnancy or termination of pregnancy by cesarean section, premature birth are more at risk. Stress associated with caring for a child and not accepting their own body after birth can also cause depression in women. First month from the postnatal period is very important because of the possibility of depressive disorders. In the post-partum period three depressive disorders may occur (baby blues, postpartum depression and postpartum psychosis). Baby blues, so-called post-partum sadness can develop four days after the baby's birth and can last up to 12 days. Anxiety, feelings of hopelessness, sleep disorders, attention and appetite disorders, lack of interest in the child and the environment are the main symptoms of post-partum depression. Postpartum depression lasts from 3 to 9 months, sometimes up to 1 year after the birth of the child. Depressive disorders in the postnatal period can have a negative impact on the development of the motherchild relationship, with long-term social, emotional consequences. and cognitive effects on mother and child. Aim of the study. Evaluation of the psychological particularities of the post-partum period and the possibility of the appearance of the emotional disorders and post-partum depression. Materials and methods. All relevant information was obtained from literature review. Results. The term postpartum depression is used to define depressive symptomatology that begins in the postnatal period and represents a complex of physical, emotional and behavioral changes. Depression, historically referred to as melancholia, was classified as a mental disorder in the 1800s, when the first efforts were made to collect statistical data on the incidence of mental illness. Since then, major depression has been included in the Statistical and Diagnostic Manual of Mental Disorders (DSM), since its inception in 1952. Thus, it has been proposed that the estimated incidence of 10-20% of postpartum depression was initially classified as a major depression subtype, referred to as “major depressive disorder, with postpartum outset” in DSM-4, and is currently classified as “major depressive disorder with outset in the peripartum period” in DSM-5, because the manifestation of symptoms begins during pregnancy in about 1/3 patients with post-partum depression. According to DSM-5 postpartum depression is a major form of depression that starts in the first 4 weeks postpartum. The diagnosis of postpartum depression is based not only on the notion of time since the outset of depression, but also on its severity. An extensive study that attempted to estimate the incidence of psychiatric disorders in pregnant and postpartum women has shown an increased risk of depression in the postpartum period compared to non-pregnant women. In general, existing data in the literature suggest that the peripartum period is a vulnerable time for depression. The prevalence of postpartum depression is considered to be about 10-20%, however the prevalence varies greatly, depending on culture and depending on the income level of the countries where the studies are conducted. Thus, it has been proposed that the estimated incidence of 10-20% of the postpartum depression may be an underestimated global problem, and how the postpartum depression is often undiagnosed / underdiagnosed, with some estimates that over 50% of women with post-partum depression remain undiagnosed. Conclusions. Women with pre-existing psychiatric disorders have an increased risk of recurrence or exacerbation during pregnancy and should be carefully monitored. Developing a screening program and extending the intervention program to subclinical and non-clinical symptoms would help mothers cope better with maternity challenges and the emotional problems they encounter during this period of their life.