Diagnostics and modern trends in therapy of postpartum depression


Authors: A. Šebela;  J. Hanka;  P. Mohr
Authors‘ workplace: Národní ústav duševního zdraví, Klecany, primář prof. MUDr. P. Mohr, Ph. D.
Published in: Ceska Gynekol 2019; 84(1): 68-72
Category:

Overview

Objective: To bring actual summary of knowledge about diagnostics and modern trends in therapy of postpartum depression.

Design: Review.

Setting: National Institute of Mental Health, Klecany.

Methods: Narrative review.

Results: First assessment of depressive symptoms among puerperal women can be done by screening instruments. Baby blues and postpartum psychosis must be kept in mind during the differential diagnostics of postpartum depression. Both nonpharmacological and pharmacological interventions can be used for postpartum depression treatment. As for nonpharmacological interventions, cognitive behavioral therapy is the most evidence based one. Antidepressants from the selective serotonin reuptake inhibitor group (SSRI) are the first choice from pharmacological interventions. Parenting support is also an important component of modern care of women with postpartum depression.

Conclusion: Systematic cooperation between psychiatrist and gynecologists-obstetricians is a precondition of the effective postpartum depression treatment. The therapeutic intervention is chosen according to severity of depressive symptoms.

Keywords:

puerperium – postpartum depression – antidepressants – psychotherapy


Sources

1. Ahokas, A., Kaukoranta, J., Wahlbeck, K., Aito, M. Estrogen deficiency in severe postpartum depression: successful treatment with sublingual physiologic 17beta-estradiol: a preliminary study. J Clin Psychiatry, 2001, 62, p. 332–336.

2. Ammerman, RT., Altaye, M., Putnam, FW., et al. Depression improvement and parenting in low-income mothers in home visiting. Archives of Women’s Mental Health. 2015, 18, p. 555–563. doi: 10.1007/s00737-014-0479-7.

3. Appleby, L., Warner, R., Whitton, A., Faragher, B. A controlled study of fluoxetine and cognitive-behavioural counselling in the treatment of postnatal depression. BMJ, 1997, 314(7085), p. 932–936.

4. Austin, MP., et al. Clinical practice guidelines for depression and related disorders – anxiety, bipolar disorder and puerperal psychosis – in the perinatal period. A guideline for primary care health professionals. Committee at GEA: Melbourne, Australia, 2011.

5. Bauer, A., Parsonage, M., Knapp, M., et al. Costs of perinatal mental health problems [published October 20, 2014]. https://www.centreformentalhealth.org.uk/costs-of-perinatal-mh-problems. Accessed July 2, 2018.

6. Benyshek, DC., Cheyney, M., Brown, J., Bovbjerg, ML. Placentophagy among women planning community births in the United States: Frequency, rationale, and associated neonatal outcomes. Birth, 2018, May 2. doi: 10.1111/birt.12354.

7. Bloch, M., Meiboom, H., Lorberblatt, M., et al. The effect of sertraline add-on to brief dynamic psychotherapy for the treatment of postpartum depression: a randomized, double-blind, placebo-controlled study. J Clin Psychiatry, 2012, 73(2), p. 235–241.

8. Břicháček, V. Edinburghská škála postnatální deprese: ověření v České republice. Iga MZ ČR 2000.

9. Di Scalea, TL., Wisner, KL. Antidepressant medication use during breastfeeding. Clin Obstet Gynecol,. 2009, 52(3), p. 483–497.

10. Fortinguerra, F., Clavenna, A., Bonati, M. Psychotropic drug use during breastfeeding: a review of the evidence. Pediatrics, 2009, 124(4), p. e547–556.

11. Gregoire, AJP., Kumar, R., Everitt, B., et al. Transdermal oestrogen for treatment of severe postnatal depression. Lancet, 1996, 347, p. 930–933.

12. Gressier, F., Rotenberg, S., Cazas, O., Hardy, P. Postpartum electroconvulsive therapy: a systematic review and case report. Gen Hosp Psychiatry, 2015, 37(4), p. 310–314.

13. Hahn-Holbrook, J., Cornwell-Hinrichs, T., Anaya, I. Economic and health predictors of national postpartum depression prevalence: a systematic review, meta-analysis, and meta-regression of 291 studies from 56 countries. Front Psychiatry, 2018, 8, p. 248. doi: 10.3389/fpsyt.2017.00248. eCollection 2017.

14. Hantsoo, L., Ward-O‘Brien, D., Czarkowski, KA., et al. A randomized, placebo-controlled, double-blind trial of sertraline for postpartum depression. Psychopharmacology, 2014, 231(5), p. 939–948.

15. Kacířová, I., Grundmann, M. Léky a kojení. Klin Farmakol Farm, 2008, 22(1), s. 30–33.

16. Karoly, LA., Kilburn, MR., Cannon, JS. Early childhood interventions: proven results, future promise. Santa Monica, CA: RAND, 2005.

17. Mah, BL., Van Ijzendoorn, MH., Smith, R., Bakermans-Kranenburg, MJ. Oxytocin in postnatally depressed mothers: its influence on mood and expressed emotion. Prog Neuropsychopharmacol Biol Psychiatry, 2013, 40, p. 267–272.

18. Mezinárodní klasifikace nemocí: Mezinárodní statistická klasifikace nemocí a přidružených zdravotních problémů ve znění desáté decenální revize MKN-10. Vyd. 3. Praha: Ústav zdravotnických informací a statistiky České republiky, 1992.

19. Milgrom, J., Danaher, BG., Gemmill, AW., et al. Internet Cognitive Behavioral Therapy for Women With Postnatal Depression: A Randomized Controlled Trial of MumMoodBooster. Eysenbach G, ed. J Med Internet Res, 2016, 18(3), p. e54. doi:10.2196/jmir.4993.

20. Mohr, P., et al. Psychofarmaka v těhotenství a laktaci. Postgrad Med, 2012, 14, 1, s. 17–23.

21. Mohr, P. Poporodní psychické poruchy. In Takács, L., Sobotková, D., Šulová, L. Psychologie v perinatální péči: Praktické otázky a náročné situace. Praha: Grada Publishing, 2015, s. 75–101.

22. Molenaar, NM., Kamperman, AM., Boyce, P., Bergink, V. Guidelines on treatment of perinatal depression with antidepressants: An international review. Aust N Z J Psychiatry, 2018, 52(4), p. 320–327.

23. Molyneaux, E., Howard, LM., McGeown, HR., et al. Antidepressant treatment for postnatal depression. Cochrane Database Syst Rev. 2014, 9:CD002018.

24. Moses-Kolko, EL., Berga, SL., Kalro, B., et al. Transdermal estradiol for postpartum depression: A promising treatment option. Clin Obstet Gynecol, 2009, 52(3), p. 516–529. doi:10.1097/GRF.0b013e3181b5a395.

25. O‘Hara, MW., Stuart, S., Gorman, LL., Wenzel, A. Efficacy of interpersonal psychotherapy for postpartum depression. Arch Gen Psychiatry, 2000, 57(11), p. 1039–1045.

26. Righetti-Veltema, M., Conne-Perréard, E., Bousquet, A., Manzano, J. Postpartum depression and mother-infant relationship at 3 months old. J Affect Disord, 2002, 70(3), p. 291–306.

27. Sanders, MR., Kirby, JN., Tellegen, CL., Day, JJ. The triple P-Positive Parenting Program: A systematic review and meta-analysis of a multi-level system of parenting support. Clin Psychol Rev, 2014, 34, p. 337–357.

28. Sanger, C., Iles, JE., Andrew, CS., Ramchandani, PG. Associations between postnatal maternal depression and psychological outcomes in adolescent offspring: a systematic review. Arch Womens Ment Health, 2015, 18(2), p. 147–162.

29. Sobotková, D, Štembera Z. Psychologické aspekty v perinatální medicíně v letech 1980–2000: III. poporodní období. Čes Gynek, 2003, 68(6), s. 385–389.

30. Sobotková, D., Šembera, Z. Psychologické aspekty v perinatální medicíně v letech 1980–2000: I. těhotenství. Čes Gynek, 2003, 68(4), s. 249–254.

31. Stein, A., Pearson, RM., Goodman, SH., et al. Effects of perinatal mental disorders on the fetus and child. Lancet, 2014, 384(9956), p. 1800–1819.

32. Stephens, S., Ford, E., Paudyal, P., Smith, H. Effectiveness of psychological interventions for postnatal depression in primary care: a meta-analysis. Ann Family Med, 2016, 14(5), p. 463–472. doi:10.1370/afm.1967.

33. Takács, L., Smolík, F., Mlíková Seidlerová, J., et al. Poporodní blues – česká adaptace dotazníku „Maternity Blues Questionnaire“. Čes Gynek, 2016, 81(5), s. 355–368.

34. Wisner, KL., Hanusa, BH., Perel, JM., et al. Postpartum depression: a randomized trial of sertraline versus nortriptyline. J Clin Psychopharmacol, 2006, 26(4), p. 353–360.

35. Yonkers, KA., Lin, H., Howell, HB., et al. Pharmacologic treatment of postpartum women with new-onset major depressive disorder: a randomized controlled trial with paroxetine. J Clin Psychiatry, 2008, 69(4), p. 659–665.

Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine
Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account