Tesi di dottorato di ricerca
Anxiety and Depressive simptomatology during pregnancy and in the Post-Partum period
Settore scientifico disciplinare
Corso di studi
NEUROBIOLOGIA E CLINICA DEI DISTURBI AFFETTIVI
Relatore Prof. Mauri, Mauro
- psychiatric symptomatology in women after delivery
- protective effect
- pharmacological treatment
Data inizio appello
Data di rilascio
ABSTRACT<br><br>Beckground: Although prevalence, risk factor for and consequences of postpartum<br>depression have been studied extensively, less is known about anxiety disorders and<br>the connections between depression and anxiety during this period. The link between<br>anxiety during pregnancy and perinatal depression (PND) requires special attention<br>due to the high prevalence of anxiety disorders in the general population and the high<br>rates of comorbidity between anxiety and depression. The aims of this present study<br>are: to evaluate whether antenatal anxiety disorders are a significant predictors of<br>postnatal depression and/or low birth-weight; to evaluate the predictive role of Panic-<br>Agoraphobic (PAS-SR) and Obsessive-Compulsive spectrum (OBS-SR)<br>symptomatology; to examine the psychometric properties of the EPDS and State<br>STAI anxiety scale in patients affected by anxiety disorders, mood disorders or<br>anxiety and mood disorders.<br><br>Methods: 1066 women between the 12th and the 15th week of gestation were<br>recruited at the Department of Obstetrics and Gynaecology of the Azienda<br>Ospedaliera Universitaria Pisana (Pisa, Italy) in the framework of the Program<br>‘Perinatal Depression - Research & Screening Unit (PND-ReScU)’; Axis-I disorders<br>were diagnosed with the Structured Clinical Interview for Axis-I Disorders (SCID-I);<br>depressive symptoms were investigated with the Edinburgh Post-natal Depression<br>Scale (EPDS); Anxiety symptoms were assessed by the State-Trait Anxiety Inventory<br>(STAI I-II). Women returned the Self-Report version of the Structured Clinical<br>Interview for Panic-Agoraphobic Spectrum at 6th month of pregnancy, while Self-<br>Report version of the Structured Clinical Interview for Obsessive-Compuilsive<br>Spectrum at 8th month of pregnancy.<br><br>Results: Women with antenatal anxiety disorders have a significantly increased risk<br>of experiencing PND. Women with current Panic Disorder have strongest risk both<br>for minor Depressive Disorder or Major Depressive Disorder and self-report anxiety<br>symptoms during early postpartum period compared to other anxiety disorders.<br><br>Conclusion: Interestingly, the measurement of maternal anxiety features through<br>spectrum instruments (i.e. PAS-SR and OBS-SR) seems to provide evidence of being<br>practical in predicting the onset or the recurrence of postnatal depressive disorders.<br>Factor analysis identified symptom profiles that may be clinically relevant for<br>understanding the nature of maternal anxiety and their effects on the developing<br>postpartum depression. Thus, the current findings indicate that anxiety should be a<br>focus of increased attention because it forecasts subsequent illness and may also have<br>a direct effect on the foetus. Examining psychological adjustment to pregnancy and<br>transition to parenthood our results highlight the importance of considering comorbid<br>disorders and suggest that it may be possible to identify a substantial<br>proportion of women who are at risk for developing anxiety and mood disturbances<br>during the postnatal period.
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