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Tesi etd-07022014-134709


Thesis type
Tesi di specializzazione (5 anni)
Author
CIAPONI, BENEDETTA
URN
etd-07022014-134709
Title
PERINATAL DEPRESSION: PREVALENCE, RISK FACTORS AND SCREENING TOOLS RESULTS FROM THE PERINATAL DEPRESSION - RESEARCH & SCREENING UNIT (PND-ReScU) STUDY
Struttura
MEDICINA CLINICA E SPERIMENTALE
Corso di studi
PSICHIATRIA
Commissione
relatore Prof. Mauri, Mauro
Parole chiave
  • prevalence
  • early screening
  • Perinatal depression
  • anxiety in pregnancy
  • risk factors
Data inizio appello
22/07/2014;
Consultabilità
completa
Riassunto analitico
ABSTRACT<br>Postpartum depression (PPD) is a mental disorder carrying substantial risk not only<br>for the health of mother and child, but the whole family. Depression may emerge<br>during pregnancy, carry over into the postpartum period or develop soon after<br>delivery and even many months later. Several studies have been conducted for<br>determining the etiology of PPD and identifying risk factors which may predict its<br>occurrence during pregnancy. Several risk factors measured during pregnancy show<br>a strong relation to PPD, including current and past history of depression and<br>anxiety disorder, negative stressful life events, marital discord and poor social<br>support. Most of this risk factors have been incorporated into scales and used for the<br>screening and selection of high-risk women during pregnancy for prevention trials.<br>In general, these instruments, used to identify a group of women with substantial<br>increased risk for PPD over the base rate, can be useful as basis for conversation<br>between woman and her healthcare provider. Despite its positive attribute, there is<br>no single set of criteria for assessing the benefit of routine perinatal depression<br>screening programs, and this lead to different approaches.<br>Women were enrolled in two different groups (N=555) and they were the same<br>likelihood of being part of group 1 (N=268) or group 2 (287). In the 1st group<br>women enter the study at the beginning of pregnancy and prospectively followed up<br>to 1 year after delivery; in the 2nd group women were recruited after the delivery<br>and prospectively followed up to 1 year after childbirth. The setting for the study<br>was based on an ongoing collaboration between the Department of Obstetrics and<br>Gynecology and the Department of Psychiatry, Neurobiology, Pharmacology and<br>Biotechnologies of the Azienda Ospedaliero-Universitaria Pisana (AOUP).<br>Women were repeatedly administered a set of instruments that included the<br>Edinburgh Postnatal Depression Scale (EPDS), the State-Trait Anxiety Inventory<br>(STAI) and the Postpartum Depression Predictors Inventory-Revised (PDPI-R). The<br>diagnostic assessment was conducted using the Structured Clinical Interview for<br>DSM-IV Axis I Disorders (SCID-I).<br>The aim of this study was to assess the effectiveness of an early screening in<br>reducing prevalence rate of postpartum distress. In particular We assessed anxiety<br>and depressive symptoms.<br>Overall We found that 48 women (18.8%) reported depressive symptoms<br>throughout the 1 year after childbirth and 25 (11.8%) women reported state anxiety<br>symptoms greater than 90┬░ percentile. In particular we found that carry out an early<br>screening during pregnancy significantly reduce the likelihood of having depressive<br>(12.0% vs 23.6%; OR=2.26; 95%CI: 1.13-4.52) or anxiety (5.0% vs 18.0%;<br>OR=4.18; 95%CI: 1.50-11.59) symptoms in the postpartum period.<br>Antenatal screening of risk factors for postpartum distress is effective in reduce<br>postpartum distress features.
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