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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
Supervisors
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
Postpartum depression (PPD) is a mental disorder carrying substantial risk not only
for the health of mother and child, but the whole family. Depression may emerge
during pregnancy, carry over into the postpartum period or develop soon after
delivery and even many months later. Several studies have been conducted for
determining the etiology of PPD and identifying risk factors which may predict its
occurrence during pregnancy. Several risk factors measured during pregnancy show
a strong relation to PPD, including current and past history of depression and
anxiety disorder, negative stressful life events, marital discord and poor social
support. Most of this risk factors have been incorporated into scales and used for the
screening and selection of high-risk women during pregnancy for prevention trials.
In general, these instruments, used to identify a group of women with substantial
increased risk for PPD over the base rate, can be useful as basis for conversation
between woman and her healthcare provider. Despite its positive attribute, there is
no single set of criteria for assessing the benefit of routine perinatal depression
screening programs, and this lead to different approaches.
Women were enrolled in two different groups (N=555) and they were the same
likelihood of being part of group 1 (N=268) or group 2 (287). In the 1st group
women enter the study at the beginning of pregnancy and prospectively followed up
to 1 year after delivery; in the 2nd group women were recruited after the delivery
and prospectively followed up to 1 year after childbirth. The setting for the study
was based on an ongoing collaboration between the Department of Obstetrics and
Gynecology and the Department of Psychiatry, Neurobiology, Pharmacology and
Biotechnologies of the Azienda Ospedaliero-Universitaria Pisana (AOUP).
Women were repeatedly administered a set of instruments that included the
Edinburgh Postnatal Depression Scale (EPDS), the State-Trait Anxiety Inventory
(STAI) and the Postpartum Depression Predictors Inventory-Revised (PDPI-R). The
diagnostic assessment was conducted using the Structured Clinical Interview for
DSM-IV Axis I Disorders (SCID-I).
The aim of this study was to assess the effectiveness of an early screening in
reducing prevalence rate of postpartum distress. In particular We assessed anxiety
and depressive symptoms.
Overall We found that 48 women (18.8%) reported depressive symptoms
throughout the 1 year after childbirth and 25 (11.8%) women reported state anxiety
symptoms greater than 90┬░ percentile. In particular we found that carry out an early
screening during pregnancy significantly reduce the likelihood of having depressive
(12.0% vs 23.6%; OR=2.26; 95%CI: 1.13-4.52) or anxiety (5.0% vs 18.0%;
OR=4.18; 95%CI: 1.50-11.59) symptoms in the postpartum period.
Antenatal screening of risk factors for postpartum distress is effective in reduce
postpartum distress features.
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