> Postpartum depression: risk factors

The causes of depression during and after childbirth are diverse and complex. But there are risk factors that can be identified and taken into account during pregnancy, which perhaps should be considered by the operators during the course of preparation, during the hospitalization of childbirth, or in the following controls in the puerperium.

One of the first factors is the interaction psicobiologica: the roots of the postpartum depressions are the product of an interaction between biological factors, psychological and environmental. Some women may be vulnerable to depression è, in rare cases it is believed that fall under the spectrum of disorders called mood (major depression, manic depressive), in fact, important to an accurate patient’s medical history, and family during pregnancy.

must Be assessed on certain styles of personalityà, which make it more vulnerable to depression in pregnancy or after childbirth. Typical features observed are: low self-esteem, hyper-control, impulsività, ipertimia and perfectionism.

must Be assessed on the traumatic events in childhood (relationships disturbed in the childhood, abuse, bereavement, abandonment,etc); the traumatic events in pregnancy both psychological (dismissal, illness and death of family, diseases, migrations, removals), physical of pregnancy (threat of abortion, disorders, placental, disease issues), childbirth (complicated delivery) and puerperium (newborn diseases, prematurità, congenital malformations).

The disease of the child can be problematic for various factors: concern for the health of the baby, the disappointment and the fear of imperfections, the hospitalization that forced the mom to a very complicated and tiring, so much so più impede the start of the long awaited (for most moms but not all) breast-feeding.

in Addition, many diseases of the child, making this a last, sleepless, irritable, and suffering, forcing the mother to cuddle the baby for many hours and not sleep at night. Often all of usò accentuates the solitude, the body becomes very suffering, and exacerbates the mental pain, they may lead to feeling of rejection of their condition, and lì it joins the circuit of the fault.

should Be also investigated aspects of family and social (including past pregnancies, events of loss, from bereavement, conflicts in the sphere of marriage, the abuse and ill-treatment, or the thought that the pregnancy can resolve conflicts of the couple); or the conditions of life (economic, employment, isolation, migration, and the lack of supports, etc).

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General recommendations

    the

  • to Take care of sé for (food, activitiesà physical, pleasures);
  • the

  • Invitation to rest and not to be too perfectionist;
  • the

  • to Avoid to isolate and stay at home;
  • the

  • don’t pretend to control everything and not have unrealistic expectations on the sé;
  • the

  • Invitation to be together with the partner and try to find moments of intimacyà.
  • the

  • to Get help from partners in the care of the child;
  • the

  • Not to delegate to their own mother and mother-in-law of the maternal role, using them as consultants;
  • the

  • to Get support in household chores;
  • the

  • Take the time necessary before returning to work.

Recommendations for women with depression

    the

  • will Not combat the feelings of depression;
  • the

  • Not to feel guilty;
  • the

  • Accept the feelings ‘destructive’ and ask for help;
  • the

  • it is absolutely Necessary to aid in the management of the house and in the early years of the child.

Recommendations for family members

    the

  • Avoid having a judgmental attitude and critical;
  • the

  • Avoid blame;
  • the

  • Respect your time;
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  • Incoraggiatela to speak of her feelings;
  • the

  • Sollecitatela to ask for help;
  • the

  • to Consult a specialist or a group self-help;
  • the

  • to Give concrete support in addition to emotional;
  • the

  • do Not underestimate the symptoms.

Self-assessment Test (test of Edimburg)

This test is composed of 10 very simple questions that can be useful to women. Bench" born to be administered in the post-natal period, its use has been extended to include the period of gestation.

this is a test of self-assessment to understand where you is, if the alarm bells have to be taken into consideration and you should seek specialists for a request for help. Do not be afraid, you have to choose between the different answers, the one that best corresponds to your mood of the last seven days:

1) I was able to laugh and see the funny side of things:

    the

  • (a) you, beautifully = 0
  • the

  • (b) Not really like usual= 1
  • the

  • (c) Definitely= 2
  • the

  • (d) For no=3

2) I have asked in a positive way to the events:

    the

  • (a) Because I’ve never done= 0
  • the

  • (b) A little less than usual= 1
  • the

  • (c) Moltodiversa from the usual= 2
  • the

  • (d) different =3
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3) I felt guilty for no reason when things were not going well:

    the

  • (a) most of the times=3
  • the

  • (b) Yes, sometimes= 2
  • the

  • (c) Not very often=1
  • the

  • (d) most of The times No, never= 0

4) I become anxious or worried without good reason:

    the

  • (a) No, not at all=0
  • the

  • (b) Almost never=1
  • the

  • (c) Yes, sometimes=2
  • the

  • d) Yes, very often=3

5) I have felt scared or panicky without a very good reason:

    the

  • (a) Yes, often=3
  • the

  • (b) Yes, sometimes=2
  • the

  • (c) No, not much=1
  • the

  • (d) No, never=0

6) I felt overwhelmed by the things that happened:

    the

  • (a), the più sometimes they are not able to deal with them=3
  • the

  • (b), may not hold as well as usual=2
  • the

  • (c) No, the più of the times, I have faced quite well=1
  • the

  • (d) No, I addressed good as always=0

7) I’m so unhappy that I have difficultyà to sleep:

    the

  • (a) Yes, most of the times=3
  • the

  • (b) Yes, sometimes=2
  • the

  • (c) Not very often=1
  • the

  • (d) Never=0.

8) I felt sad or depressed:

    the

  • (a) Yes, most of the times=3
  • the

  • (b) Yes, quite frequently=2
  • the

  • (c) Not very often=1
  • the

  • (d) Never=0

9) I’m so unhappy that I cried:

a) Yes, most of the times=3

b) Yes, fairly often=2

c) Only occasionally=2

d) No, never=0.

10) The thought hurt me, I è come in mind:

    the

  • (a) Yes, fairly often=3
  • the

  • (b) Some of the time=2
  • the

  • (c) Almost never=1
  • the

  • (d) Never=0

At this point, it’s about making the sum if &is greater than 12, we should do a chat with someone. Remember that the questionnaire is not has absolutely no diagnostic value but è an index; any diagnosis is possible only through an individual assessment, articulated and più complex is made by a clinician.

A case as example

gave birth to 39 years, comes from a family history very difficult (the parents of the children of the flowers  l’have been entrusted to the grandmother as soon as it is born)and didn’t work. A previous miscarriage has revealed a serious autoimmune disease that suffers from the father, who takes to the articolazionie and dà a dangerous trend because it’s bleeding. Thereò forced her to perform injections of heparin on the belly. The 25 week, you è added to a hepatic problem, and pressure that forces it to suspend l’heparin without that doctors do not take the responsibilityà clinical decision. The start of the panic attacks. It is hypothesized that a cardiac disorder genetic child, which may have been responsible for l’heparin. Is subsequently admitted to hospital with bronchiolitis. Of course the patient has a little bit of milk, the pediatrician recommends that you stop breastfeeding. One day it happens an episode disturbing: breast-feeding the bursts the bottles, and the baby is crying for 9 hours straight and it appears the obsessive thought that the child has ingested glass fragments. The pediatrician, reassure her: “You should worry only if there was blood in the stool”. After a month, it appears the blood in the stool, the child is hospitalized for intestinal bleeding.

The patient tells me “after ten days of peace, c’è was a discussion stupid with my partner, I thought that I loved più, I thought, if we are not able to go d’agreement, not even for a week, how are we going to go next with this child all of your life? I shut myself in the room as to let me go, suddenly taking the child in her arms I was afraid to hurt him with the scissors, I had a’image of the child naked possessed, I tried to hide all the knives in the house, then I left the baby to my husband and ran away to ask for the help of friends”.

As we have seen, another factor in the trigger about the ball married (conflicts, unwanted pregnancies, pregnancy as a hope to resolve conflicts in the copy), as in the case above cited.

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Finally, the social dimension as financial worries, work problems, social isolation, lack of media, the condition of single mother.

the Center Depression Post-Partum ASL ROMA 3 Via Colautti 30 – Contact person: Dr. ssa Elisabetta Spinelli Tel: 333 3517503 Mail: This email address is being protected from spambots. Is must enable JavaScript to see it.

IN ARGOMENTO:

    the

  • post-natal depression, symptoms, causes and treatment
  • the

  • Baby blues, cos’è
  • the

  • How to recognize postpartum depression
  • the

  • post-natal Depression: what to do, what care
  • the

  • postpartum depression symptoms
  • The puerperal psychosis: how to recognize the symptoms
  • the

  • post-natal Depression: therapy, psychiatric evaluation and hospitalization

February 27, 2017