• Screening diagnostic algorithm of anxiety and anxiodepressive disorders in women during pregnancy and postpartum period

Screening diagnostic algorithm of anxiety and anxiodepressive disorders in women during pregnancy and postpartum period

PERINATOLOGIYA I PEDIATRIYA. 2017.1(69):74-79; doi 10.15574/PP.2017.69.74

Screening diagnostic algorithm of anxiety and anxiodepressive disorders in women during pregnancy and postpartum period

Pushkar'ova T.M., Skrypchenko N. Ya.
SI «Institute of Pediatrics, Obstetrics and Gynecology of NAMS of Ukraine», Kyiv

Objective — to present developed by the authors and approved screening diagnostic algorithm of anxiety and anxiodepressive disorders in women during pregnancy and postpartum period.

Materials and methods. In total 247 pregnant women at the midpregnancy aged 17 to 45 years were enrolled in a screening psychodiagnostic test that was carried out at the SI «Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine». Among them 67 pregnant women from 22 to 38 years of age with the high rates of anxiety score according to the state-trait anxiety and/or depression inventory and other scales were examined by applying the in-depth clinical and clinically psychopathological studies (the index group). The control group included 31 pregnant women from 24 to 39 years of age with the low rates of anxiety score according to the mentioned above tests. The step-wise screening diagnostic algorithm of anxiety and anxiodepressive disorders in pregnant women during second trimester and postpartum (6–8 weeks and at the end of 1-year term) period was developed by the clinicians of Center of psychosomatics and psychotherapy of children and women, and first implemented in practice at the Obstetric Clinic of the SI «Institute of Paediatrics, Obstetrics and Gynaecology of the NAMS of Ukraine» and then approved.

Results. Data resulting from the screening psychodiagnostic study revealed the widespread phenomenon of anxiety and depression and its high rates according to anxiety and/or depression and other scales that prove the topicality of such a research focused on improvement of psychological counselling for pregnant women and mothers with babies.

Conclusions. The efficiency of the developed step-wise screening diagnostic algorithm on early determination of depressive disorders in women during pregnancy and postpartum period, which must be implemented in medical, obstetric and specialized (psychological and psychiatric) fundamental practices with the aim of improving the quality of mental health care of pregnant women and mothers with babies.

Key words: depression and anxiety disorders, pregnancy, postpartum period, postpartum depression, screening, informed consent, pathopsychological diagnostics.

References

1. Byuleten VOOZ. 2009. http://www.who.int/bulletin/volumes/ru.

2. Karagodina EG, Pushkareva TN. 2004. Ob osobennostyah funktsionirovaniya eticheskih printsipov v psihodiagnosticheskom protsesse. Arhiv psihiatrii. 10; 4: 17—21.

3. Pushkareva TN, Sheludchenko TA, Mirza AV. 2003.K voprosu diagnostiki poslerodovoy depressii. Arhiv psihiatrii. 7; 1: 42—46.

4. Pushkareva TN. 2004. Kliniko-psihopatologicheskie harakteristiki trevozhnyih i depressivnyih rasstroystv u beremennyih zhenschin s perinatalnyimi poteryami v anamneze. Arhiv psihiatrii. 10; 2: 94—98.

5. Pushkareva TN. 2003. Metodologicheskie osnovyi izucheniya trevozhnyih i depressivnyih rasstroystv u beremennyih i materey v poslerodovom periode. Arhiv psihiatrii. 8; 2: 55-59.

6. Pushkareva TN. 2005. Poslerodovaya depressiya: rasprostranennost, klinika, dinamika. Psykhichne zdorovia. 3(8): 31—36.

7. American Academy of Pediatrics. Intrapartum and postpartum care of the mother. In: Guidelines for Perinatal Care. 7th ed. Elk Grove Village, Ill.: American Academy of Pediatrics; Washington, D.C.: American College of Obstetricians and Gynecologists; 2012.

8. Cox JL, Holden JM, Sagovsky R. 1987. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry. 150: 782—786. https://doi.org/10.1192/bjp.150.6.782; PMid:3651732

9. Cox JL. 1996. Perinatal mental disorders — a cultural approach. International Review of Psychiatry. 8: 9—16. https://doi.org/10.3109/09540269609037813

10. Depression during and after pregnancy. https://www.womenshealth.gov/publications/our-publications/fact-sheet/depression-pregnancy.html. Accessed July 1, 2015.

11. Depressive disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed July 16, 2015.

12. Lee DT, Yip SK, Chiu HF et al. 1998. Detecting postnatal depression in Chinese women. Validation of the Chinese version of the Edinburgh Postnatal Depression Scale. British Journal of Psychiatry. 172: 433—437. https://doi.org/10.1192/bjp.172.5.433; PMid:9747407

13. Oates MR, Cox JL, Neema S et al. 2004, Jan. Postnatal depression across countries and cultures: a qualitative study. The British Journal of Psychiatry. 184(46): s10-s16; https://doi.org/10.1192/bjp.184.46.s10

Содержание журнала Full text of article