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Abstract
THE CURRENT STATE OF THE PROBLEM OF PERINATAL PSYCHOSOMATIC DISORDERS IN PREGNANT WOMEN Scherbina N., Potapova L., Scherbina I., Lipko O., Mertsalova O.
Objective: to study the characteristics of the psychosomatic state of women during pregnancy using the Edinburgh Postpartum Depression Scale (EPDS). Materials and Methods: sixty pregnant women in the III trimester of pregnancy were tested using the EPDS questionnaire, a 10-point self-assessment scale that covers the general symptoms of depression. To determine the internal consistency and reliability of this scale, the Cronbach alpha indicator, a statistical indicator that allows evaluation of whether the features included in the questionnaire measure the same thing (high internal agreement), or different things (low internal agreement), was calculated. Results: Subjectively, all pregnant women noted simplicity, unambiguity and clear wording of the questions, which indicated good acceptability of this questionnaire for the use in the complex of standard monitoring of pregnant women in an antenatal clinic. The Cronbach alpha coefficient was 0.775, which corresponds to a sufficient degree of consistency of the internal elements of the scale. Screening for depressive disorders using EPDS during pregnancy revealed psychosomatic problems of the perinatal period. Data obtained using this scale demonstrate high rates of depressive manifestations in pregnant women. Psychopathological disorders were detected in 40% of women, while in 23% the symptoms of the current "major" depression were identified. The frequency of development of depressive symptoms increases significantly in the presence of a high obstetric risk, characteristic of the current pregnancy (threat of premature birth, hypertensive disorders during pregnancy, intrauterine infection of the fetus, retardation of the fetus development), as well as compromised obstetric and gynecological history. EPDS can be used as a reliable diagnostic tool to prevent pregnancy-related adverse outcomes. Conclusions: identifying the risk factors of pregnancy, screening and examining psychosomatic symptoms with EPDS, and timely referral for psychiatric care are key issues for reducing the risk among women with psychosomatic disorders during pregnancy and the postpartum period.
Keywords: pregnancy, psychosomatic disorders, Edinburgh postpartum depression scale.
Абстракт.
СУЧАСНИЙ СТАН ПРОБЛЕМИ ПЕРИНАТАЛЬНИХ ПСИХОСОМАТИЧНИХ РОЗЛАДІВ У ВАГІТНИХ.
Щербина М., Потапова Л., Щербина I., Ліпко О., Мерцалова О.
Мета дослідження: вивчити особливості психосоматичного стану жінок під час вагітності з використанням Единбурзької шкали післяпологової депресії (EPDS). Матеріали і методи: проведено тестування за опитувальником EPDS 60 вагітних жінок в III триместрі вагітності. EPDS є шкалою самооцінки, складається з 10 пунктів охоплює загальну симптоматику депресії. Для визначення внутрішньої узгодженості і надійності зазначеної шкали розраховувався показник альфа Кронбаха, статистичний показник, що дозволяє оцінити вимірюють чи ознаки, що входять в опитувальник одне і те ж (висока внутрішня згода, або різні речі (низький внутрішній згоду). Результати дослідження: суб'єктивно все вагітні відзначали простоту, однозначність і зрозумілу формулювання питань, що свідчило про хорошу прийнятності даного опитувальника для застосування в комплексі стандартного спостереження за вагітними в жіночій консультації. Значення коефіцієнта альфа Кронбаха склало 0,775, що відповідає достатньому ступені узгодженості внутрішніх елементів шкали. Проведений скринінг на наявність депресивних розладів за допомогою EPDS під час вагітності дозволив виявити психосоматичні проблеми перинатального періоду. Дані, отримані на основі застосування цієї шкали демонструють високі показники присутності депресивних проявів у вагітних жінок. Психопатологічні розлади виявлено у 40% жінок, при цьому у 23% визначені симптоми поточної «великої» депресії. Частота розвитку депресивних симптомів значно підвищується при наявності високого акушерського ризику, характерного для поточної вагітності (загроза передчасних пологів, гіпертензивні порушення під час вагітності, внутрішньоутробне інфікування плода, ретардація плода), а також обтяженого акушерського і гінекологічного анамнезів. EPDS може бути використана як надійний діагностичний інструмент для попередження несприятливих наслідків, пов'язаних з вагітністю. Висновок: виявлення факторів ризику вагітності, скринінг і вивчення психосоматичних симптомів у вагітних із використанням EPDS, а також своєчасне направлення для надання психіатричної допомоги, є ключовими питаннями зниження ризику серед жінок з психосоматичними розладами під час вагітності та в післяпологовому періоді.
Ключові слова: вагітність, психосоматичні розлади, Единбурзька шкала післяродової депресії.
Абстракт
СОВРЕМЕННОЕ СОСТОЯНИЕ ПРОБЛЕМЫ ПЕРИНАТАЛЬНЫХ ПСИХОСОМАТИЧЕСКИХ РАССТРОЙСТВ У БЕРЕМЕННЫХ.
Щербина Н., Потапова Л., Щербина И., Липко О., Мерцалова О.
Цель исследования: изучить особенности психосоматического состояния женщин во время беременности с использованием Эдинбургской шкалы послеродовой депрессии (EPDS).Материалы и методы: проведено тестирование по опроснику EPDS 60 беременных женщин в III триместре беременности. EPDS является шкалой самооценки, состоит из 10 пунктов и охватывает общую симптоматику депрессии. Для определения внутренней согласованности и надежности указанной шкалы рассчитывался показатель альфы Кронбаха, статистический показатель, позволяющий оценить измеряют ли признаки, входящие в опросник одно и то же (высокое внутреннее согласие, или разные вещи (низкое внутреннее согласие). Результаты исследования: Субьективно все беременные отмечали простоту, однозначность и понятную формулировку вопросов, что свидетельствовало о хорошей приемлемости данного опросника для применения в комплексе стандартного наблюдения за беременными в женской консультации. Значение коэффициента альфа Кронбаха составило 0,775, что соответствует достаточной степени согласованности внутренних элементов шкалы. Проведенный скрининг на наличие депрессивных расстройств с помощью EPDS во время беременности позволил выявить психосоматические проблемы перинатального периода. Данные, полученныена основе применения этой шкалы демонстрируют высокие показатели присутствия депрессивных проявлений у беременных женщин. Психопатологические расстройства выявлены у 40% женщин, при этом у 23% определены симптомы текущей «большой» депрессии. Частота развитии депрессивных симптомов значительно повышается при наличии высокого акушерского риска, характерного для текущей беременности (угроза преждевременных родов, гипертензивные нарушения во время беременности, внутриутробное инфицирование плода, ретардация плода), а также отягощенного акушерского и гинекологического анамнезов. EPDSможет быть использована как надежный диагностический инструмент для предотвращения неблагоприятных исходов, связанных с беременностью. Заключение: выявление факторов риска беременности и родов, скрининг и изучение психосоматических симптомов cиспользованием EPDS, а также своевременное направление для оказания психиатрической помощи, являются ключевыми вопросами снижения риска среди женщин с психосоматическими расстройствами во время беременности и в послеродовом периоде.
Ключевые слова: беременность, психосоматические расстройства, Эдинбургская шкала послеродовой депрессии.
References
Zhuk SI, Shurevska OD (2016) Psychosocial aspects of threatened preterm labour: Women Helth 6(122); 86–89.
Shidhaye R, Mendenhall E, Sumathipala K, Sumathipala A, Patel V. (2013) Association of somatoform disorders with anxiety and depression in women in low and middle income countries: a systematic review. Int Rev Psychiatry; 25:65–76.
NICE. Antenatal and postnatal mental health% Clinical management and service guidance (2007), London.
Gavin NI, Gaynes BN, Lohr KN, et al. (2005) Perinatal depression: a systematic review of prevalence and incidence. ObstetGynecol; 106:1071–1083.
Nylen KJ, Williamson JA, O'Hara MW, Watson D, Engeldinger J. (2013) Validityof somatic symptoms as indicators of depression in pregnancy. Arch Women Ment Health; 16: 203–10.
Ayers S. Delivery as a traumatic event: prevalence, risk factors, and treatment for postnatal posttraumatic stress disorder (2004), ClinObstetGynecol; 47:552–67.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (fifth edn). (2013) Arlington, VA: American Psychiatric Publishing
Henshaw C. Mood disturbance in the early puerperium: a review (2003)Arch Women Mental Health; 6(suppl 2): S33–42.
O'Hara M, Swain A. Rates and risk of postpartum depression-a meta-analysis. (1996)Int Rev Psychiatry; 8:37–54.
Perkin M, Bland J, Peacock J, et al. (1993) The effect of anxiety and depression during pregnancy on obstetric complications. J ObstetGynaecol 100: 629–634.
Ross LE, Dennis C-L. (2009) The prevalence of postpartum depression among women with substance use, an abuse history, or chronic illness: a systematic review. J Womens Health (Larchmt); 18:475–86.
Lancaster CA, Gold KJ, Flynn HA, Yoo H, Marcus SM, Davis MM. (2010) Risk factors for depressive symptoms during pregnancy: a systematic review. Am J ObstetGynecol;202:5–14.
Robertson E, Grace S, Wallington T, Stewart DE. (2004) Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry; 26:289–95.
Stein A, Fairburn CG(1996) Eating habits and attitudes in the postpartum period.Psychosom Med; 58:321–25.
Micali N, Simonoff E, Treasure J. (2011) Pregnancy and post-partum depression and anxiety in a longitudinal general population cohort: the effect of eating disorders and past depression. J Affect Disord; 131:150–57.
Kwan R, Bautista D, Choo R,Shirong C, Chee C, Seang Mei S, ChongY-S, Kwek K, Meaney M.J., Rush J., Chen H (2015) The Edinburgh Postnatal Depression Scale as a measure for antenatal dysphoria. JReproductive and Infant Psychology, 33:1, 28–41.
Leung SSL, Leung C, Lam TH, et al. (2011) Outcome of a postnatal depression screening programme using the Edinburgh Postnatal Depression Scale: a randomized controlled trial. J Public Health (Oxf); 33: 292–301.
Earls M, YogmanMichael W., MattsonG, Rafferty J and Committee on psychological aspects of child and family health (2019) Incorporating Recognition and Management of Perinatal Depression Into Pediatric Practice; J Pediatric January 143 (1); https://doi.org/10.1542/peds.2018–3259
Jayci E. Knights, Michelle L. Salvatore, Gunda Simpkins, Krystal Hunter, Meena Khandelwal (2016)In search of best practice for postpartum depression screening: is once enough?; EurJ ObstetGynaecol and Reprod Biol206: 99–104
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