Rozprawy doktorskie na temat „Post-partum depression”
Kliknij ten link, aby zobaczyć inne rodzaje publikacji na ten temat: Post-partum depression.
Utwórz poprawne odniesienie w stylach APA, MLA, Chicago, Harvard i wielu innych
Sprawdź 41 najlepszych rozpraw doktorskich naukowych na temat „Post-partum depression”.
Przycisk „Dodaj do bibliografii” jest dostępny obok każdej pracy w bibliografii. Użyj go – a my automatycznie utworzymy odniesienie bibliograficzne do wybranej pracy w stylu cytowania, którego potrzebujesz: APA, MLA, Harvard, Chicago, Vancouver itp.
Możesz również pobrać pełny tekst publikacji naukowej w formacie „.pdf” i przeczytać adnotację do pracy online, jeśli odpowiednie parametry są dostępne w metadanych.
Przeglądaj rozprawy doktorskie z różnych dziedzin i twórz odpowiednie bibliografie.
1
Johansson, Jessica. "Effekt av SSRI läkemedel vid post partum depression". Thesis, Linnéuniversitetet, Institutionen för kemi och biomedicin (KOB), 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-31906.
Pełny tekst źródłaStreszczenie:
Post partum depression (PPD) drabbar mellan 10 – 15 % av nyförlösta mödrar. Att drabbas av en PPD kan orsaka känslomässiga och kognitiva besvär för hela familjen. Kvinnan löper också en större risk att drabbas av en depression senare i livet, vilket är en faktor som kan påverka mammans relation till barnet och sin omgivning. En tidig korrekt behandling är viktig för mammans framtida välbefinnande. Bland möjliga orsaker till post partum depression nämns hormonförändring, förändrad nivå av neurotransmittorer, nutritionella orsaker och sömnbrist. Behandlingen av PPD är inriktad mot psykoterapi, antidepressiv behandling och elektrokonvulsiv behandling (ECT). Syftet med denna litteraturstudie var att titta på effekten av det antidepressiva läkemedlet serotoninåterupptagshämmare (SSRI). Studierna som granskades i detta arbete hämtades från Pubmed. Fem studier valdes och samtliga var randomiserade kliniska prövningar. Tre av studierna visade ingen signifikant skillnad mellan SSRI och placebo/psykoterapi/tricykliskt antidepressiva (Nortriptylin). I två av studierna hittades en signifikant skillnad, med en bättre effekt för SSRI i jämförelse med placebo respektive samtal. I studie 2 erhölls en signifikant skillnad med avseende på remission efter 8 veckor (p=0.04) och i studie 3 var det en signifikant skillnad mellan andelen som nådde behandlingsmålet <13 på Edinburgh Postnatal Depression Scale (EPDS) efter 4 veckor. Vad gäller förbättringen av den kliniska sjukdomsbilden nådde fler lägre poäng på mätskalorna i de grupper där SSRI var inkluderat. Samtliga behandlingar som inkluderades i studierna nådde goda resultat. Sammanfattningsvis är SSRI ett bra alternativ för behandling av PPD, men i den inledande fasen kan det dock inte ses som bättre än psykoterapi eller behandling med nortriptylin. I den framtida forskningen skulle det vara intressant att se fler och framförallt större studier för att klargöra effekten av SSRI vid PPD.
2
Highet, Nicole. "Evaluation of community treatments for post partum depression". Thesis, Highet, Nicole (1998) Evaluation of community treatments for post partum depression. Professional Doctorate thesis, Murdoch University, 1998. https://researchrepository.murdoch.edu.au/id/eprint/52313/.
Pełny tekst źródłaStreszczenie:
Treatment efficacy was evaluated for 186 women seeking treatment for Post Partum Depression (PPD) in the community. Self report questionnaires were designed to assess clinical depression and anxiety (psychological and physiological). Risk factors for PPD, satisfaction with treatment and changes in support received from general sources, the baby’s father, and health providers were also considered with respect to treatment outcome.
Comparison of treated subjects with those on a waitlist demonstrated that treatment significantly reduced psychological depression and anxiety. Psychological intervention was as effective as pharmacological intervention in the treatment of psychological symptoms, and receiving both treatments in combination was of no clinical benefit in the immediate or longer term. Individual treatment was associated with more rapid treatment gains initially than group treatment; however, the benefits of groups emerged during the six months following treatment, leading both interventions to be equally effective in the longer term. Cognitive therapy was not superior to the combination of non-specific counselling and behavioural strategies, either immediately following treatment or six months later. Satisfaction with treatment services was positively related to immediate treatment outcome.
The results from the present study have important implications for clinical practice and research of PPD. The clinical efficacy of psychological treatment, and the associated clinical and financial benefits strongly advocate its role for the treatment of PPD. Since the findings parallel the literature for general depression, the integration of knowledge and research practices for general depression should be applied to extend understanding of PPD and refine clinical management practices.
3
Kane, Heather Lynne Kleinman Sherryl. "Emotion work, labeling, and gender in post-partum and post-adoptive depression". Chapel Hill, N.C. : University of North Carolina at Chapel Hill, 2006. http://dc.lib.unc.edu/u?/etd,615.
Pełny tekst źródłaStreszczenie:
Thesis (Ph. D.)--University of North Carolina at Chapel Hill, 2006.Title from electronic title page (viewed Oct. 10, 2007). "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Department of Sociology." Discipline: Sociology; Department/School: Sociology.
4
CAVALIERI, ANNA PAOLA. "Associazione tra positività agli anticorpi antiperossidasi in gravidanza e depressione post partum". Doctoral thesis, Università degli Studi di Roma "Tor Vergata", 2009. http://hdl.handle.net/2108/808.
Pełny tekst źródłaStreszczenie:
Sebbene il rapporto tra disturbi dell’umore e puerperio fosse noto fin dai tempi di Ippocrate, molti casi di depressione post parto (DPP) non sono adeguatamente diagnosticati. Per cui le ricerche hanno tentato di identificare un marker precoce di DPP, onde poter identificare per tempo le donne a rischio. Nel complesso intreccio dei fattori eziopatogenetici, sicuramente la tiroide occupa un posto importante, sebbene non prioritario. Nella nostra ricerca abbiamo indagato sul ruolo degli anticorpi antiperossidasi (anti TPO) in gravidanza, come fattore di rischio indipendente per lo sviluppo di sintomi depressivi in puerperio. Lo studio, di tipo osservazionale prospettico, è stato condotto su un campione di 162 donne sane in gravidanza. Sono state escluse le donne con anamnesi positiva per depressione e disturbi psichiatrici. Durante la visita eseguita nel I trimestre di gravidanza, oltre ad una accurata anamnesi, è stato eseguito un prelievo ematico per il dosaggio di fT4, TSH, anti TPO; nella stessa occasione le donne hanno compilato dei questionari per la valutazione di sintomi ansiosi (STAI) e depressivi (BECK DI). Le donne sono state poi rivalutate per sintomatologia depressiva a 7 giorni dopo il parto e nuovamente a 30 giorni dopo il parto, tramite il questionario di Edinburgo (EPDS). Mediante l’analisi di regressione multipla lineare abbiamo cercato di individuare i fattori di rischio indipendenti per DPP. L’analisi statistica dei risultati ha evidenziato come la presenza di anti TPO durante il I trimestre di gravidanza, sia un fattore di rischio indipendente per elevati sintomi depressivi a 7 e a 30 giorni dopo il parto. Le gestanti positive agli anti TPO sembrano presentare un rischio aumentato di DPP, indipendentemente dalla funzionalità tiroidea. La correlazione tra umore depresso e malattie autoimmunitarie non è stata ancora ben chiarita. La depressione nelle donne con anti TPO potrebbe essere legata allo stato generale associato con la condizione di autoimmunità o ad alterazioni tiroidee subcliniche. I risultati del nostro studio suggeriscono che la presenza di anti TPO in gravidanza possa essere considerata come un marker precoce e indipendente di rischio aumentato per DPP. In tal modo il ginecologo potrebbe avere a disposizione uno strumento per l’identificazione di donne a rischio aumentato, da valutare insieme ad altri noti fattori di rischio anamnestici.Yet even though the relationship between depressive mood and the puerperium has been documented since the time of Hippocrates, fewer than half of all the cases of postpartum depression are adequately diagnosed. Therefore the question arises as to whether markers exists for PPD; in other words, can we identify women at higher risk? The thyroid is surely not the primary cause of PPD, but evidences suggests that thyroid hormones cannot be ignored as important factors in the cascade of biological events leading to the onset of PPD. In this work we investigated whether the presence of thyroperoxidase antibodies (TPO Abs) during pregnancy could be a marker for an increased risk for postpartum depression. In this prospective observational work a sample of 162 healthful pregnant women was studied. We excluded women with a personal history of depression and psychiatric disorders. During the first trimester TSH, free thyroxine and TPO Abs testing was performed; in the same period the women also completed the State Trait Anxiety Inventory and the Beck Depression Inventory. In the post partum period, at 7/10 and 30 days after delivery, the women completed the Edinburgh Post Partum Depression Scale (EPDS). Multiple logistic regression was performed to determine independent risk factors for post partum depression. The statistical analysis showed that the presence of TPOAbs at the first trimester of pregnancy is significantly associated with depressive symptoms at 7 and 30 postpartum day. Women who are positive to TPOAbs in early gestation are prone to postpartum depression, independently of thyroid dysfunction. The relationship between autoimmune thyroid disease and depressive mood remains undecided. The depression may be related to the general malaise associated with an autoimmune condition (positive thyroid antibody status) or to subtle fluctuations in thyroid hormones. This study suggests that the presence of TPOAbs during gestation could be regarded as an indipendent marker for the occurrence of PPD. This finding may helps the gynaecologist to identify women at risk for PPD, in the context of other well known risk factors.
5
Gerde, Karen D. "Feline odor-induced anxiety in post-partum female rats". Pullman, Wash. : Washington State University, 2010. http://www.dissertations.wsu.edu/Thesis/Spring2010/k_gerde_061810.pdf.
Pełny tekst źródłaStreszczenie:
Thesis (M.S. in pharmacology and toxicology)--Washington State University, May 2010.Title from PDF title page (viewed on July 23, 2010). "Graduate Program in Pharmacology and Toxicology." Includes bibliographical references (p. 25-30).
6
Rick, Linda. "BVC-sköterskans reflektioner och erfarenheter av att stödja mammor med Post partum depression : Intervjustudie". Thesis, Högskolan i Gävle, Avdelningen för hälso- och vårdvetenskap, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-21261.
Pełny tekst źródłaStreszczenie:
Bakgrund: Post partum depression är den vanligaste psykiatriska störningen som kan uppstå efter en förlossning. Ungefär 13 % av alla nyblivna mammor drabbas eller visar tecken på en depression. Syftet: Syftet med studien var att beskriva BVC sköterskans reflektioner och erfarenheter av att stödja mammor med Post partum depression. Metod: Beskrivande design med kvalitativ ansats. Åtta BVC-sköterskor på fem hälsocentraler medverkade. Semistrukturerade intervjuer genomfördes och analyserades med kvalitativ innehållsanalys. Resultat: EPDS var en bra enkät för att hitta mammor med PPD och för att få ett bra samtal med mammorna. Svårigheter framkom då mamman inte kunde det svenska språket. Det var viktigt att se mamman, inte bara barnet och att ge tid för stöd och samtal. Mammorna följdes upp via telefon och täta besök på mottagningen vid behov. Det upplevdes svårt då mamman inte ville ta emot hjälp när BVC-sköterskan bedömde att hon behövde detta. BVC-sköterskorna beskrev att mammor som visat sig ha PPD hänvisades till en psykolog. BVC-sköterskan ansåg sig inte ha tillräckligt mycket kunskap för att ge behandlande samtal men kunde lyssna och ge stöd genom att finnas där för dem. Slutsats: EPDS-enkäten är ett bra verktyg för att tidigt fånga upp mammor med PPD, enkäten är också ett bra stöd i samtalet med mamman. Det är viktigt att fokusera på mamman och inte bara på barnet och att tillräckligt med tid för samtal avsätts för att ge stöd. Mer handledning och utbildning behövs inom ämnet PPD för att kunna ge bättre stöd till mammor men även papporna.Introduction: Postpartum depression is the most common psychiatric disorders that may occur following childbirth. Approximately 13% of all new mothers suffer or shows signs of depression. The purpose: The purpose of this study was to describe the child health care nurse´s reflections and experiences to support mothers with post partum depression. Method: Descriptive design with a qualitative approach. Eight child health care nurses at five health-centers participated. Semi-structured interviews were conducted and analyzed by qualitative content analysis. Results: EPDS was an adequate instrument in order to find mothers with PPD and to initiate positive conversations with mothers. Difficulties emerged when mothers didn’t speak Swedish. It was important to see the mother, not just the child and to give time for support and conversations. Mothers were followed-up by telephone made frequent visits to the clinic when necessary. It was difficult when mothers didn’t accept help even though the child health care nurse found it necessary. Mothers who had PPD symptoms were referred to a psychologist by the child health care nurse. The child health care nurse’s perceived deficient knowledge providing therapeutic conversations but could listen and provide support by being there for the mothers. Conclusion: EPDS is an adequate tool for early identification of mothers with PPD, the instrument is a good help when talking to the mother. It is important to focus on the mother and not just on the child and allow enough time for conversation aside providing support. More guidance and training is needed within the topic PPD for improved support to mothers, but also fathers.
7
Svensson, Linda, i Malin Vester. "BVC-sjuksköterskors erfarenheter av att ge stöd till mödrar med post partum depression". Thesis, Högskolan i Skövde, Institutionen för vård och natur, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-6842.
Pełny tekst źródłaStreszczenie:
Bakgrund: En moder som lider av post partum depression har svårare att knyta an till sitt barn. Barnets kognitiva och känslomässiga utveckling kan då hämmas. Det är viktigt att tidigt upptäcka dessa mödrar för att på så vis kunna erbjuda stöd och förkorta moderns sjukdomstid. Syfte: Syftet var att belysa BVC-sjuksköterskors erfarenheter av att ge stöd till mödrar med post partum depression. Metod: Datamaterialet analyserades med kvalitativ innehållsanalys med induktiv ansats. Data insamlades genom intervjuer med åtta BVC-sjuksköterskor med specialistexamen som distriktssköterska verksamma inom barnhälsovård. Resultat: Ur analysen av datamaterialet framträdde sex kategorier så som; följsam till moderns behov, erbjuda råd och vägledning, bygga upp moderns insikt om post partum depression, initiera samarbete runt modern, känsla av egen otillräcklighet, kommunikationsproblem med 14 underkategorier. Konklusion: För att kunna erbjuda modern ett optimalt stöd behöver en relation byggd på förtroende skapas mellan BVC-sjuksköterskan och modern. Kommunikation är ett viktigt verktyg för att skapa tillit vilket är en förutsättning för relationen.Background: A mother who is suffering from post partum depression has difficulties with the attachment to her child. As a result of this, the child’s cognitive and emotional development can be harmed. It is important to detect these mothers at an early stage, to offer support in order to shorten the time of suffering. Aim: The aim of this study was to illustrate child health care nurses’ experiences of giving support to mothers with postpartum depression. Method: The data were analyzed using qualitative content analysis technique with inductive approach. Eight interviews with child health care nurses’ who work with childrens’ health care were performed. Results: Six categories emerged from the analysis; Responsive to the needs of the mother, offer advice and guidance, build awareness of postpartum depression, initiate collaboration around the mother, sense of their own inadequacy, communication problem and 14 subcategories. Conclusion: In order to offer the mother optimal support needs a relationship between the child health care nurse and the mother be created, which is built on trust. Communication is an important tool to build trust, which is essential for the relationship.
8
Al-joumeyli, Jasmin Rim, i Vivi-Ann Landén. "Riskfaktorer för Post Partum Depression i samband med graviditet och förlossning – en litteraturstudie". Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-270533.
Pełny tekst źródłaStreszczenie:
Background: A systematic use of the Edinburgh Postnatal Depression Scale (EPDS), symptoms of postpartum depression (PPD) can be identified at an early stage, followed by timely required actions. Mental health and well-being can be perceived as sensitive objective. Joyce Travelbee and Johan Cullberg advocate nursing theoretical approaches to promote good communication and crisis management, which is the fundamental base of this master thesis. Purpose: To study risk factors for postpartum depression (PPD). Method: A descriptive literature review based on 16 quantitative studies with different study designs. Results: Risk factors for PPD may be previous or current mental and physical health issues, childbirth experiences, and socioeconomic factors. Conclusion: The results indicates association between PPD and, ill health, delivery and socioeconomics. With increased knowledge about risk factors and the value of early measures and preventive efforts, chances to prevent PPD may increase.
9
Hallberg, Emma, i Lisa Lundmark. "Moderskapets oväntade reaktioner". Thesis, Umeå universitet, Institutionen för omvårdnad, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-73551.
Pełny tekst źródłaStreszczenie:
Bakgrund: Förlossningsdepression (Post partum depression) är vanligt förekommande, cirka 13 procent av nyblivna mammor drabbas. Faktorer som påverkar uppkomsten är bland annat tidigare missfall, hormonella rubbningar, depression tidigare i livet eller att förlossningen varit komplicerad. Första symtomet som uppträder är ofta sömnstörningar och sedan följer oro, osäkerhet, hopplöshet, skam och gråt. Syfte: Litteraturstudiens syfte var att belysa kvinnors upplevelser att drabbas av post partum depression. Metod: Sökning av vetenskapliga artiklar gjordes i databaserna EBSCO (CINAHL och Academic search elite), PubMed och SveMed+. För analys av artiklar användes metasyntes och utifrån materialet skapades fem huvudkategorier och elva underkategorier. Resultat: Huvudkategorierna belyste kvinnors upplevelser av PPD, Behov av stöd från omgivning och anhörig, Personligt förhållningssätt, Känslomässiga reaktioner i samband med PPD, Krav från omgivning och Känsla av maktlöshet. Slutsats: Kvinnor som led av PPD upplevde rollen som mamma mycket påfrestande. De beskrev brist på stöd från omgivning och sjukvårdspersonal, samt att de inte blev tagna på allvar när hjälp söktes. Dålig information och kunskap om PPD bidrog till känsla av misslyckande och därför valde en del kvinnor att isolera sig.
10
Benech-Plaire, Gaëlle. "La dépression postnatale et l'étude MATQUID : revue de la littérature, présentation du PHRC A 1995, étude prospective d'une cohorte de 135 femmes sur 6 mois". Bordeaux 2, 1998. http://www.theses.fr/1998BOR23060.
Pełny tekst źródła
11
Gamble, Jennifer Anne, i n/a. "Improving Emotional Care For Childbearing Women: An Intervention Study". Griffith University. School of Nursing, 2003. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20030904.154204.
Pełny tekst źródłaStreszczenie:
Childbirth can be associated with short and long-term psychological morbidity including depression, anxiety and trauma symptoms. Some previous studies have used psychological interventions to reduce postpartum distress but have primarily focussed on attempting to relieve symptoms of depression with little recognition of trauma symptoms. Furthermore, the intervention used in these studies has generally been poorly documented. The first aim of the present study was to develop a counselling framework, suitable for use by midwives, to address psychological trauma following childbirth. Multiple methods were used to develop the intervention including focus groups with women and midwives. Both the women and midwives gave unequivocal support for postpartum debriefing. Themes that emerged from the focus groups with women included the need for opportunities to talk about their birth experience, an explanation of events, an exploration of alternative courses of action that may have resulted in a different birth experience, talking about their feelings such as loss, fear, anger and self-blame, discussing social support, and discussing possible future childbearing. There was a high level of agreement between the women's and midwives' views. These themes were synthesized with contemporary literature describing counselling interventions to assist in reconciling a distressing birth experience and a model for understanding women's distressing birth experiences to develop a counselling framework. The counselling intervention was then tested using a randomised controlled study involving 400 women recruited from antenatal clinics of three public hospitals. When interviewed within seventy-two hours of birth, 103 women reported a distressing birth experience and were then randomised into either the treatment or control group. Women in the intervention group had the opportunity to debrief at the initial postpartum interview (< 72 hours postpartum) and at four to six weeks postpartum. The prevalence of posttraumatic stress disorder was quite high; 9.6% of participants meeting the diagnostic criteria for acute PTSD at four to six weeks postpartum. Fewer participants (3.5%) met the diagnostic criteria for chronic PTSD at three months postpartum. As with previous research relating to childbearing women, few demographic factors or antenatal psychological factors were associated with the development of a PTSD symptom profile following childbirth. The development of PTSD symptom profile was strongly associated with obstetric intervention and a perception of poor care in labour. This finding is also consistent with previous research. Emotional distress was reduced for women in the intervention group in relation to the number of PTSD symptoms [t (101) = 2.144, p = .035], depression [c2 (1) = 9.188, p = .002], stress [c2 (1) = 4.478, p = .029] and feelings of self-blame [t (101) = -12.424, p <.001]. Confidence about a future pregnancy was higher for these women [t (101) = -9.096, p <.001]. Although there was not a statistically significant difference in the number of women with a PTSD symptom profile at three months postpartum, fewer women in the intervention group (n=3) than in the control group (n=9) met PTSD criteria. Likewise, there were fewer women in the intervention group (n=1) with anxiety levels above mild than in the control group (n=6). Importantly, this study found that offering women who have had a traumatic birth the opportunity for counselling using the framework documented in this dissertation was not harmful. This finding is in contrast to previous findings of other studies. The intervention was well received by participants. All the women in the intervention group found the counselling sessions helped them come to terms with their birth experience. Maternity service providers need to be cognizant of the prevalence of this debilitating condition and be able to identify women at risk for early intervention and referral to a mental health practitioner if appropriate. This research offers further support for the compelling need to implement changes to the provision of maternity services that reduce rates of obstetric intervention and humanise service delivery as a means of primary prevention of birth-related PTSD.
12
Peraudeau, Laure Guillemot-Mortagne Flore. "La dépression du post-partum l'Edinburgh Postnatal Depression Scale, un moyen efficace de dépistage précoce ? /". [S.l.] : [s.n.], 2008. http://castore.univ-nantes.fr/castore/GetOAIRef?idDoc=52051.
Pełny tekst źródła
13
BARBOLOSI, OBERLE CHRISTINE. "Pathologie depressive du post-partum : 3eme partie enquete exposes/non exposes concernant 4 facteurs de risque : resultats preliminaires". Saint-Etienne, 1991. http://www.theses.fr/1991STET6403.
Pełny tekst źródła
14
SANTORO, ELENA. "GLI EFFETTI DELL'EXPRESSIVE WRITING SUI SINTOMI DEPRESSIVI ETRAUMATICI DA STRESS POST-PARTUM". Doctoral thesis, Università Cattolica del Sacro Cuore, 2015. http://hdl.handle.net/10280/6213.
Pełny tekst źródłaStreszczenie:
Il presente studio intervento randomizzato è stato condotto su 140 donne assegnate - a seguito del parto - alla condizione di scrittura espressiva (EW) o alla condizione di scrittura neutra non-emotiva (NW). L’obiettivo era indagare gli effetti della scrittura espressiva sull’esperienza del parto sia sul funzionamento psicologico – sintomi depressivi e postraumatici da stress- (Studio 1a), sia sul funzionamento genitoriale - stress che la madre incontra nell’esercizio del suo ruolo e nell’interazione con il bambino – (Studio 2) al follow-up a tre mesi dal parto. Inoltre, sono state indagate le differenze individuali (moderatori) e i meccanismi psicologici- linguistici (mediatori) associati al cambiamento positivo a seguito della scrittura espressiva (Studio 1b). Gli studi hanno evidenziato che i sintomi depressivi e di intrusione connessi al trauma si riducevano nelle donne assegnate alla condizione EW nel confronto con la condizione NW e che a beneficiare dell’intervento erano le donne con sintomi acuti post-partum (Studio 1a). L’elaborazione cognitiva dell’esperienza stressante del parto attraverso le sessioni di scrittura è stata identificata come il meccanismo chiave, responsabile degli effetti benefici sulla sintomatologia depressiva postnatale (Studio 1b). Infine, il terzo studio ha identificato un effetto positivo della scrittura espressiva sulla qualità dell’interazione madre-bambino moderato da alcune caratteristiche individuali.One hundred forty women participated in the present randomized intervention study. Right after giving birth women were assigned to the Expressive Writing (EW) intervention group or to the non-emotional neutral writing (NW) condition. The aim was to investigate the effects in the childbirth experience of expressive writing both on psychological functioning - depression and post-partum traumatic stress symptoms - (Study 1a), and on parental functioning - the stress experienced by mothers in their parental role and in the interaction with the newborn - (Study 2) at a three-month follow-up after delivery. Individual differences were investigated as moderators and psycholinguistic mechanisms as mediators associated with positive changes following expressive writing (Study 1b). Results indicate that depression and intrusive symptoms related to the trauma decreased in EW women compared to NW women, and that acute post-partum symptom women benefited the most (Study 1a). Cognitive elaboration of the childbirth traumatic experience taking place during writing sessions is the key mechanism responsible for the beneficial effects on postnatal depression symptoms (Study 1b). Finally, the third study indicated a positive effect of expressive writing on the quality of mother-child interaction. The effect resulted moderated by some individual characteristics.
15
Dalbos-Bouillard, Barbara. "Facteurs de risque de la dépression du post-partum : matquid, 1995". Bordeaux 2, 2000. http://www.theses.fr/2000BOR23073.
Pełny tekst źródła
16
Kogima, Elisabeth Octaviano. "Depressão puerperal em adolescentes cadastradas na estratégia saúde da família do município de Embu Guaçu - SP". Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/6/6136/tde-24022011-103426/.
Pełny tekst źródłaStreszczenie:
A depressão maior tem sido considerada comum, recorrente e debilitante principalmente durante a adolescência. Quando nesta fase do ciclo da vida, a menina adolescente engravida e se torna mãe, a situação se configura um problema de Saúde Pública. Em si, a adolescência já é um processo de mudança tanto física, como psicológica, quanto mais se neste período uma gravidez for vivenciada. Ter um bebê é uma decisão bastante difícil e a complexidade dos fatores envolvidos torna de grande importância o apoio das famílias envolvidas. Desta forma, a maternidade pode se apresentar como fator relevante no desenvolvimento da depressão feminina muitas vezes relacionada ao estresse que o evento pode provocar. Objetivo: Determinar a prevalência do transtorno depressivo em puérperas adolescentes que são atendidas nas Unidades de Estratégia de Saúde da Família do Município de Embu Guaçu e caracterizar as puérperas adolescentes com grande probabilidade de desenvolverem transtorno depressivo. Método: Foram rastreadas as puérperas adolescentes com grande probabilidade de transtorno depressivo a fim de determinar a prevalência do transtorno depressivo pós-parto através da EPDS e do Questionário socioeconômico e obstétrico elaborado pela pesquisadora. Análise dos resultados: As variáveis quantitativas foram descritas por meio de medidas de tendências centrais, de variabilidades e intervalo de confiança. As qualitativas foram apresentadas por frequências e proporções. Resultados: 39 por cento (n=18) das adolescentes apresentaram sintomas de depressão pós-parto, com pontuação maior ou igual a doze, com IC95 por cento (25; 54). 15,21 por cento (7) das puérperas adolescentes obtiveram pontuação maior ou igual a 9 e menor que 12 o que representa moderada possibilidade de desenvolver um quadro depressivo. As adolescentes parecem ser mais novas do que os seus parceiros, têm filhos com cerca de 5 meses, moram juntos com parceiros, são brancas, com ensino médio incompleto. Pouco mais da metade tem renda de até oitocentos reais, a maioria usa algum tipo de medicamento e não utiliza drogas ou substâncias ilícitasMajor Depression has been considered common, recurrent and debilitating, especially in adolescence. When adolescent girls become pregnant at this stage of the life cycle, situation becomes a public health problem. Adolescence itself is already a changing process, physical and psychological, much more when a pregnancy is experienced. Its a very difficult decision having a baby, with complexes factors involved, what suggests the need of support from the families involved. Motherhood presents itself as a relevant factor in the development of female depression, often related to stress. Objective: To set the prevalence of depressive disorder in post partum adolescents who are enrolled at Family Health Strategy and characterize those who have great probability of developing depressive disorders. Methods: Post partum adolescents were screened through EPDS and characterized by a Socioeconomic and obstetric questionnaire constructed by the researcher. Analysis: Quantitative variables were described by measures of central tendency, and variability of the confidence interval. Qualitative variables were presented as frequencies and proportions. Results: 39 per cent (n = 18) of adolescents had postpartum depression symptoms, with scores greater than or equal to twelve, with CI95 per cent (25, 54). 15.21 per cent (7) of the adolescent mothers scored higher than or equal to 9 and less than 12, which represents moderate possibility of developing a depressive disorder. The teenagers seem to be younger than their partners, their babies have about five months, most of them live together with partners, are white, with incomplete secondary education. Slightly more than half have incomes of up to 400 dollars, most use some kind of medication and does not use drugs or illegal substances
17
Blomqvist, Erik. "The association between experiences of Intimate Partner Violence and Post Partum Depression : a study within the BASIC cohort". Thesis, Uppsala universitet, Medicinska fakulteten, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-207664.
Pełny tekst źródła
18
Bjuvéus, Maria, i Tanja Temonen. "BVC-sjuksköterskans erfarenheter av att stödja samspelet mellan mor och barn vid post partum depression : En kvalitativ intervjustudie". Thesis, Högskolan i Borås, Institutionen för Vårdvetenskap, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-19142.
Pełny tekst źródłaStreszczenie:
Föräldraskapet innebär en stor livsförändring och medför både positiva och negativa upplevelser. Det är viktigt att föräldrar och barn får ett fungerande samspel för att ha möjlighet att utveckla en god anknytning. Bristande samspel har konsekvenser för barnets utveckling men även för hela familjen. Nyblivna föräldrar befinner sig i en sårbar period i livet och var tionde kvinna drabbas av en depression efter förlossningen. Familjen behöver stöd från omgivningen och BVC-sjuksköterskan har en viktig del i detta stöd. Syftet med studien är att beskriva BVC-sjuksköterskans erfarenheter av att stödja samspelet mellan mor och barn vid post partum depression. Sex BVC-sjuksköterskor intervjuades och materialet tolkades genom kvalitativ innehållsanalys. BVC-sjuksköterskorna beskrev att det är viktigt att tidigt se ett samspel mellan mor och barn och att uppmärksamma föräldrarnas välbefinnande. För att BVC-sjuksköterskan ska ha möjlighet att stödja familjen är en god vårdrelation nödvändig. Relationen bör bygga på respekt och tillit och BVC-sjuksköterskans roll är att vara lyhörd och vägledande. Vid hög arbetsbelastning samt vid ovilja till stöd från familjen upplevde sköterskan en känsla av otillräcklighet och maktlöshet. BVC-sjuksköterskan spelar en stor roll i det viktiga nätverket kring familjen och agerar som spindeln i nätet när hennes egna resurser inte räcker till. BVC-sjuksköterskorna beskrev en förändring i samhället vilket påverkar föräldraskapet samt Barnhälsovården idag. Studiens fynd diskuteras utifrån tidigare forskning och författarnas erfarenheter.Program: Specialistsjuksköterskeutbildning med inriktning mot distriktssköterska
Uppsatsnivå: D
19
Gamble, Jennifer Anne. "Improving Emotional Care For Childbearing Women: An Intervention Study". Thesis, Griffith University, 2003. http://hdl.handle.net/10072/365390.
Pełny tekst źródłaStreszczenie:
Childbirth can be associated with short and long-term psychological morbidity including depression, anxiety and trauma symptoms. Some previous studies have used psychological interventions to reduce postpartum distress but have primarily focussed on attempting to relieve symptoms of depression with little recognition of trauma symptoms. Furthermore, the intervention used in these studies has generally been poorly documented. The first aim of the present study was to develop a counselling framework, suitable for use by midwives, to address psychological trauma following childbirth. Multiple methods were used to develop the intervention including focus groups with women and midwives. Both the women and midwives gave unequivocal support for postpartum debriefing. Themes that emerged from the focus groups with women included the need for opportunities to talk about their birth experience, an explanation of events, an exploration of alternative courses of action that may have resulted in a different birth experience, talking about their feelings such as loss, fear, anger and self-blame, discussing social support, and discussing possible future childbearing. There was a high level of agreement between the women's and midwives' views. These themes were synthesized with contemporary literature describing counselling interventions to assist in reconciling a distressing birth experience and a model for understanding women's distressing birth experiences to develop a counselling framework. The counselling intervention was then tested using a randomised controlled study involving 400 women recruited from antenatal clinics of three public hospitals. When interviewed within seventy-two hours of birth, 103 women reported a distressing birth experience and were then randomised into either the treatment or control group. Women in the intervention group had the opportunity to debrief at the initial postpartum interview (< 72 hours postpartum) and at four to six weeks postpartum. The prevalence of posttraumatic stress disorder was quite high; 9.6% of participants meeting the diagnostic criteria for acute PTSD at four to six weeks postpartum. Fewer participants (3.5%) met the diagnostic criteria for chronic PTSD at three months postpartum. As with previous research relating to childbearing women, few demographic factors or antenatal psychological factors were associated with the development of a PTSD symptom profile following childbirth. The development of PTSD symptom profile was strongly associated with obstetric intervention and a perception of poor care in labour. This finding is also consistent with previous research. Emotional distress was reduced for women in the intervention group in relation to the number of PTSD symptoms [t (101) = 2.144, p = .035], depression [c2 (1) = 9.188, p = .002], stress [c2 (1) = 4.478, p = .029] and feelings of self-blame [t (101) = -12.424, p <.001]. Confidence about a future pregnancy was higher for these women [t (101) = -9.096, p <.001]. Although there was not a statistically significant difference in the number of women with a PTSD symptom profile at three months postpartum, fewer women in the intervention group (n=3) than in the control group (n=9) met PTSD criteria. Likewise, there were fewer women in the intervention group (n=1) with anxiety levels above mild than in the control group (n=6). Importantly, this study found that offering women who have had a traumatic birth the opportunity for counselling using the framework documented in this dissertation was not harmful. This finding is in contrast to previous findings of other studies. The intervention was well received by participants. All the women in the intervention group found the counselling sessions helped them come to terms with their birth experience. Maternity service providers need to be cognizant of the prevalence of this debilitating condition and be able to identify women at risk for early intervention and referral to a mental health practitioner if appropriate. This research offers further support for the compelling need to implement changes to the provision of maternity services that reduce rates of obstetric intervention and humanise service delivery as a means of primary prevention of birth-related PTSD.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Nursing
Full Text
20
Barbosa, Maria Aparecida Rodrigues da Silva. "Vivências e significados da depressão pós-parto de mulheres no contexto da família". Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/7/7141/tde-16042015-160037/.
Pełny tekst źródłaStreszczenie:
Introdução: A depressão pós-parto tem sido tratada ao longo do tempo como um problema das mulheres e poucos estudos têm abordado as repercussões desse evento nas relações familiares. Objetivos: Compreender as vivências e significados da depressão pós-parto materna para a mulher e sua família; Desenvolver um modelo teórico representativo da experiência da mulher e da família diante da depressão pós-parto materna. Método: Estudo qualitativo teve como referencial teórico norteador o Interacionismo Simbólico e como referencial metodológico a Teoria Fundamentada nos Dados. Os participantes deste estudo foram mulheres que tiveram depressão pós-parto e seus familiares, recrutados através de Hospitais Públicos e Unidades Básicas de Saúde do município de Cuiabá-MT. Os dados foram coletados por meio de entrevistas em profundidade com a mulher e o familiar. O número de famílias participantes foi se configurando, de acordo com a análise e a teoria emergente, totalizando dez famílias. Resultados: A análise dos dados permitiu identificar o modelo teórico Oscilando entre o apoio e a necessidade de manter o controle que representa as percepções e estratégias presentes na experiência da mulher e da família visando à adaptação da vida familiar às circunstâncias da vida afetadas pela depressão. Três categorias estruturam a experiência estudada: Lutando com a maternidade, Perdendo-se no meio de sentimentos na luta com o desconhecido e Assumindo o controle. Conclusões: O estudo permitiu identificar um processo psicossocial, em que controle e apoio constituem os elementos simbólicos centrais de como a mulher com depressão pós-parto e a família manejam a experiência desde o início dos sintomas até a constatação do diagnóstico. O modelo teórico contribui para a compreensão dos significados construídos e as condições que afetam a mulher e a família, e orientam a organização e a comunicação familiar.Introduction: Post-partum depression has been treated over time as a womens problem and few studies have addressed the impact of this event on family relationships. Objectives: To understand the experiences and meanings of maternal post-partum depression for the woman and her family; To develop a theoretical model representative of the woman and her familys experience when facing post-partum depression. Method: It is a qualitative study that had as a guiding theoretical referential the Symbolic Interactionism and as a methodological referential the Grounded Theory. The participants of this study were women who had post-partum depression and their families, recruited through public hospitals and basic health units in the municipality of Cuiabá-MT. The data were collected through in-depth interviews with the woman and family. The number of families who participated was being configured according to the analysis and the emergent theory, totalizing ten families. Results: The data analysis allowed the theoretical model to be identified Oscillating between the support and the need to maintain control which represents the perceptions and strategies present in the experience of the woman and her family aiming at adapting family life to the circumstances of life affected by depression. Three categories structure the experience under study: Struggling with maternity, Losing herself in the middle of feelings in the struggle with the unknow and Taking control. Conclusions: The study allowed identifying a psychosocial process in which the control and support constitute the core symbolic elements of how the woman with post-partum depression and her family deal with the experience from the onset of the symptoms until the results of the diagnosis. The theoretical model contributed to the understanding of the constructed meanings and the conditions that affect the woman and her family, and guide the family organization and communication.
21
Weiss, Julie. "The Interaction of Post-Partum Depression and Maternal Knowledge of Infant Development on Change in Sensitive and Responsive Parenting during Early Infancy". ScholarWorks@UNO, 2013. http://scholarworks.uno.edu/td/1774.
Pełny tekst źródłaStreszczenie:
Sensitive and responsive parenting during early infancy is highly understudied, particularly in families with a low socioeconomic status. Longitudinal data from 41 mothers and their 4 to 16 week old infants found that accurate maternal knowledge of infant development positively affected parenting contemporaneously and over time while depression did not affect parenting in this sample. Implications for intervention and research are discussed.
22
Pranal, Marine. "Hémorragies du post-partum immédiat : Estimations visuelles des pertes sanguines par les sages-femmes et les étudiants sages-femmes et prévalence des troubles psychologiques en cas d'hémorragie du post-partum immédiat : Etude PSYCHE". Thesis, Université Clermont Auvergne (2017-2020), 2019. http://www.theses.fr/2019CLFAS008.
Pełny tekst źródłaStreszczenie:
Objectifs : Les objectifs de notre travail étaient d’une part d'évaluer la précision des estimations visuelles des pertes sanguines (EVPS) par les sages-femmes et les étudiants sage-femme (Volet 1) et d’autre part d’évaluer les conséquences psychologiques maternelles après une hémorragie du post-partum immédiat (HPP) (Volet 2). Volet 1 : Nous avons réalisé une étude transversale multicentrique (n=16 656). Les étudiants en maïeutique et les sages-femmes françaises devaient estimer via un questionnaire en ligne 8 photographies de volume de pertes sanguines différentes. Chaque photographie était dupliquée et distribuée aléatoirement dans le questionnaire avec une mesure étalon de 50 mL. Nous avons observé que le pourcentage global d’estimation exacte du volume des pertes proposé était faible dans les deux groupes de répondants (34,1%). Le seuil de l’HPP a toujours été diagnostiqué avec succès mais identifié dans moins de la moitié des cas pour l’HPP sévère. L’accord intra-observateur était plus fort (kappa pondéré ≥ 0,8) pour les valeurs les plus élevées (1 000 ml et 1 500 ml). Les sages-femmes avaient tendance à sous-estimer la quantité de perte de sang mais dans une moindre mesure que les étudiants. Indépendamment de la catégorie de répondant ou du diagnostic (HPP ou HPP sévère), la spécificité de l’EVPS en tant que test diagnostic était supérieure à sa sensibilité. Volet 2 : Notre second volet était une étude monocentrique transversale répétée descriptive et à visée étiologique sur une cohorte de femmes ayant accouché au CHU de Clermont-Ferrand [n= 1 298 ; 528 femmes avec une HPP = exposées (GE) et 770 femmes sans HPP = non exposées (GNE)]. La prévalence de la dépression chez les femmes après une HPP immédiat (< 24 heures) est évaluée à M2, M6 et M12 du post-partum via le questionnaire l’EPDS. L’anxiété est évaluée aux mêmes périodes avec les questionnaires STAI-YA et le GAD-7 et le trouble de stress post-traumatique (TSPT) via l’IES-R. Tous les questionnaires étaient auto-renseignés. La participation globale des femmes à M2 était de 63,7% (GE: 63% et GNE : 64,1%). Nous avons retrouvé des prévalences chez les exposées de 24,1% pour la DPP (vs. GNE : 18,3%), 20,4 % d’anxiété (vs. GNE : 13,4%) et 12,9% de TSPT (vs. GNE : 7,8%). Après ajustement, seul le risque d’avoir un TSPT à M2 restait significativement augmenté chez les femmes ayant eu une HPP (ORa=2,11 ; IC95% : 1,11-4,00). Les analyses à M6 et M12 seront réalisées lorsque le suivi de toutes les femmes sera terminé. Conclusion : Volet 1 : Les étudiants en maïeutique avaient tendance à sous-estimer la quantité de perte de sang plus souvent que les sages-femmes malgré l’aide d’une mesure étalon. L’HPP (≥ 500 ml) a toujours été identifiée mais la sévérité (≥ 1 000 ml) dans moins de la moitié des cas. La difficulté de l’EVPS doit être soulignée lors de la formation initiale des étudiants et lors de la formation continue des professionnels.Volet 2 : La DPP, l’anxiété et le TSPT sont fréquents dans le post-partum y compris parmi les femmes n’ayant pas eu d’HPP. La survenue d’un TSPT est à surveiller à M2 chez les femmes ayant une HPP. Il est important de repérer ces troubles chez toutes les femmes en post-partum afin de mettre en place un suivi adapté et individualisé et ainsi favoriser le lien mère-enfantObjectives: The objectives were to assess the accuracy of visual estimates of blood loss (EVPS) by midwives and midwifery students (Part 1) and secondly to assess the psychological consequences after postpartum haemorrhage (PPH) (Part 2). Part 1: We performed a multicenter cross-sectional study (n = 16,656). French practicing midwives and midwifery students were asked to estimate eight photographs of the volume of blood loss via online survey. Each photograph was duplicated and randomly ordered in the questionnaire with a reference 50 mL. We observed that the overall percentage of exact estimates of the volume of losses proposed was low in both groups of respondents (34.1%). PPH threshold was always successfully diagnosed but identified in less than half of the cases for severe PPH. Intra-observer agreement was better for the extreme values (100 mL and 1500 mL) with higher agreement (weighted kappa ≥ 0.8) for the highest values (1000 mL and 1500 mL). Midwives tended to underestimate the amount of blood loss but to a lesser extent than students. Regardless of respondent category or diagnosis (HPP or severe PPH), the specificity of the EVPS as a diagnostic test was greater than its sensitivity. Part 2: Our second component was a monocentric cross-sectional descriptive and etiologically oriented study on a cohort of women who gave birth at Clermont-Ferrand University Hospital [n = 1298; 528 women with HPP = exposed (GE) and 770 women without HPP = unexposed (GNE)]. The prevalence of depression in women after immediate PPH (<24 hours) was assessed at postpartum M2, M6 and M12 using the EPDS questionnaire. Anxiety was assessed at the same time with the STAI-YA and GAD-7 questionnaires and post-traumatic stress disorder (PTSD) via the IES-R. All questionnaires were self-reported. The overall participation of women at M2 was 63,7% (GE: 63% and GNE: 64,1%). We found prevalences in exposed patients of 24,1% for DPP (vs. GNE: 18,3%), 20,4% anxiety (vs. GNE: 13,4%) and 12,9% TSPT (vs. GNE: 7,8%). After adjustment, only the risk of having PTSD at M2 remained significantly increased in women who had PPH (ORa = 2,11, 95% CI: 1,14-4,00). Analyzes at M6 and M12 will be carried out when the follow-up is completed. Conclusion: Part 1: Students midwives tended to underestimate the amount of blood loss more often than midwives despite using a standard measure. HPP (≥ 500 ml) was always identified but severe PPH (≥ 1000 ml) was identified in less than half of the cases. The difficulty of the EVPS must be emphasized during the initial training of the students and during professional’s trainings. Part 2: DPP, anxiety, and PTSD are common in the postpartum period including women who have not had PPH. The occurrence of PTSD is to be monitored at M2 in women with PPH. It is important to identify these disorders in all postpartum women in order to implement adapted and individualized follow-up of these women and thus to promote the mother-child bond
23
FERRO, VALENTINO. "Disagio e depressione perinatali durante la crisi della maternità. Impatto sulla relazione madre-bambino". Doctoral thesis, Università degli Studi di Milano-Bicocca, 2017. http://hdl.handle.net/10281/143711.
Pełny tekst źródłaStreszczenie:
Introduzione. La transizione alla maternità è un momento nella vita della donna molto importante ed è una crisi evolutiva, che nella maggior parte dei casi ha un esito positivo. In alcuni casi la maternità può essere influenzata negativamente dall’insorgere nella donna di disagi psichici (Milgrom et al., 2001). Uno dei disagi della maternità è la depressione post-partum, che si manifesta con un’incidenza all’incirca del 13%, ha un eziologia multifattoriale e ha ricadute sulla salute e acquisizione del ruolo di madre, sull’instaurarsi della relazione madre/bambino, sulla regolazione emotiva diadica e sul rapporto con il partner (Karney & Bradbury, 1995; O’Hara & McCabe, 2013; Pearson et al., 2013). La depressione post-partum è spesso associata con sintomi depressivi durante la gravidanza e questa continuità predice conseguenze peggiori sulla salute psichica della madre (Grigoriadis et al., 2013).
Inoltre anche l’ansia si può presentare in comorbidità con i sintomi depressivi sia in gravidanza sia nel post-partum, l’incidenza è più alta in gravidanza, 18-25%, e decresce dopo il parto fino al 4,7% (Figueiredo & Conde, 2011 Sherry et al., 2014). L’ansia perinatale influenza negativamente gli scambi interattivi della diade madre bambino, queste madri sono più intrusive e i loro figli mostrano: pianto eccessivo, temperamento difficile e meno stati affettivi condivisi (Austin et al., 2008; Feldman, 2007; Reck et al., 2012). Un altro stato di disagio psichico è lo stress parentale che si può presentare nella transizione alla genitorialità (Abidin, 1990), ma non ci sono studi su questo stato in relazione con la depressione post-partum e/o l’ansia.
Obiettivi. Il presente lavoro è suddiviso in tre ricerche che hanno lo scopo di indagare l’incidenza della depressione post-partum, le variabili che predicono maggiormente la depressione post-partum, la relazione fra ansia patologica depressione post-partum e stress parentale e come queste variabili influenzino gli stili interattivi e la regolazione emotiva della diade.
Metodo. Le donne che hanno partecipato alle differenti ricerche sono state contattate presso l’ASL 2 di Savona fra la gravidanza e i primi mesi di post-partum. In tutte le ricerche la depressione è stata indagata con l’EPDS (Cox et al., 1987), l’ansia con lo STAI-Y (Spielberger, 1983), lo stress parentale con il PSI (Abidin, 1987), la percezione del rapporto di coppia con il DAS (Spanier, 1976), gli stili interattivi con il sistema di codifica video CARE-INDEX (Crittenden, 1994) e la regolazione emotiva diadica con il sistema di codifica video ICEP (Weinberg & Tronick, 1999; Riva Crugnola et al., 2013).
Risultati. Le tre ricerche mettono in luce diversi risultati, fra cui come l’ansia in gravidanza sia un fattore predittivo della depressione post-partum e come durante la transizione alla maternità l’aumentare dei fattori di rischio psicosociali sia associato a una maggiore depressione post-partum. Le ricerche sottolineano la stretta relazione fra depressione post-partum, stress parentale e ansia perinatale e come quest’ultima influenzi maggiormente gli stili di regolazione emotiva diadici meno adeguati. Infine la depressione post-partum influenza la percezione della donna della qualità del rapporto di coppia e predice stili interattivi disfunzionale della madre e del bambino.
Conclusioni. I seguenti studi mettono in evidenza la necessità di effettuare screening preventivi e mettere in atto interventi mirati a aiutare e a promuovere il benessere delle madri.Background. The transition to the motherhood is a important moment in woman life and it is also a developmental crisis, in most cases this transition has a positive outcome. Motherhood in some cases is negatively influenced by woman mental illness (Milgrom et al., 2001). Post-partum depression is one of these perinatal mental illness and its incidence is 13%, it has a multifactorial etiology and it influence the woman well-being, the mother-child relationship, the dyadic emotional regulation and the relationship with partner (Karney & Bradbury, 1995; O’Hara & McCabe, 2013; Pearson et al., 2013). Postpartum depression often is associated with depressive symptoms during pregnancy and this predict worse consequences on the mother's psychological well-being (Grigoriadis et al., 2013). The perinatal anxiety often occurs in comorbidity with depressive symptoms both in pregnancy and in the postpartum, the incidence of anxiety is higher in pregnant between 18% and 25% than in the post-partum period 4.7% (Figueiredo & Conde, 2011 Sherry et al., 2014). The perinatal anxiety has negative influence on mother-infant relationship, these mothers are more intrusive and their children have excessive crying, difficult temperament and less shared positive states (Austin et al., 2008; Feldman, 2007; Reck et al., 2012). Another perinatal mental distress is parenting stress that may occur in the transition to parenthood (Abidin, 1990), but there are few studies on the relationship of parenting stress, post-partum depression and anxiety. Aims. This paper is divided in three studies investigating different themes, like: the incidence of postpartum depression, the variables who predict postpartum depression, the relationship between anxiety postpartum depression and parenting stress and how these variables influence the relationship styles and emotional regulation of the mother-child dyad. Methods. The women who participated in the research were contacted in ASL2 of Savona between pregnancy and first months of post-partum. In all three studies post-partum depression has been investigated with EPDS (Cox et al., 1987), anxiety with STAI-Y (Spielberger, 1983), parenting stress wih PSI (Abidin, 1987), dyadic adjustment with partner with DAS (Spanier, 1976), the relationship styles with the video coding system CARE INDEX (Crittenden, 1994) and the emotional regulation of the mother-child with the video coding system ICEP (Weinberg & Tronick, 1999; Riva Crugnola et al., 2013). Results. The three studies underline different results, like: anxiety during pregnancy is predictor of post-partum depression; mothers who have a lot of psychosocial risk factors have more probability to develop depressive symptoms in pregnancy and in the post-partum period; the effect of this risk factors is pejorative in depression symptomatology in the transition to the motherhood; maternal depression, anxiety and parenting stress are associated, anxiety is a grater predictor than depression of less adequate styles of mother-infant emotion regulation; post-partum depression affects the dyadic adjustment with partner and dysfunctional relationship styles of mother-child dyad. Conclusions. The results of these studies highlight the importance of doing early screening and well-timed and preventive intervention programs to help the mother wellbeing.
24
Folino, Cristiane da Silva Geraldo. "Sobre dores e amores: caminhos da tristeza materna na elaboração psíquica da parentalidade". Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/47/47131/tde-02102014-161452/.
Pełny tekst źródłaStreszczenie:
A gestação e os primeiros tempos da vida de um bebê são fundamentais para o estabelecimento do vínculo com seus pais; além de garantir sua sobrevivência, fornecem matéria-prima para as tramas de seu psiquismo, formando um solo no qual se desenvolverão suas relações ao longo da vida. Concomitante a essa construção, transcorre um processo análogo com os pais, que se vão construindo gradativamente nessa condição ao se relacionar com o filho. No entanto, esses primeiros tempos podem ter um forte impacto em quem gera e cuida do bebê. Assim, a finalidade deste estudo é iluminar as vivências psíquicas da mulher no pós- -parto e verificar que recursos desenvolve para lidar com o trabalho psíquico necessário para enfrentar os lutos e construir e exercitar a parentalidade. Por meio de uma pesquisa qualitativa balizada teoricamente pela psicanálise, estudaram-se cinco duplas mãe-bebê. Houve ao menos quatro encontros como cada dupla: pelo menos um na gestação e três após o parto (uma semana, um mês e dois meses). Os encontros gestacionais se deram num lugar escolhido pela participante e os no puerpério, em sua casa. Com o instrumental da psicanálise, fizeram-se entrevistas semidirigidas e observação da relação que a mãe estabelecia com o bebê e com a pesquisadora. Analisou-se cada caso em separado e se verificaram possíveis confluências entre eles. Tendo em conta a especificidade do funcionamento psíquico materno e o impacto das exigências de um filho para quem deve ajudá-lo a viver, a pesquisa revelou a importância de considerar a amplitude dos fenômenos de gestar e cuidar. Esse papel, que toda mãe deve exercer, foi vivido, ao menos num primeiro momento, como brutal e desorganizador não só pela mulher, mas por toda a família. As dificuldades de se metabolizarem essas vivências e as perdas inerentes ao processo por exemplo, o bebê ideal, a maternidade idealizada, o narcisismo, o ritmo anterior e a rotina, entre outras podem prejudicar a construção e o exercício da parentalidade e mesmo obstar a superação do baby blues, eventualmente desencadeando fenômenos depressivos (manifestos ou encobertos). Os ganhos reais decorrentes da chegada do bebê podem ser vividos a partir desse contato com as perdas e de sua elaboração. Concluiu-se também que se devem construir mecanismos de prevenção e cuidados para a família nesses primeiros tempos de vida do bebê, com a colaboração entre as várias disciplinas envolvidas e com políticas de saúde pública. Entre as questões levantadas a esse propósito, alerta-se para o risco de se negligenciarem ou, no outro extremo, patologizarem as dores inerentes à delicada construção da parentalidadeGestation and the first times in a babys life are fundamental to the establishment of bonds with the parents; apart from guaranteeing their survival, it provides the basis for the webs of their psychism, forming the ground on which their relationships will develop throughout their life. Concomitant to this construction, the parents go through an analogue process, gradually building themselves in this condition as they relate to the child. However, these first times may have a strong impact on who generates and cares for the baby. Thus, the aim of this study is to enlighten the womans post-partum psychic experiences and to verify the resources developed to cope with the psychic work necessary to face the grieves and to build and exercise parenthood. Through a qualitative research theoretically bound by psychoanalysis, five mother-baby pairs were studied. There were a minimum of four encounters with each pair: at least one on gestation e three post-partum (one-week, one-month and two-month old). The gestational meetings took place at a location chose by the participant and the puerperium encounters, at her home. With psychoanalysis instrumental, semi-guided interviews and observation of the relationship established by the mother with the baby and with the researcher took place. Each case was separately analyzed and possible confluences between them were verified. Taking into account the specificity of the psychic maternal functioning and the impact of the demands of a child on who must help them live, the research revealed the importance of considering the amplitude of the carrying and caring phenomena. This role, that all mothers must play, was experienced, at least at first, as brutal and disorganizing not only by the woman, but by the whole family. The difficulties of metabolizing these experiences and the losses inherent to the process for instance, the ideal baby, idealized motherhood, narcissism, the previous rhythm and the routine, among others may damage the construction and the exercise of parenthood and even thwart the overcoming of the baby blues, eventually unfolding depressive phenomena (manifest or covered). The real gains resulting from the babys arrival may be lived from this contact with the losses and its elaboration. It was also concluded that prevention and care mechanisms for the family must be built in these first times of the baby\'s life, with collaboration between the various disciplines involved and with public health policies. Amongst the issues raised to this purpose, an alert is made to the risk of neglecting or, on the other end, pathologizing the pains inherent to the delicate construction of parenthood
25
Gruss, Stephanie Mayes. "Is Safe Haven Legislation an Efficacious Policy Response to Infant Abandonment: A Biopsychosocial Profile of the Target Population". VCU Scholars Compass, 2006. http://scholarscompass.vcu.edu/etd/1362.
Pełny tekst źródłaStreszczenie:
This study represents an attempt to describe the extent and features of safe haven legislation in the United States, discuss implementation issues, and to examine if the legislation is reaching its intended target audience in order to answer the question, "Is safe haven legislation an efficacious response to infant abandonment?" Safe havens are designated locations where infants can be anonymously abandoned without fear of prosecution or incarceration. As of May of 2006, forty-seven states have passed such legislation, citing the need for an alternative to unsafe infant abandonment leading to an infant's death, and an alternative to infanticide (the killing of an infant within one year of its birth). Since the initial passage of this legislation in Texas in 1999, there have been more unsafe infant abandonments than accounts of safe haven abandonments. As this legislation provides for anonymous infant abandonment researchers cannot study the population of women actually utilizing safe havens. Therefore, the study of women seeking connection with safe havens in comparison to the population of women who have engaged in infant abandonment resulting in an infant's death is considered one of the sole viable sources of insight into this problem. The scope of the research is exploratory in nature and analyses are considered preliminary due to the lack of data that exists in this area and the relative newness of the legislation.A quantitative analysis of women likely to utilize safe havens reveals that they have a mean age of 19, are unmarried, have entered into prenatal care late, have disclosed their pregnancy to someone, and are currently dating the birthfather. The findings from this analysis were compared to those from a national linked birth and infant death dataset to ascertain if women seeking safe havens have similar biopsychosocial characteristics as those engaging in unsafe abandonment leading to an infant's death. Similar biopsychosocial characteristics were found including mother's age, marital status, late entry into prenatal care, disclosure of pregnancy, and dating status. A regression analysis was used to construct a biopsychosocial profile of women likely to abandon an infant. Findings suggest that legislators and those involved with safe havens have some knowledge of their target population, but are not effectively reaching this audience, nor promoting the existence of safe havens. They also appear to be utilizing research findings on infanticide inappropriately, in order to profile their target audience. This effectively limits the promulgation of education and early identification services that could prevent both safe haven and unsafe infant abandonments. This study concludes with policy reform recommendations.
26
Loyal, Déborah. "Déterminants Psychosociaux et Culturels du Burnout Maternel et des Symptômes Dépressifs Périnataux". Thesis, Bordeaux, 2017. http://www.theses.fr/2017BORD0821/document.
Pełny tekst źródłaStreszczenie:
Alors qu’une maternité heureuse est une aspiration collective, il est établi que de nombreuses femmes souffrent de détresse psychologique dans la période périnatale. Or, la santé psychologique des femmes ne peut être considérée indépendamment de leurs rôles au sein de la société et des normes qui y sont attachées. Ce travail de recherche vise à tester un modèle psychosocial et culturel de compréhension des troubles de l'adaptation à la maternité, (symptômes dépressifs postpartum et burnout). Dans une première étude, différentes étapes auprès de plusieurs populations (N = 250, 22, 474, 249 et 231) ont mené à la validation en langue française d’une échelle de mesure des croyances associées au rôle maternel. Dans un second temps, un suivi longitudinal a été mis en place auprès de femmes rencontrées en fin de grossesse puis à 2 et 4 mois postpartum (N = 129). Ces travaux ont permis d’établir la validité convergente, prédictive et de construit du concept de burnout maternel. Par ailleurs, le poids des caractéristiques psychosociales et normatives du rôle maternel dans le développement de symptômes dépressifs et de burnout a été exploré. Pour finir, des analyses en cluster ont permis de dégager des profils d’articulation, plus ou moins adaptatifs, entre investissement dans la maternité et dans la vie professionnelle. Ces travaux ouvrent des perspectives de recherche concernant le concept de burnout maternel dans la période postpartum et la prise en compte des aspects socio-normatifs du rôle maternel dans la prévention et la prise en charge de ces troublesWhereas a happy motherhood is a collective aspiration, it is known that many women are reporting psychological distress during the perinatal period. Yet, women’s psychological health can not be considered regardless of their roles in society and norms associated. This research work aims to test a psychosocial and cultural model to understand adjustment disorder regarding motherhood (postpartum depressive symptoms and burnout). In a first study, various steps with different populations (N = 250, 22, 474, 249 and 231) have led to the validation in French of a scale assessing beliefs associated with the maternal role. Then, a longitudinal follow up was settled with women who were seen during late pregnancy and at 2 and 4 months postpartum (N = 129). This work has served to demonstrate the convergent, predictive and construct validity of maternal burnout. Furthermore, the impact of motherhood psychosocial and normative characteristics in the development of depressive and burnout symptoms have been explored. Finally, cluster analyses were conducted to identify more or less adaptive patterns regarding articulation of investment in motherhood and working life. This research work has opened research avenues regarding maternal burnout in the postpartum period and considerations of socio-normative aspects of the mothering role regarding prevention and care of those troubles
27
Thevenoux, Gaillard Isabelle. "Etude des interactions entre le tempérament du nourrisson et la dépression maternelle : enquête auprès de 78 dyades mère-enfant". Bordeaux 2, 2001. http://www.theses.fr/2001BOR23012.
Pełny tekst źródła
28
Buil, Aude. "Amélioration du soin peau-à-peau en médecine néonatale par l'installation en Flexion Diagonale Soutenue (FDS) : impact sur le grand prématuré, sa mère et la construction de leur espace de communication Kangaroo supported diagonal flexion positioning: new insights into skin-to-skin contact for communication between mothers and very preterm infants Kangaroo supported diagonal flexion positioning: positive impact on maternal stress and postpartum depression risk and on skin-to-skin practice with very preterm infants Impact de l’installation en flexion diagonale soutenue sur le maternage tactile spontané lors de la première séance de peau-à-peau en réanimation néonatale Changer l’installation du soin peau à peau en néonatalogie pour une communication précoce de qualité Une installation innovante lors du peau à peau en néonatologie". Thesis, Sorbonne Paris Cité, 2018. http://www.theses.fr/2018USPCB095.
Pełny tekst źródłaStreszczenie:
Contexte : le soin peau-à-peau est actuellement une pratique de soin courant au sein des services de médecine néonatale. Il constitue une opportunité relationnelle unique qui peut être proposée très rapidement après la naissance prématurée et qui a déjà montré de nombreux bénéfices pour le nouveau-né prématuré et ses parents. Ce soin comme tout autre soin reste améliorable et ajustable au contexte de haute technologie des pays industrialisés afin notamment de créer une niche sensorimotrice et relationnelle optimale. Objectif : l'objectif de la recherche action réalisée dans le cadre de ce doctorat vise précisément à tester l'apport d'un changement d'installation lors du peau-à-peau en réanimation néonatale. L'hypothèse défendue est que l'installation novatrice en Flexion Diagonale Soutenue (FDS) serait une voie d'amélioration non seulement en termes d'opportunité interactionnelle individualisée parent-bébé, mais également en termes de soutien à la construction de la parentalité mise à mal par la naissance prématurée et en termes de prévention posturale et motrice du nouveau-né prématuré. Méthode : nous avons mené une recherche interventionnelle monocentrique prospective cas-contrôle. Quarante-deux grands prématurés nés entre 27 et 32 semaines et leurs mères ont été inclus de mai 2015 à juillet 2016, répartis dans deux groupes : le groupe 1 avec l'installation en peau-à-peau couramment pratiquée in situ, soit verticalement avec un coussin d'allaitement (groupe 'Verticale') puis le groupe 2 avec l'installation en Flexion Diagonale Soutenue (groupe 'FDS'), observé consécutivement et apparié sur le groupe 1, en fonction du terme et du poids des enfants inclus. L'étude a porté sur le nouveau-né grand prématuré, sa mère et leur communication multimodale (modalités vocale, visuelle, tactile et sourire) sur cinq temps : à la naissance, au 1er peau-à-peau, 15 jours plus tard, à l'âge du terme corrigé, et à trois mois d'âge corrigé, soit sur une durée de six à sept mois par dyade. Résultats : dès le tout premier peau-à-peau, les mères installées en 'FDS', manifestent un maternage tactile spontané plus actif et varié, davantage affectif, et proposent d'emblée une enveloppe sonore plus dense et plus musicale. Les mères du groupe 'FDS' montrent un risque de dépression postpartum significativement plus bas après 15 jours de pratique peau-à-peau et à l'âge du terme corrigé, allongent naturellement le temps de séances et développent enfin une plus grande variabilité dans leur portage à bras. Installés en peau-à-peau durant l'hospitalisation, non seulement chacun des 2 partenaires manifestent plus de comportements multimodaux mais les comportements du nouveau-né grand prématuré apparaissent contingents (à 1 sec) à ceux de la mère en plus grande proportion. Au terme corrigé, les différences se résorbent en partie, mais on observe un meilleur investissement de l'état éveillé calme avec un engagement visuel des enfants davantage centré sur le visage de leur mère. Par ailleurs, à cet âge, les nouveau-nés grands prématurés du groupe 'FDS' présentent moins de déformations posturales et une meilleure organisation de la motricité spontanée. Conclusion : cette recherche de doctorat met en évidence que la pratique du soin peau-à-peau peut être améliorée avec l'installation en 'FDS', en soutenant physiquement le nouveau-né prématuré et psychiquement sa mère, et enfin en enrichissant la communication multimodale mère-enfant et en leur offrant l'opportunité précoce d'être plus sensibles l'un à l'autre comme socle de rencontreContext: nowadays, skin-to-skin care is common practice in neonatal medicine services. It provides a unique relational opportunity that can be offered shortly after premature birth and it has already shown many benefits for the premature new-born and his/her parents. Like other care practices, skin-to-skin care can still be improved and adjusted to the high-technology environment of industrialized countries, in order to create an optimal sensorimotor and relational niche. Objective: the objective of the research-action of this doctoral thesis was precisely to test the benefit of a change of positioning during skin-to-skin care in NICU. Our hypothesis was that the innovative positioning in Supported Diagonal Flexion ('SDF') would allow improvements in the opportunity for individualized parent-new-born interactions, but also provide support to the construction of parenthood, plagued by premature birth, and improve postural and motor prevention in the premature new-born. Methods: we conducted a prospective monocentric interventional control-case study. Forty-two very premature infants, born between 27 and 32 weeks of gestation, and their mothers were included from may 2015 to july 2016. They were allocated to two groups: group 1 with skin-to-skin installation as it is commonly carried out in situ, which is 'Vertical' with a nursing pillow ('Vertical' group) and group 2 with Sustained Diagonal Flexion ('FDS' group), observed consecutively and matched with group 1 according to the term and weight of the children included. The study looked at the very premature infant, his/her mother et their multimodal communication (vocal, visual, tactile and smile) at five stages: at birth, during the first skin-to-skin, 15 days later, at term corrected age and at three months corrected age, thus on a six to seven months' time-span for each dyad. Results: from the very first skin-to-skin, mothers installed in 'FDS' displayed more affective, active and varied spontaneous tactile mothering, and immediately offer a more dense and musical sound cocoon. Mother in the 'FDS' group had a significantly lower risk of post-partum depression after 15 days of skin-to-skin practice and at term corrected age, they naturally lengthened the duration of skin-to-skin sessions and developed more variability when carrying their infant in their arms. When installed in 'FDS' during hospitalization, the two partners dispayed more multimodal behaviours and the infant's behaviours were contingent (1 s) to the mother's in greater proportion. At term corrected age, these differences partly reversed, but we observed a better investment of the calm awake state, with the child's visual engagement more focused on his/her mother's face. At term corrected age, premature infants in the 'FDS' group showed less postural deformations and a better organization in spontaneous motricity. Conclusion: this doctoral thesis demonstrates that skin-to-skin practice can be improved through the 'SDF' positionning, by physically supporting the new-born, psychologically supporting his/her mother, and finally allowing richer multi-modal mother-child communication by offering the early opportunity to be more sensitive to one another as a basis for the relationship
29
BRANCATO, VALERIA. "Neuropsicoendocrinologia dell'allattamento: depressione post-partum ed allattamento". Doctoral thesis, Università degli Studi di Roma "Tor Vergata", 2008. http://hdl.handle.net/2108/629.
Pełny tekst źródłaStreszczenie:
Lo scopo dello studio è stato quello di esaminare la relazione tra allattamento materno e depressione post-partum.
In particolare si è voluto indagare sulla presenza di sintomi depressivi nel post-partum a 7 giorni, 1 mese, 3 mesi, 6 mesi e 12 mesi dopo il parto ed una eventuale relazione tra questi e l’allattamento materno.
Materiali e Metodi. Lo studio è stato condotto su un campione di n. 240 pazienti in gravidanza inviate alla Casa di Cura Città di Roma per la partecipazione ai Corsi di Accompagnamento alla Nascita nel periodo di tempo compreso tra Gennaio 2006 e Marzo 2008. Criteri di inclusione: pazienti in gravidanza con un’età gestazionale compresa tra la 22a e la 34a settimana al primo incontro; età materna compresa tra 20 e 40 anni. Criteri di esclusione: patologia della gravidanza: ipertensione cronica in gravidanza, PIH, diabete gestazionale, minaccia di parto prematuro, patologie o malformazioni fetali diagnosticate in utero.
Il primo incontro è stato effettuato in epoca gestazionale compresa tra la 22a e 34a settimana, durante i corsi di accompagnamento alla nascita. La valutazione della sintomatologia depressiva è stata effettuata in gravidanza tra la 22a e la 34a settimana di gestazione, tramite la somministrazione del questionario di Beck e dopo il parto a 7 giorni, 1 mese, 3 mesi, 6 mesi e 12 mesi, mediante la somministrazione della scala di Edinburgh (EPDS). La valutazione dell’allattamento è stata effettuata contestualmente alla somministrazione della scala di Edinburgh a 7 giorni, 1 mese, 3 mesi, 6 mesi e 12 mesi.
Risultati
E’ stata effettuata una selezione delle pazienti in due gruppi: 1° gruppo: gruppo di controllo: n. 74 pazienti risultate negative prima del parto al test di Beck e dopo il parto al questionario di Edinburgh. 2° gruppo: gruppo di pazienti positive al questionario di Edinburgh: n. 88 pazienti risultate positive al questionario di Edinburgh 7 giorni dopo il parto, e mantenutesi tali 1 mese, 3 mesi, 6 mesi ed 1 anno dopo il parto. La percentuale di allattamento varia tra il gruppo 1 (gruppo controllo) e le pazienti del gruppo 2 (positivo allo screening con il questionario di Edinburgh). Tra le donne del gruppo 1 la percentuale di allattamento materno risulta maggiore rispetto alle pazienti che praticano l’allattamento materno nel gruppo 2, lungo tutto il periodo di osservazione del campione: a 7 giorni, 1 mese, tre mesi, 6 mesi, 1 anno. Tale dato risulta particolarmente evidente a 7 giorni, 1 mese, 3 mesi e 6 mesi, mentre ad un anno le percentuali di allattamento materno tendono a sovrapporsi nei due gruppi, così come le percentuali relative alle altre modalità di allattamento, complementare e artificiale.
Conclusioni
I dati ottenuti da questo studio pongono l’accento sulla minore percentuale di donne che, positive al test di Edinburgh nel post-partum, riesce sin dall’immediato post-partum stesso ad allattare. Si tratta di una differenza percentuale che si evidenzia nel corso dei diversi mesi di follow-up delle pazienti, rimanendo ben chiara sino a 6 mesi dal parto. Da valutare attentamente sono i risultati ad 1 anno dal parto, quando le percentuali tra i due gruppi si sovrappongono, probabilmente in considerazione della scarsa numerosità del campione ad 1 anno. Si ritiene, inoltre, che tutte le donne esposte al rischio di depressione post-partum dovrebbero essere incoraggiate ad allattare al seno, e dovrebbero avere il sostegno sociale necessario affinché comincino e mantengano un buon rapporto di allattamento.The aim of this study was to evaluate the relationship between breastfeeding and post-partum depression. Particularly I want to evaluate the presence of depressive symptoms in the post-partum period at 7 days, 1 month, 3 months, 6 months and 12 months after delivery and the presence of a relationship between those ones and breastfeeding. Materials and Methods The study was realized on a pool of n. 240 patients in pregnancy attending to the Casa di Cura Città di Roma for Prenatal Course in the period between January 2006 and March 2008. Inclusion Criteria: patients in pregnancy between 22 and 34 weeks at the first meeting; maternal age between 20 and 40 years. Exclusion Criteria: pathology of pregnancy, PIH, cronic hypertension, gestational diabetes, preterm labor, fetal patholgy or malformations diagnosed in utero. The first meeting was realized between 22 and 34 weeks of gestation, during the Prenatal Courses. The evaluation of depressive symptoms was realized between 22 and 34 weeks GA, by the administration of the Beck test (BDI) and, after delivery, at 7 days, 1 month, 3 months, 6 months and 1 year, by the administration of the Edinburgh Depression Post-natal Scale (EPDS). Evaluation of breastfeeding was realized at 7 days, 1 month, 3 months, 6 months and 12 months after delivery using the OMS Classification of Infant Feeding. Results The patients were partitioned in two groups: 1° group: group of control: n. 74 patients negative ante partum to the Beck test, and after delivery to the EPDS. 2° group: group of patients positive to the EPDS: n. 88 patients positive to the EPDS at 7 days after delivery, 1 month, 3 months, 6 months and 1 year. The breastfeeding percentage varies between group 1 and group 2. Between the woman of group 1 the pecentage of breastfeeding is major than in group 2, along all the observation period. This result is more evident at 7 days, 1 month, e and 6 months after delivery, while at 1 year the percentage of breastfeeding are the same in the two groups, such as the other feeding modalities. Conclusions The data obtained in this study show that the women positive to the EPDS in the post-partum period have less likelihood to breastfeed their own babies, yet immediately in post-partum. This difference is evident up to 6 months after delivery. The results at 1 year have got to be evaluated carfully because of the poorly numerousness of the campion at 1 year of follow-up. Of major importance is that ,all women at risk of post-partum depression, should be promoted to breastafeed their babies, and should recieve the social supporte to begin and continue the breastfeeding opportunity.
30
Almeida, Eduardo Farina de. "Efeito antidepressivo e ansiolítico do extrato metanólico de Hibiscus tiliaceus em modelo animal de depressão pós-parto". reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2012. http://hdl.handle.net/10183/67656.
Pełny tekst źródłaStreszczenie:
Hibiscus tiliaceus L. (Malvaceae) é usado popularmente em desordens do pós-parto. O extrato metanólico de flores de H. tiliaceus apresentou atividade antidepressiva-like nos testes de nado forçado e de suspensão da cauda, ambos são amplamente usados como modelos animais preditivos da atividade antidepressiva. Além disso, o extrato demonstrou uma tendência de aumento do tempo gasto nos braços abertos no labirinto em cruz elevado. Considerando que o extrato de H. tiliaceus, que contém fitoesteróis como o estigmasterol, o stigmastadienol e o stigmastadienone, pode ser útil no tratamento ou prevenção da depressão pós-parto relacionadas à retirada crônica de altos níveis de hormônios associados à gestação. Nosso objetivo foi avaliar o efeito de extratos de H. tiliaceus em modelo animal de depressão pós-parto e ansiedade. Utilizamos ratas Wistar fêmeas submetidas ao modelo de depressão pós-parto induzido por hormônios (estradiol e progesterona), administrados por via subcutânea. Após período gestacional induzido, os animais receberam água, veiculo ou extrato de H. tiliaceus nas doses de 100 e 400mg/kg, via oral (gavagem). No período pós-parto, as ratas foram submetidas a testes comportamentais de nado forçado, o labirinto em cruz elevado e de preferência claro-escuro como modelos preditivo de depressão e ansiedade. Foi obsevado um aumento no tempo de imobilidade associado a uma diminuição na tentativa de fuga, no teste do nado forçado, em animais submetidos ao modelo de depressão pós-parto comparado ao grupo controle, sugerindo que este modelo é capaz reproduzir sintomas de depressão pós-parto. Não houve diferença significativa nos testes de ansiedade entre os animais submetidos ao modelo de depressão pós-parto comparado aos controles. A administração de extrato metanólico de H. tiliaceus não foi capaz de alterar o comportamento relacionado à depressão e ansiedade em ratas Wistar.Postpartum affective disorders are rarely modeled. The depressive-like behavior of hormone withdrawal following hormone-simulated "pregnancy" was described in Long-Evans and Sprague Dawley rats. Our aim was to evaluate the validity of hormone withdrawal following hormonesimulated "pregnancy" method in Wistar rats as a model of depression and/or anxiety. Recently, it was demonstrated an antidepressant-like profile of methanol extract of Hibiscus tiliaceus L., a plant used in postpartum disorders, in adult male Swiss albino mice, then, we also investigated the antidepressant and anxiolytic-like activities of the methanol extract of H. tiliaceus flowers using this animal model of postpartum disorder. Ovariectomized rats received daily injections of the vehicle or hormones (estradiol and progesterone) to simulate the 23-day gestational period in the rat. Days 24-27 were considered the ''post-partum'' period, where the methanolic extract of H. tiliaceus or vehicle were administered by gavage. Rats were submitted to forced swimming, elevated plus-maze test and lightdark box tests. Rats submitted to ''post-partum depression model'' increased the immobility time in forced swimming. The methanolic extract of H. tiliaceus administration did not alter the immobility time in the forced swim test. In the light-dark box test, rats submitted to post-partum depression model showed decreases in number of rearing in dark compartment. In conclusion, our data indicate that Wistar rats may be an adequate model postpartum affective disorders, showing ''depressive-like'' symptoms in the forced swim test without any anxiogenic effect. Besides, we could suggest that decrease on number of rearing in the dark compartment may indicate the motivational state.
31
Dugravier, Romain. "CAPEDP : une étude longitudinale périnatale évaluant une intervention à domicile de prévention de la dépression postnatale et des troubles de la relation mère-enfant auprès d'une population de femmes présentant des critères de risque psychosociaux". Thesis, Paris 6, 2014. http://www.theses.fr/2014PA066227/document.
Pełny tekst źródłaStreszczenie:
La dépression postnatale (DPN) est un facteur de risque de trouble des interactions précoces mère-enfant et de troubles de santé mentale de l’enfant. Si les programmes de visites à domicile (VAD) en périnatalité ciblent souvent la prévention de la DPN, les résultats sont peu probants.CAPEDP est la première étude contrôlée randomisée de VAD destinée à des familles multirisques d’une telle ampleur menée en France. Ce travail en décrit les résultats sur la DPN. 440 femmes sont recrutées et randomisées en deux groupes : primipares, âgées de moins de 26 ans, et au moins un facteur de risque parmi : un faible niveau d’éducation, des revenus faibles et/ou être isolées. Le groupe intervention bénéficie de VAD menées par des psychologues du troisième trimestre de grossesse aux deux ans de l’enfant. La symptomatologie de la DPN est évaluée à l’inclusion et 3 mois après la naissance avec l’Edinburgh Postnatal Depression Scale (EPDS). A 3 mois post-partum, les scores moyens à l’EPDS sont respectivement de 9.4 (5.4) pour le groupe contrôle et de 8.6 (5.4) pour le groupe intervention (p = 0.18). Pour certains sous-groupes de femmes ayant bénéficié de l’intervention les scores EPDS sont plus faibles que le groupe contrôle : celles avec peu de symptômes dépressifs en prénatal (EPDS<8), celles qui pensent être avec le père pour élever leur enfant, et celles avec un niveau d’éducation supérieur au BEPC. CAPEDP n’a pas démontré d’efficacité pour prévenir la DPN. Les analyses post hoc montrent que l’intervention peut être efficace pour des femmes sans certains facteurs de risque. Il serait utile de développer des recherches plus intégrées dans le dispositif de droit communPostnatal maternal depression (PND) is a significant risk factor for infant mental health. Although often targeted in perinatal home-visiting programs with vulnerable families, little impact on PND has been observed. CAPEDP is the first French randomized controlled trial for multi-risk families evaluating the impact on PND symptomatology of a home-visiting intervention using psychologists in a sample of women presenting risk factors.440 women were recruited at their seventh month of pregnancy. All were first-time mothers, under 26, with at least one of three additional psychosocial risk factors: low educational level, low income, or planning to raise the child without the father. Participants were randomized into either the intervention or the control group. The intervention consisted of intensive multifocal home visits through to the child’s second birthday. The control group received care as usual. PND symptomatology was assessed at baseline and three months after birth using the Edinburgh Postnatal Depression Scale (EPDS).At three months postpartum, mean EPDS scores were 9.4 (5.4) for the control group and 8.6 (5.4) for the intervention group (p = 0.18). The intervention group had significantly lower EPDS scores than controls in certain subgroups of women: with few depressive symptoms at inclusion (EPDS<8), who were planning to raise the child with the child’s father, with a higher educational level.CAPEDP failed to demonstrate an overall impact on PND. However, post-hoc analysis reveals the intervention was effective in subgroups of women without certain risk factors. Effective overall reduction of PND symptomatology may require more tailored interventions
32
Michel, Estelle. "Les antidépresseurs chez la femme enceinte et allaitante". Bordeaux 2, 1998. http://www.theses.fr/1998BOR2P007.
Pełny tekst źródła
33
Goutaudier, Nelly. "Prématurité : vécu maternel, état de stress posttraumatique et dépression du postpartum". Thesis, Toulouse 2, 2013. http://www.theses.fr/2013TOU20122.
Pełny tekst źródłaStreszczenie:
ETUDE 1- Le traumatisme de l’accouchement prématuré et de la césarienne, un sentiment de culpabilité, une anxiété et une ambivalence envers l’enfant et l’équipe médicale ont été rapportés. Des difficultés dans l’investissement du lien mère-enfant et dans l’accès au rôle de mère ainsi que l’importance du partage d’expérience avec des femmes ayant accouché avant-terme ont également été identifiés. Enfin, des signes de dépression postnatale et de stress posttraumatique ont été relevés. ETUDE 2- 53% des participantes ont rapporté un score à l’IES-R indiquant un probable ESPT. La présence de symptômes de dépression postnatale (ß = 0,40, p< 0,05), de difficultés pendant la grossesse (ß= 0,20, p< 0,05), la perception maternelle de l’enfant comme étant vulnérable (ß = 0,17, p< 0,05), l’insatisfaction de la grossesse (ß = -0,13; p< 0,05) et des cognitions maternelles mal-adaptées (ß = -0,12, p< 0,05) étaient indépendamment associés à l’intensité des symptômes d’ESPT. ETUDE 3- 3 profils de femmes ont été identifiés: les parturientes au profil « dépressif », « faible niveau de symptômes » et les mères du groupe « dépressif anxieux traumatisé ». Nos résultats démontrent également une forte comorbidité entre troubles anxieux et dépression postnatale ainsi que l’influence négative des symptômes de dépression postnatale sur le lien mère-enfant. ETUDE 4- 64,3% des femmes de l’échantillon ont rapporté un score à l’EPDS indiquant une possible dépression postnatale. Le placement de l’enfant sous assistance respiratoire (ß = 0,23, p< 0,05), le type de prématurité (ß= 0,16, p< 0,05), et la baisse de la qualité de la relation conjugale (ß = -0,39, p< 0,05) étaient indépendamment associés à l’intensité des symptômes de dépression postnataleSTUDY 1- Trauma of premature birth and c-section, feelings of guilt, anxiety, ambivalence towards the infant, the medical staff and the infant’s hospital discharge, were all part of their perception. Furthermore, difficulties for mothers to define themselves as such and the importance of sharing with women who have been through the same experience were evidenced. Postpartum depression and PTSD symptoms were also highlighted. STUDY 2- 53% of participants scored above the cut-off for probable PTSD. Increased postpartum depressive symptoms (ß = 0.40, p< .05), difficulties during pregnancy (ß= 0.20, p< .05), maternal perception of infant vulnerability (ß = 0.17, p< .05), decreased satisfaction with delivery (ß = -0.13; p< .05) and cognitions relating to role change (ß = -0.12, p< .05) were independently associated with PTSD symptoms. STUDY 3- 3 profiles were highlighted: “depressive”, “low level of symptoms” and “anxious-depressive-traumatized” mothers. Our findings also evidenced a high comorbidity between anxious and depressive symptoms as well as a negative impact of postpartum depression on mother-infant bond. STUDY 4- 64.3% of our sample reported a score on the EPDS highlighting a probable postpartum depression. Having an infant who experienced ventilator support (ß = 0.23, p< 0,05), type of prematurity (ß= 0.16, p< 0,05), and decreased quality of marital relationship (ß = -0.39, p< 0,05) were independently associated with the intensity of postpartum depressive symptoms
34
Murday, Nasah. "La transmission de l'obésité selon les aspects psychiques et émotionnels". Thesis, Sorbonne Paris Cité, 2019. http://www.theses.fr/2019USPCC055.
Pełny tekst źródłaStreszczenie:
Partant de la genèse de l’obésité et des études réalisées sur sa transmission multifactorielle, par voie directe et indirecte, nous examinons les concepts théoriques de base afin de dégager une réflexion sur les aspects psychiques et émotionnels impliqués dans ce processus. Le monde pulsionnel du sujet obèse demeure régi par le processus primaire en raison de sa fragilité narcissique et de ses fonctions pare-excitantes peu efficaces. Le débordement pulsionnel associé à un défaut dans la constitution de l’engramme de la faim et de la satiété, et d’autres facteurs (l’isolement, la situation socio-économique, …) motivent les conduites de suralimentation compulsionnelles à visée anti-vide, antidépressive et anti-traumatique. A l’appui de l’observation directe des interactions alimentaires entre six mères obèses/cinq mères non-obèses et leur bébé, nous dégageons les éléments potentiellement obésigéniques et traumatogènes dans la relation. Le contrôle maternel, le manque d’exploration par le bébé, la pauvreté des échanges affectifs et la difficulté maternelle à s’accorder à son bébé, témoignent de ses stratégies défensives, nuisibles au lien intersubjectifBeginning with the genesis of obesity and studies carried out on its multiple factors of transmission, directly and indirectly, we examine the basic theoretical concepts in order to point out the psychic and emotional features involved in this process. The driving world of the obese remains governed by the primary process because of his narcissistic fragility and his inefficient protective shield. The overflowing impulses associated with a defect in the engram constitution of hunger and satiety, plus other factors (isolation, socio-economic situation, ...) motivate compulsive behaviors with anti-emptiness, anti-depressive and anti-traumatic, aspects. In support of the direct observation of food interactions between six obese mothers/five non-obese mothers and their babies, we identify potentially obesigenic and traumatic features within the relationship. Maternal control, the lack of child’s exploration, poor emotional exchanges and the maternal difficulty to tune up with her baby, testify to her defensive strategies at play, harmful to the intersubjectivity bond
35
CRISAFI, Cettina. "Fattori di rischio psicosociale ed evolutivo per la depressione post partum". Doctoral thesis, Università degli Studi di Palermo, 2014. http://hdl.handle.net/10447/90896.
Pełny tekst źródła
36
Chabrol, Henri. "Les interactions precoces dans les depressions du post-partum : etude des interactions mere-bebe, pere-mere-bebe dans 10 familles de meres deprimees dans le post-partum et dans 10 familles temoins". Toulouse 2, 1994. http://www.theses.fr/1994TOU20039.
Pełny tekst źródłaStreszczenie:
Les interactions mere-bebe, pere-bebe et mere-pere-bebe ont ete etudiees dans 10 familles de meres deprimees dans le post-partum et dans 10 familles temoins, quand le bebe avait entre 3 et 6 mois. Les interactions face-a-face ont ete videoscopees pendant 2 minutes chacune et ont ete cotees seconde par seconde en utilisant un repertoire comportemental. Les interactions mere-bebe, pere-bebe et pere-mere-bebe apparaissent aussi positives dans les 2 groupes. Par contre, la comparaison des interactions dyadiques et triadiques dans chacun des 2 groupes a montre certaines particularites du groupe des deprimeesMother-infant, father-infant and father-mother-infant interactions were studied in 10 families with a postpartum depressed mother and in 10 control families when the infants were 3 to 6 months of age. Face-to-face interactions were videotaped during 2 minutes each and were coded using behavioral descriptions and a 1s. Time base. Mother-infant, father-infant and father-mother-infant interactions were as positive in the 2 groups. On the other hand, the comparison of dyadic and triadic interactions in each groups showed some distinctive features of depressed mothers'group
37
Douteaud, Stéphanie. "Déterminants et effets des trajectoires de stress prénatal sur les issues de la grossesse et la dépression postpartum". Thesis, Montpellier 3, 2014. http://www.theses.fr/2014MON30099.
Pełny tekst źródłaStreszczenie:
Introduction : En France, comme ailleurs, la prévalence de la dépression post-partum (DPP) (environ 10% des femmes) n'est pas plus importante que celle d'autres formes de dépression mais elle pose un important problème de dépistage car, les femmes consultent moins rendant difficile sa prévention. Les recherches visant à améliorer la prévention de la DPP s'appuient sur deux modèles principaux, le modèle de la vulnérabilité au stress et le modèle bio-psycho-social. L'un comme l'autre décrivent le stress psychologique prénatal comme étant un important déterminant de la DPP. Néanmoins, si le stress est fréquemment évalué, il n'est mesuré en général qu'une fois et tardivement dans la grossesse. Il n'est donc actuellement pas possible de connaître ni son évolution ni l'effet de cette évolution sur la DPP. En conséquence, un premier objectif de ce travail doctoral est d'identifier et de caractériser des trajectoires de stress afin d'évaluer leurs effets sur la DPP. Par ailleurs, certaines recherches montrent que les complications obstétricales lors de l'accouchement ont un effet délétère sur la santé psychologique des femmes en postpartum et d'autres que le stress prénatal augmente le risque de complications obstétricales. Nous faisons donc l'hypothèse qu'une élévation du stress associée à des complications obstétricales à l'accouchement augmente considérablement le risque de DPP, mais que cela diffère d'une femme à l'autre en fonction du niveau des déterminants du stress.Méthode : La santé des mères, leur trait d'anxiété et des variables socio-économiques ont été relevées chez 164 femmes avant la fin des deux premiers mois de la grossesse. Le stress perçu, l'état d'anxiété, le soutien social et les stratégies de coping ont été évalués à 2, 6 et 9 mois de grossesse pour 163 femmes puis à 1 et 6 mois postpartum pour 91 d'entre elles. Par ailleurs, les résultats du dépistage prénatal des pathologies fœtales, le terme de la grossesse, le poids de naissance du bébé, ses résultats à l'Apgar et le type d'accouchement (dystocique versus eutocique) ont également été relevés. Enfin, la mesure de la DPP a été effectuée 6 mois après l'accouchement. Nous avons calculé des trajectoires individuelles de stress et mesuré l'effet de ces trajectoires sur les variables liées à l'accouchement pour 163 femmes puis sur la DPP pour 91 d'entre elles.Résultats : Trois trajectoires ont été identifiées en prépartum comme en postpartum. Une première où le stress est faible en début de grossesse, augmente jusqu'en début de post-partum et diminue légèrement en fin de période postnatale. Une seconde où le stress est modéré en début de grossesse, diminue jusqu'au milieu de la grossesse, augmente en fin de grossesse et se stabilise en période postnatale. Une dernière où le stress est élevé en début de grossesse, puis diminue jusqu'en fin de grossesse et continue de diminuer en période postnatale. Lorsque le stress suit les trajectoires 2 et 3, la durée de gestation est plus courte, F(2,138) = 3,45, p < 0,05, η2 = 0,048, l'usage de la césarienne est plus fréquent, OR = 2,62,p < 0,05, IC95% = [1,01 – 6,75] ainsi que l'accouchement dystocique, OR = 3,54, p < 0,005, IC95% = [1,18 – 10,52]. En revanche, les trajectoires de stress n'ont pas d'effet sur la DPP.Discussion : Nos résultats sont encourageants et permettent de montrer que l'évolution de la perception du stress pendant la grossesse a un effet sur la durée de gestation, les complications obstétricales et l'usage de la césarienne. En revanche, elle n'en a pas sur la DPP. Cependant nos résultats suggèrent que le stress pourrait avoir un effet uniquement chez les femmes vulnérables et que la DPP s'insèrerait dans un continuum dépressif, alors contigu à la vulnérabilité au stress. Les recherches ultérieures devraient donc évaluer le lien entre des trajectoires individuelles de dépression et de stress du début de la grossesse en fin de postpartum afin de tester cette hypothèseIntroduction : In France, as well as in other countries, the prevalence of postpartum depression (PPD) (about 10% of women) is not more important than other forms of depression, but it is a major problem of screening, because women less consult, making prevention difficult. Researches to improve the prevention of DPP are essentially based on two models, the stress-vulnerability model and the bio-psycho-social model. The both models describe the prenatal psychological stress as an important determinant of the PPD. However, if stress is frequently assessed, it is usually measured only once and late in pregnancy. So, by now, it is not possible to know its evolution or to know its effects on PPD. Accordingly, a primary objective of this doctoral work is to identify and characterize trajectories of stress to assess their effects on the DPP. Moreover, some researches showed that obstetric complications during childbirth have a deleterious effect on the psychological health of postpartum women. Others proved that prenatal stress increases the risk of obstetric complications. So we assume that an elevated stress associated with obstetric complications in childbirth significantly increases the risk of PPD. Neverthless it differs from one woman to another depending on the level of stress determinants.Method: The health of mothers, their anxiety-trait level and socio-economic variables were recorded among 164 women before the end of two months of pregnancy (T0). Perceived stress, state anxiety, social support and coping strategies were evaluated at 2, 6 and 9 months of pregnancy for 163 women and at 1 and 6 months postpartum for 91 of them. Moreover, the results of prenatal screening for fetal pathologies, the term of pregnancy, baby's birth weight, results of Apgar and type of delivery (dystocic versus eutocic) were recorded. Finally, the measurement of the PPD was performed 6 months after delivery. We calculated trajectories of stress and we measured the effect of these trajectories on the variables related to childbirth for 163 women and on DPP for 91 of them.Results: Three trajectories were identified in prepartum and postpartum. A first trajectory where the stress is low in early pregnancy, increases until early postpartum and decreased slightly at the end of the postnatal period. A second where the stress is moderate in early pregnancy decreases until the middle of pregnancy, increases in late pregnancy and postpartum. A final trajectory where stress is high in early pregnancy and then decreases until the end of pregnancy and continues to decrease in postpartum. When the stress follows the paths 2 and 3, the gestation period is shorter, F(2,138) = 3.45, p <0.05, η2 = 0.048, the use of cesarean section is more common, OR = 2.62, p < 0.05, CI 95% = [1.01- 6.75] as well as dystocic labor, OR = 3.54, p <0.005, CI 95% = [1.18-10.52]. In contrast, the trajectories of stress does not have an effect on the PPD.Discussion: Our results are encouraging and show that the perception of stress during pregnancy has an effect on the duration of pregnancy, obstetric complications and the use of cesarean section. However it has no effect on the DPP, but our results suggest that stress may have an effect only among vulnerable women and that the DPP would fit into a depressive continuum, while adjacent to the vulnerability to stress. In conclusion, future researches should assess the link between trajectories of stress and depression from early pregnancy to late postpartum to test this hypothesis
38
Panagiotou, Danai. "Évaluation de l'impact de l'Accompagnement Personnalisé en Réseau Coordonné (APRC) des femmes enceintes souffrant de troubles anxiodépressifs et bipolaires et leurs bébés". Thesis, Bourgogne Franche-Comté, 2019. http://www.theses.fr/2019UBFCC019.
Pełny tekst źródłaStreszczenie:
Introduction : La dépression périnatale est un sujet majeur de santé publique. Les effets néfastes qui en découlent pour la grossesse, le développement pré- et postnatal de l’enfant et le lien mère-enfant sont largement documentés. Les études montrent que les femmes avec des troubles anxio-dépressifs et bipolaires sont plus à risque d’en développer une en période périnatale.Ces dernières années, différentes interventions non-médicamenteuses ont été mises en place. En France, l’Accompagnement Personnalisé en Réseau Coordonné (APRC) en est un exemple. Si depuis 40 ans il apparaît comme un nouveau paradigme de soins périnataux pour les futurs parents vulnérables, son efficacité au plan scientifique reste à démontrer.Objectif principal : évaluer si l’APRC permet de limiter les effets néfastes des troubles anxio-dépressifs et bipolaires pour la mère et le bébé lors du postpartum.Objectifs secondaires : évaluer a) les effets de l’APRC, b) leur stabilité à 3, 6 et 9 mois du postpartum, c) leur lien avec les différents facteurs de risque et de protection intra- (antécédents psychologiques et obstétricaux, ressources personnelles) et interpersonnels (étayages).Méthodologie : Il s’agit d’une étude comparative, longitudinale et prospective en deux temps avec une approche mixte :1) Comparaison des dyades ayant bénéficié de l’APRC (groupe clinique, n = 40) avec des dyades ayant eu un accompagnement classique (groupe contrôle, n = 30) à 3 mois du postpartum. Pour l’évaluation quantitative, nous avons évalué la dépression (EPDS, PDSS, HADS) et l’anxiété postnatales (STAI-Y), la santé mentale générale (GHQ), le vécu de l’accouchement (LAS), le stress post-traumatique du postpartum (PPQ), le développement psychomoteur du bébé (BLR) et la présence de retrait relationnel chez le bébé (ADBB). Nous avons aussi exploré les ressources personnelles (PBI), le soutien social (SSQ), ainsi que les relations dyadiques, parentales et familiales (DAS, PAI, QSC, FRI) et l’efficacité parentale (PEPP). Pour l’évaluation qualitative, nous avons effectué des entretiens semi-directifs et des observations cliniques.2) Évaluation de l’évolution des dyades du groupe clinique à 3, 6 et 9 mois du postpartum, avec les outils et l’approche mixte précédemment décrits.Résultats : 1) Lors de la comparaison inter-groupes, les dyades du groupe clinique montrent significativement de meilleurs résultats pour la plupart des mesures. Au T1, 40% des femmes du groupe clinique dépassent le seuil à l’EPDS, contre 73,3% du groupe contrôle. Seulement, 22,5% des femmes déprimées en anténatal du groupe clinique développent une dépression postnatale (DPN), contre 40 % du groupe contrôle. Selon l’analyse de régression, l’état de stress post-traumatique et la dépression anténatale sont plus prédictifs de la DPN chez le groupe contrôle, tandis que les antécédents dépressifs ne le sont que pour ce dernier. Globalement, les bébés du groupe clinique présentent des scores significativement supérieurs au BLR et inférieurs à l’ADBB par rapport au groupe contrôle, moins de retard psychomoteur (10% versus 40%) et de retrait relationnel (17,5% versus 40%). Nous n’avons pas trouvé de corrélation entre la DPN et les troubles chez l'enfant pour le groupe clinique contrairement au groupe contrôle.2) Lors de l’étude longitudinale du groupe clinique, nous avons noté une amélioration de la symptomatologie maternelle pour toutes les mesures de dépression et d’anxiété état. L’évolution maternelle positive se reflète aussi sur l’état des bébés : leurs scores à l’ADBB diminuent tandis que les scores au BLR augmentent de manière significativeIntroduction: Maternal depression is a major public mental health issue. Its impact on pregnancy, the pre- and postnatal development of the infant and the mother-infant relationships are well established. Besides, studies show that women with anxio-depressive and bipolar troubles are at high risk of developing perinatal depression.The last decades, several non-pharmaceutic interventions have been created. In France, the Personalized Interdisciplinary Network Care (PINC) is an example. Even if it is considered as the paradigm of perinatal care for vulnerable parents for more than 40 years, its efficacy has yet to be assessed with a quantitative and qualitative method.Primary objective: to assess the PINC efficacy in limiting adverse maternal and infant outcomes for women with anxio-depressive and bipolar disorders and their babies.Secondary objectives: to assess a) the PINC effects, b) their sustainability at 3, 6 and 9 months postpartum, c) their link to the different intra- (psychopathology, obstetric antecedents, personal resources) and interpersonal (supports) risk and protection factors.Methods: A comparative, longitudinal and prospective study with a mixed protocol in two timepoints:1) Comparison of two groups of women and their infants who received either PINC (clinical group, N=40) or classic obstetric/midwife care (control group, N=30) at 3 months postpartum. For the quantitative part, we measured postpartum depression (EPDS, PDSS, HADS) and anxiety (STAI-Y), general mental health (GHQ) and postpartum post-traumatic stress (PPQ), the infants’ psychomotor development (BLR) and sustained relational withdrawal (ADBB). In addition, we investigated the personal resources (PBI), the social support (SSQ), the dyadic, parental and family relationships (DAS, PAI, QSC, PES, FRI) and the parental efficiency. For the qualitative part, we utilized semi-structured clinical interviews and observations.2) Evaluation of the mother-infant evolution for the clinical group at 3,6 and 9 months postpartum with the same tools and mixed approach as described above.Results: 1) Intergroup comparative analysis: Women and infants whose mothers received PINC showed significantly better outcomes at most measures. At 3 months postpartum, 40% of the PINC mothers developed a postpartum depression (PPD), compared to 73.3% of the controls. Only 22.5% antenatally depressed women of the clinical group developed a PPD, compared to 40% of the controls. Regression analysis showed that the postpartum post-traumatic stress disorder and the antenatal depression were more predictive of PPD for the controls than for the clinical group, while prior history of depression was predictive only for the former. Overall, the babies of the clinical group presented higher scores for the BLR and lower for the ADBB compared to the controls, less psychomotor delay (10% vs 40%) and relational withdrawal (17.5% vs 40%). No correlation was found between the maternal depression and disturbances in the infant’s development for the clinical group.2) Longitudinal follow-up of the clinical group: The maternal symptomatology was improved at all the depression and anxiety-state measures. The positive maternal evolution was reflected on their babies, too (their scores were significantly reduced at the ADBB and increased at the BLR)
39
Karkun, Sandhya. "Occupational role performance and post-partum depression A pilot exploratory study /". 2005. http://proquest.umi.com/pqdweb?did=1014311391&sid=13&Fmt=2&clientId=39334&RQT=309&VName=PQD.
Pełny tekst źródłaStreszczenie:
Thesis (M.S.)--State University of New York at Buffalo, 2005.Title from PDF title page (viewed on May. 03, 2006) Available through UMI ProQuest Digital Dissertations. Thesis adviser: Nochajski, Susan M. Includes bibliographical references.
40
Smith, Jeremy W., J. R. Seckl, A. Tudor Evans, Brenda Costall i James W. Smythe. "Gestational stress induces post-partum depression-like behaviour and alters maternal care in rats". 2004. http://hdl.handle.net/10454/3639.
Pełny tekst źródłaStreszczenie:
NoGestational stress (GS) produces profound behavioural impairments in the offspring and may permanently programme hypothalamic¿pituitary¿adrenal (HPA) axis function. We investigated whether or not GS produced changes in the maternal behaviour of rat dams, and measured depression-like behaviour in the dam, which might contribute to effects in the progeny. We used the Porsolt test, which measures immobility in a forced-swim task, and models depression in rodents, while monitoring maternal care (arched-back nursing, licking/grooming, nesting/grouping pups). Pregnant rats underwent daily restraint stress (1 h/day, days 10¿20 of gestation), or were left undisturbed (control). On post-parturition days 3 and 4, dams were placed into a swim tank, and time spent immobile was measured. GS significantly elevated immobility scores by approximately 25% above control values on the second test day. Maternal behaviours, in particular arched-back nursing and nesting/grouping pups, were reduced in GS dams over post-natal days 1¿10. Adult offspring showed increased immobility in the Porsolt test, and also hypersecreted ACTH and CORT in response to an acute stress challenge. These data show that GS can alter maternal behaviour in mothers, and this might contribute to alterations in the offspring. GS may be an important factor in maternal post-natal depression, which may in turn detrimentally effect the offspring because depressed mothers do not sufficiently care for their offspring.
41
Ahmed, Sherief. "Association between asthma during pregnancy and postpartum depression". Thèse, 2016. http://hdl.handle.net/1866/19548.
Pełny tekst źródłaStreszczenie:
Il a été démontré dans plusieurs études épidémiologiques qu’il existe un risque important de dépression chez les femmes souffrant d'asthme en dehors de la grossesse. Cependant, on en connait peu sur l'association entre l'asthme pendant la grossesse et la dépression post-partum. Par conséquent, le but de cette étude était de quantifier la force de l’association entre l'asthme pendant la grossesse et la dépression post-partum.
À l’aide des bases de données administratives du Québec, nous avons construit une cohorte de 35,520 grossesses de femmes asthmatiques et 197,057 grossesses de femmes non asthmatiques qui ont accouchées entre 1998 et 2009. Les femmes asthmatiques ont été identifiées à l'aide d’une définition opérationnelle validée. Nous avons utilisé la définition de Statistiques Canada pour détecter la dépression post-partum. Cette définition se base sur les codes diagnostics de la dépression enregistrés dans les bases de données de la RAMQ et de MED-ECHO dans l’année suivant l’accouchement. Un modèle d'équations généralisées a été utilisé pour estimer les ratios de cotes (RC) brutes et ajustés et les intervalles de confiance (IC) à 95% entre l’asthme pendant la grossesse et la dépression post-partum. La proportion de femmes ayant eu une dépression post-partum au cours de l’année suivant l’accouchement était plus élevée chez les asthmatiques que chez les non-asthmatiques (6,1% contre 2,9%). Après ajustement pour les variables potentiellement confondantes, nous avons observé que les femmes asthmatiques étaient 58% plus susceptibles de souffrir de dépression post-partum que les femmes non-asthmatiques (RC ajusté : 1,58 ; IC 95%, 1,50 à 1,67).
Les résultats de notre étude suggèrent un risque accru de dépression post-partum chez les femmes asthmatiques. Une attention particulière devrait être accordée aux symptômes dépressifs chez les femmes asthmatiques dans l’année suivant l’accouchement pour détecter la dépression post-partum plus rapidement et intervenir plus efficacement.There is evidence from several epidemiological studies on the increased risk of depression among women with asthma outside of pregnancy. However, we found no studies designed to investigate the association between asthma during pregnancy and postpartum depression. Therefore, the purpose of this study was to assess the association between asthma during pregnancy and postpartum depression. Based on Quebec administrative databases, we constructed a cohort of 35,520 pregnancies from asthmatic women and 197,057 pregnancies from non-asthmatic women who delivered between 1998 and 2009. Asthmatic women were identified using a validated operational definition. Postpartum depression was defined and specified with diagnostic codes for depression from the definition of Statistics Canada recorded in the RAMQ or MED-ECHO databases and assessed 1 year postpartum. A generalized estimating equation model was used to estimate the crude and adjusted odds ratios (ORs) of postpartum depression and 95% confidence intervals (CI) comparing women with and without asthma during pregnancy. The proportion of postpartum depression 1 year after delivery was higher among asthmatic compared to non-asthmatic pregnant women (6.1% vs. 2.9%). After adjusting for potential confounders, we observed that women with asthma were 58% more likely to have postpartum depression (adjusted OR: 1.58; 95%CI, 1.50-1.67) than women without asthma during pregnancy. The findings of our study suggest an increased risk of postpartum depression among asthmatic women. Attention should be given to depressive symptoms in asthmatic women in the year postpartum to detect postpartum depression more rapidly and intervene more efficiently.