Özkan ÖZDAMAR, Onat YILMAZ, Hacer BEYCA, Murat MUHCU

Gebelik ve Postpartum Dönemde Sık Görülen Ruhsal Bozukluklar (Common Psychiatric Disorders in Pregnancy and Postpartum Period)

Psikiyatrik hastalıkların görülme sıklığı, kadınların doğurganlık çağında diğer yaşa dönemlerine oranla kısmen artmaktadır. Gebelik ve postpartum döneminse, ruhsal hastalık görülme sıklığında artıştan çok, hastalığın alevlenmesi ile ilişkili olduğu düşünülmektedir. Buna göre, gebelik ve postpartum dönem pek çok kadın için anksiyete bozukluğu, depresyon, yeme bozukluğu ve psikoz gibi psikiyatrik hastalıklara yatkınlığın arttığı bir dönem olabilmektedir. Gebelik sürecinde bedendeki fizyolojik değişiklikler, cinsel ilgideki değişiklikler ve doğumla ilgili anksiyete, duygudurum değişikliğine katkı sağlayabilir. Bunun yanında gebelikte görülen somatik yakınmalar, depresyon ve anksiyete belirtileri hekimlerce genellikle gebelikle ilgili hormonal ve fiziksel değişikliklere bağlanmakta ve sıklıkla daha az teşhis edilebilmekte ve buna bağlı olarak da tedavileri aksamaktadır. Daha önceden hastalık öyküsü bulunan kadınların hamilelik ya da postpartum döneminde bu hastalıkların alevlenme riski bulunmaktadır. Ayrıca bu dönemlerde bazı psikiyatrik bozuklukların tedavileri değişebilmekte veya ilaç dozlarında değişikliğe gidilmesi gerekliliği ortaya çıkabilmektedir. Bu dönemdeki psikiyatrik hastalıklarla ilgili çalışmaların çoğunun son yıllarda gerçekleşmesinden dolayı klinisyenlerin bu dönemdeki bireylere yaklaşımına yönelik bilgi oldukça sınırlıdır. Tedavisi ihmal edilen bu ruhsal bozuklukların anne-çocuk ilişkisinin ciddi olarak bozulması ile sonuçlandığı göz önüne alındığında, bu konuya duyarlılık ile yaklaşılmasının gerektiği açıktır. Bu makalede gebelik ve postpartum dönemde sık karşılaşılan psikiyatrik hastalıklar konusunda makaleler gözden geçirilerek, bu hastalıkların tanısı, müdahale yöntemleri ve tedavi konularında klinisyenlere önerilerde bulunulmaktadır. Anahtar Kelimeler: gebelik; postpartum; depresyon; anksiyete; yeme bozuklukları; psikoz.AbstractPsychiatric disorders are common at women during particularly their reproductive years, when compared to other life periods. It is believed that, pregnancy and postpartum period is not associated with increased incidence of any mental disorder, but the severity of the disorder. Accordingly, pregnancy and postpartum periods may be a time of increased susceptibility to psychiatric disorders such as anxiety disorder, depression, eating disorder and psychosis. Physiological changes in the body during pregnancy, changes in sexual interest and birth-related anxiety might contribute to mood changes. Besides, somatic complaints, depression and anxiety symptoms seen in pregnancy are frequently linked to pregnancy-related hormonal and physical changes and can be less commonly diagnosed by physicians, consequently therapies are being delayed. During the pregnancy or postpartum periods of women with a prior history of disease, there is an increased risk of exacerbation of these diseases. Additionally during these periods, the treatment of certain psychiatric disorders may change or the necessity of amendment in drug doses may arise. Because studies about the psychiatric disorders in this period have been done in recent years, clinicians have limited data about approaching to the individuals in this period. Given that the neglected therapy of these disorders results in severe impairment of the mother-baby relationship, it is clear that the issue should be approached with sensitivity. In this paper, articles about common psychiatric disorders during pregnancy and postpartum period are reviewed and making suggestions to clinicians about identifying, interventions and treatments of these disorders.Key Words: pregnancy; postpartum; depression; anxiety; eating disorders; psychosis.

Anahtar Kelimeler:

gebelik, postpartum, depresyon, anksiyete, yeme bozuklukları, psikoz

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Psychiatric disorders are common at women during particularly their reproductive years, when compared to other life periods. It is believed that, pregnancy and postpartum period is not associated with increased incidence of any mental disorder, but the severity of the disorder. Accordingly, pregnancy and postpartum periods may be a time of increased susceptibility to psychiatric disorders such as anxiety disorder, depression, eating disorder and psychosis. Physiological changes in the body during pregnancy, changes in sexual interest and birth-related anxiety might contribute to mood changes. Besides, somatic complaints, depression and anxiety symptoms seen in pregnancy are frequently linked to pregnancy-related hormonal and physical changes and can be less commonly diagnosed by physicians, consequently therapies are being delayed. During the pregnancy or postpartum periods of women with a prior history of disease, there is an increased risk of exacerbation of these diseases. Additionally during these periods, the treatment of certain psychiatric disorders may change or the necessity of amendment in drug doses may arise.Because studies about the psychiatric disorders in this period have been done in recent years, clinicians have limited data about approaching to the individuals in this period. Given that the neglected therapy of these disorders results in severe impairment of the mother-baby relationship, it is clear that the issue should be approached with sensitivity. In this review, articles about common psychiatric disorders during pregnancy and postpartum period have been reviewed and suggestions to clinicians about identifying, interventionsand treatments of these disorders are being made.

Keywords:

pregnancy, postpartum, depression, anxiety, eating disorders, psychosisCİLT: 45 YIL: 2014 SAYI: 2ZEYNEP KAMİL TIP BÜLTENİ 2014;45:71-7,

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