THE IMPORTANCE OF MATERNAL MENTAL HEALTH

Yıl 2017, Cilt: 1 Sayı: 2, 29 - 36, 31.12.2017

Nalan Öztürk Nazan Aydın

https://doi.org/10.26695/mukatcad.2018.9

Öz

Pregnancy and childbirth are often perceived as happy occasions but they may sometimes turn into a distressing experience. During this period, some mental illnesses may start or the existing illnesses may deteriorate. Unfortunately, mothers’ mental health does not receive as much care and attention as their physical health, or diagnosis and treatment of psychological problems are delayed. An untreated mental illness during this period can have negative consequences for both the mother and the developing baby. Decreased self-care of mother can lead to conditions that negatively affect the course of pregnancy, such as weight loss, irregular nutrition, and the onset of diabetes. As for the baby, some of the problems which may be witnessed are low birth weight, premature birth, inadequacy in the development of the nervous system, and negative affect on emotional and behavioral development. In the postpartum period, mother with a mental illness in the postpartum period cannot display sufficient care and attention towards her baby and this may adversely affect mother-child attachment. The most common psychiatric disorder in this period is depression which is diagnosed in every 5-7 mothers. In addition to depression, anxiety disorders, mood disorders and psychosis are mental illnesses that may be diagnosed during this period. This article aims to draw attention to the importance of diagnosis and treatment of mental diseases and their implications for child mental health by informing about mental illnesses that the mother may suffer during pregnancy and postnatal period.

Anahtar Kelimeler

Maternal mental health, pregnancy, childbirth, stress, depression

ANNE RUH SAĞLIĞININ ÖNEMİ

Öz

Gebelik ve doğum sıklıkla mutluluk verici bir
durum olarak algılanmakla birlikte bazen sıkıntılı bir süreç de
yaşanabilmektedir. Bu süreçte bazı hastalıklar ilk kez ortaya çıkabilmekte ya
da var olan mevcut hastalık kötüleşebilmektedir. Bununla beraber maalesef
annelerin ruh sağlığı fiziksel sağlıkları kadar dikkate alınmamakta ya da tanı
ve tedavisi gecikmektedir. Bu dönemde tedavi edilmeyen bir ruhsal hastalık hem
anne hem de gelişmekte olan bebek için olumsuz sonuçlara yol açabilmektedir. Annede
kendine bakımında azalma, kilo kaybı, düzensiz beslenme, şeker hastalığının
başlaması gibi gebelik seyrini de olumsuz etkileyen durumlar, bebekle ilgili
olarak; düşük doğum ağırlığı, erken doğum, sinir sisteminin gelişiminde
yetersizlikler, duygusal ve davranışsal gelişiminin olumsuz etkilenmesi
görülebilmektedir. Doğum sonrası dönemde ise, ruhsal hastalığı olan bir annenin
bebeğine yeterince ilgi gösterememesi anne bebek bağlanmasının olumsuz olmasına
neden olabilmektedir. Bu dönemde en sık karşılaşılan ruhsal bozukluk depresyon
olup her 5-7 anneden birisinde görülmektedir. Depresyonun yanı sıra anksiyete
bozuklukları, duygu durum bozuklukları ve psikoz da bu dönemde görülebilen
ruhsal hastalıklardır. Bu yazıda gebelik ve doğum sonrası dönemde annede
görülebilecek ruhsal hastalıklar hakkında bilgi verilerek, tanı ve tedavinin
önemi, çocuk ruh sağlığına etkilerine dikkat çekilmesi amaçlanmıştır.

Anahtar Kelimeler

Anne ruh sağlığı, gebelik, doğum, stres, depresyon

Kaynakça

• American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th edition). Arlington (Ed.). VA: American Psychiatric Association.
• Bonari, L., Pinto, N., Ahn, E., Einarson, A., Steiner, M. ve Koren, G. (2004). Perinatal risks of untreated depression during pregnancy. Can J Psychiatry; 49, 726-735 [PMID: 15633850].
• Brockington, I. (2004). Postpartum psychiatric disor- ders. Lancet, 363, 303-10.

• Brockington, I., Chandra, P., Dubowitz, H., Jones, D., Moussa, S., Nakku, J. ve Quadros Ferre, I. (2011). WPA guidance on the protection and promotion of mental health in children of persons with severe mental disorders. World Psychiatry, 10, 93-102. [PMID: 21633678 DOI: 10.1002/j.2051-5545.2011.tb00023.x]
• Cohen, L. S., Wang, B., Nonacs, R., Viguera, A. C., Lemon, E.L. ve Freeman, M. P. (2010). Treatment of mood disorders during pregnancy and postpartum. Psychiatr Clin North Am., 33(2), 273-293.
• Dayan, J., Creveuil, C., Marks, M. N., Conroy, S., Herlicoviez, M., Dreyfus, M. et al. (2006). Prenatal depression, prenatal anxiety, and spontaneous preterm birth: A prospective cohort study among women with early and regular care. Psychosom Med., 68(6), 938–946 .
• Ding, X. X., Wu, Y. L., Xu, S. J., Zhu, R. P., Jia, X. M., Zhang, S. F., Huang, K., Zhu, P., Hao, J. H. ve Tao, F. B. (2014). Maternal anxiety during pregnancy and adverse birth outcomes: A systematic review and meta-analysis of prospective cohort studies. J. Affect. Disord., 159, 103–110. 

• Dole, N., Savitz, D. A., Hertz-Picciotto, I., Siega-Riz, A. M., McMahon, M. J. ve Buekens, P. (2003). Maternal stress and preterm birth. Am J Epidemiol, 157, 14–24.
• Fisher, J., Cabral de Mello, M., Patel, V., Rahman, A., Tran, T., Holton, S. ve Holmes, W. (2012). Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: A systematic review. Bulletin of the World Health Organization, 90, 139-149.
• Freeman, M. P. (2002). The impact of reproductive events on the course of bipolar disorder in women. J Clin Psychiatry, 63(4), 284-287.
• Gavin, N. I., Gaynes, B. N., Lohr, K. N., Meltzer-Brody, S., Gartlehner, G. ve Swinson, T. (2005). Perinatal depression: A systematic review of prevalence and incidence. Obstetrics & Gynecology, 106 (5, Part 1), 1071-1083.
• Giardinelli, L., Innocenti, A., Benni, L., et al. (2012). Depression and anxiety in perinatal period: Prevalence and risk factors in an Italian sample. Archives of Women’s Mental Health, 15(1), 21-30.
• Gotlib, I.H., Whiffen, V.E., Mount, J.H. et al. (1989). Prevalence rates and demographic characteristics associated with depression in pregnancy and the post-partum period. J Consult Clin Psychol, 57, 269-74.
• Gutteling, B. M., de Weerth, C., Willemsen-Swinkels, S.H., Huizink, A. C., Mulder, E. J., Visser, G. H. et al. (2005). The effects of prenatal stress on temperament and problem behavior of 27-month-old toddlers. Eur Child Adolesc Psychiatry, 14, 41–51.
• Huizink, A. C., Robles de Medina, P. G., Mulder, E. J., Visser, G. H. ve Buitelaar, J. K. (2003). Stress during pregnancy is associated with develop- mental outcome in infancy. J Child Psychol Psychiatry, 44, 810–818.
• Josefsson, A., Angelsioo, L., Berg, G., Ekstrom, C. M., Gunnervik, C., Nordin, C., et al. (2002). Obstetric, somatic, and demographic risk factors for postpartum depressive symptoms. Obstet Gynecol, 99(2), 223–228.
• Kendell, R. E., McGuire, R. J., Connor, Y., ve Cox, J. L. (1981). Mood changes in the first three weeks after childbirth. Journal of Affective Disorders, 1, 317–326.
• Kendell, R., Chalmers, J., Platz, C. (1987). Epidemiology of puerperal psychoses. Br J Psychiatry, 150, 662-673. Khajehei, M. (2015). Mental health of perinatal women. World J Obstet Gynecol, 4(2), 46-51.
• Lewis, G., Drife, J. O., Botting, B. J. ve Ireland, N. (2001). Why mothers die: The fifth report of the confidential enquiries into maternal deaths in the United Kingdom 1997-1999. RCOG Press.
• Lindley, A. A., Benson, J. E., Grimes, C., Cole, T.M. 3rd ve Herman, A. A. (1999). The relationship in neonates between clinically measured head circumference and brain volume estimated from head CT-scans. Early Hum Dev, 56(1), 17–29.
• Maras, P. M., Molet, J., Chen, Y., Rice, C., Ji, S. G., Solodkin, A. et al. (2014). Preferential loss of dorsal-hippocampus synapses underlies memory impairments provoked by short, multimodal stress. Mol Psychiatry, 19, 811–822.
• Marcus, S. M., Flynn, H. A. (2008). Depression, antidepressant medication, and functioning outcomes among pregnant women. Int J Gynaecol Obstet, 100, 248-51.
• Miller, L. J. (2002). Postpartum depression. Journal of the American Medical Association, 287, 762–765.
• O’Hara, M. W. ve Wisner, K. L. (2014). Perinatal mental illness: Definition, description and aetiology. Best Pract Res Clin Obstet Gynaecol, 28(1), 3-12.
• Pearson, K. H., Nona’s, R., Cohen, L. S. (2002). Practical guidelines for the treatment of psychiatric disorders during pregnancy. Pearson, K. H., Sonawalla, S. B. ve Rosenbaum, J. F. (Eds). Women’s health and psychiatry (115-123). Philadelphia: Lippincott, Williams and Wilkins.
• Porter, T., Gavin, H. (2010). Infanticide and neonaticide: A review of 40 years of research literature on incidence and causes. Trauma, Violence, & Abuse., 11(3), 99-112.
• Ross, L. E., McLean, L. M. (2006). Anxiety disorders during pregnancy and the postpartum period: A systematic review. J Clin Psychiatry, 67(8), 1285-98.
• Vesga-Lopex, O., Blanco, C., Keyes, K., Olfson, M. ve Grant, B. F. (2008). Psychiatric disorders in pregnant and postpartum women in the United States. Arch Gen Psychiatry, 65(7), 805-815.
• Viguera, A. C. (2000). Risk of recurrence of bipolar disorder in pregnant and nonpregnant women after discontinuing lithium maintenance. Am J Psychiatry, 157(2), 179-84.
• Wadhwa, P. D., Sandman, C. A., Porto, M., Dunkel-Schetter, C. ve Garite, T. J. (1993). The association between prenatal stress and infant birth weight and gestational age at birth: a prospective investigation. Am J Obstet Gynecol, 169, 858–86.
• Watson, J.P., Elliott, S.A., Rugg, A.J., Brough, D.L. (1984). Psychiatric disorder in pregnancy and the first postnatal year. Br J Psychiatry, 144, 453-462.
• Wenzel, A., Haugen, E. N., Jackson, L. C., Brendle, J. R. (2005). Anxiety symptoms and disorders at eight weeks postpartum. J Anxiety Disord, 19(3), 295-311.
• Williams, J. (2014) Best practice guidelines for mental health disorders in the perinatal period. BC Reproductive Mental Health Program & Perinatal Services BC.