A Woman Who Cannot Enjoy Her Pregnancy: Depression in Pregnancy and Puerperium
Depressive symptoms during pregnancy and after delivery are common. Overall, 7–13 % of women suffer from major depression during their pregnancy and/or in the first 3 months after delivery. Perinatal depression is associated with both maternal and child a
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A Woman Who Cannot Enjoy Her Pregnancy: Depression in Pregnancy and Puerperium Mijke P. Lambregtse-van den Berg and Inge L. van Kamp
3.1 Introduction and Aims Depressive symptoms during pregnancy and after delivery are common. Overall 7–13% of women suffer from major depression during their pregnancy and/or in the first 3 months after delivery. Perinatal depression is associated with both maternal and child adverse outcomes, but often remains unrecognized. Therefore, early detection and treatment of depression during pregnancy and in the postpartum period is crucial.
3.2 Definition in Lay Terms Perinatal depression is a specifier of a depression with an onset of mood symptoms during pregnancy or in the first 4 weeks following delivery. A diagnosis of major perinatal depression requires a depressed mood or a loss of interest or pleasure in daily activities for more than 2 weeks, along with a fixed number of emotional, somatic or cognitive symptoms. The severity of these symptoms should impair social, occupational, and/or educational functioning.
M.P. Lambregtse-van den Berg, MD, PhD (*) Department of Psychiatry/Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands e-mail: [email protected] I.L. van Kamp, MD, PhD Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands e-mail: [email protected] © Springer International Publishing Switzerland 2017 K.M. Paarlberg, H.B.M. van de Wiel (eds.), Bio-Psycho-Social Obstetrics and Gynecology, DOI 10.1007/978-3-319-40404-2_3
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M.P. Lambregtse-van den Berg and I.L. van Kamp
3.3 Didactic Goals After reading this chapter, you will be able to: • Describe the criteria for perinatal depression • Distinguish perinatal depression from pregnancy-related symptoms and maternity blues • Mention risk factors and possible etiologies of perinatal depression • Identify women with perinatal depression • Consider pharmacological and non-pharmacological options for treating perinatal depression • Weigh the risks and benefits of antidepressant medication during pregnancy and lactation period Case History
Nadia Teal, 29 years old, presents for her pregnancy booking with her midwife at 10 weeks gestation. She is pregnant for the first time. The pregnancy was unplanned and unexpected. Although she is not confident about her relationship, she is willing to keep the baby. She tells her midwife that since she learned she was pregnant, she feels tired and sick, is easily irritated, has a lack of appetite, suffers from insomnia, and has problems concentrating at work. Currently she is at home, because she is not able to work. She asks whether these symptoms are related to pregnancy and if the midwife could help her to feel better.
3.4 F acts and Figures: Definitions, Classification, and Prevalence 3.4.1 What Is the Definition of Perinatal Depression? See DSM-5 for the criteria for a major depressive disorder. According to the DSM-5, a specifier “with peripartum onset” can be applied to a major depressive episo
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