Elsevier

Asian Journal of Psychiatry

Volume 38, December 2018, Pages A1-A3
Asian Journal of Psychiatry

Editorial
A stitch in time saves nine: Untreated perinatal depression hurts future generations

https://doi.org/10.1016/j.ajp.2018.11.009Get rights and content

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History

Up until recently the prevailing belief was that pregnancy protects women from depression and that pregnant women are only vulnerable to depression in the immediate postpartum period. The earliest mention of postpartum illness or"puerperal fever," was described for the first time in 460 BCE by Hippocrates, it was documented as a post-natal state caused by“suppressed lochial discharge” that was transported to the brain, producing "agitation, delirium and attacks of mania.”(Thurtle, 1995). In the

Prevalence across Asia

Perinatal or peri-partum depression is a relatively new term that refers to depressive and related disorders encountered during pregnancy and the postpartum period. The incidence and prevalence of perinatal disorder can vary and a recent meta-analysis of 291 studies from 56 countries revealed a pooled prevalence of perinatal mood disorders of 17.7%, with significant variation across countries (Hahn-Holbrook et al., 2018). The prevalence of antepartum depression ranges from 7 to 15 percent in

Consequences of untreated perinatal depression

Untreated perinatal depression has profound negative consequences for the mother including a significant risk of suicide. Contrary to the belief that pregnancy is a protective factor against suicide, an increase in suicidal ideation is noted (Gelaye et al., 2016) and untreated depressionresults in an increase in suicides during the perinatal period (Khalifeh et al., 2016).Important sequelae of perinatal depression on the short-term and long-term emotional and physical health of the infant are

Treatment of perinatal depression

Perinatal depression is eminently treatable with a range of effective pharmacological and psychological approaches. Most antidepressant and antipsychotic medications are effective and safe to use during pregnancy (Marcus et al., 2001; Tandon and Halbreich, 2003; Janecka et al., 2018; Kimmel et al., 2018). A range of psychological treatments and mother-child interaction therapies have also been found to be effective in both effectively treating maternal depression as also mitigating the

References (31)

Cited by (17)

  • Understanding the multidimensional trajectory of psychosocial maternal risk factors causing preterm birth: A systematic review

    2020, Asian Journal of Psychiatry
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    Given a pre-existing risk of significant physical and emotional changes in the perinatal period, there is an urgent need for a call to action to prevent psychological morbidities among pregnant women (Tareen and Tandon, 2018). A multifaceted approach emphasizing the prevention of risk factors of maternal disorders, early diagnosis and screening by providers, addressing psychosocial problems, and adopting psychotherapy and medication regimens have been proposed to promote maternal and neonatal outcomes (Tareen and Tandon, 2018). The integrated approach of delivering mental health services (in conjunction with primary health services), such as supportive psychotherapy, routine maternal health monitoring, stress management, and life skills trainings have generated promising results in reducing anxiety and depression among expectant mothers living in low- or middle-income countries (George et al., 2020; Noorbala et al., 2019; Tandon et al., 2014).

  • Risk factors for postpartum depression: An evidence-based systematic review of systematic reviews and meta-analyses

    2020, Asian Journal of Psychiatry
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    What’s more, a qualitative systematic review proves that mother with PPD may suffer an increased risk for negative infant-feeding outcomes which may affects mother-to-child relationship (Dennis and McQueen, 2009). Studies of populations in the Asian region have also clearly shown that untreated PPD affects the health of future generations, and psychological interventions have been shown to be beneficial for perinatal depression in low - and middle-income countries (Gajaria and Ravindran, 2018; Tareen and Tandon, 2018). While numerous studies on the mechanisms and etiology of PPD have achieved great progress in neurobiology and endocrinology (Brummelte and Galea, 2016), there is no stop to the risk factors of PPD.

  • Transformation of attitude through brief psychoeducation program for the husbands of women with postpartum psychiatric disorders

    2020, Asian Journal of Psychiatry
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    With the shift to the next stage of life cycle, pregnancy and birth of a child prescribe new roles and responsibilities along with certain challenges in the couple subsystem (Belsky and Rovine, 1990). This new switch further might get exacerbated when a woman is affected with perinatal psychiatric disorder due to its diverse and complex nature in the form of its manifestation and consequence at individual, familial and societal level (Ganjekar et al., 2013; Tareen and Tandon, 2018; Thippeswamy et al., 2015) resulting in wide range of psychological, physical and social changes in the family functioning at the larger level (Nielsen et al., 2000; Tareen and Tandon, 2018). To get adapted to such changes most often these women require a great deal of support from their husbands and other immediate spheres (Tammentie et al., 2004; Tarkka et al., 2000).

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