Suryawanshi Om, Pajai Sandhya
Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND.
Cureus. 2022 Dec 20;14(12):e32745. doi: 10.7759/cureus.32745. eCollection 2022 Dec.
One of the most common psychological effects following childbirth is postpartum depression. Postpartum depression (PPD) has a significant negative impact on the child's emotional, mental as well as intellectual development if left untreated, which can later have long-term complications. Later in life, it also results in the mother developing obsessive-compulsive disorder and anxiety. Many psychological risk factors are linked with PPD. The pathophysiology of the development of PPD is explained by different models like biological, psychological, integrated, and evolutionary models, which relate the result of the condition with particular conditions and factors. This article also explains the role of methyldopa as a medication used during pregnancy and the postpartum phase with the development of PPD. There are different mechanisms by which methyldopa causes depression. The large-scale screening of the condition can be done by Edinburgh Postnatal Depression Scale (EPDS). The diagnosis can be made by clinical assessment, simple self-report instruments, and questionnaires provided to mothers. Currently, there has not been any specific treatment for PPD, but selective serotonin reuptake inhibitors (SSRIs) like sertraline are effective in acute management. Venlafaxine and desvenlafaxine are serotonin-norepinephrine reuptake inhibitors used for the relief of symptoms. The SSRI and tricyclic antidepressants (TCA) used in combination have a prophylactic role in PPD. Nowadays, women prefer psychological therapies, complementary health practices, and neuromodulatory interventions like electroconvulsive therapy more than previous pharmacological treatments of depression. Allopregnanolone drug made into sterile solution brexanolone leads to a rapid decline of PPD symptoms. PPD is a common and severe disorder that affects many mothers following childbirth but is ignored and not given much importance. Later it affects the child's psychological and intellectual abilities and mother-child bonding. We can easily prevent it by early diagnosis and timely care and management of the mother. Understanding the underlying pathophysiology would also go a long way in preventing and managing the disorder.
分娩后最常见的心理影响之一是产后抑郁症。产后抑郁症（PPD）如果不加以治疗，会对孩子的情感、心理以及智力发育产生重大负面影响，随后可能会引发长期并发症。在母亲日后的生活中，还会导致其患上强迫症和焦虑症。许多心理风险因素与产后抑郁症有关。产后抑郁症发展的病理生理学可以通过不同的模型来解释，如生物学模型、心理学模型、综合模型和进化模型，这些模型将该病症的结果与特定情况和因素联系起来。本文还解释了甲基多巴作为一种在孕期和产后阶段使用的药物与产后抑郁症发展之间的关系。甲基多巴导致抑郁症有不同的机制。可以通过爱丁堡产后抑郁量表（EPDS）对该病症进行大规模筛查。诊断可以通过临床评估、简单的自我报告工具以及提供给母亲的问卷来进行。目前，产后抑郁症尚无任何特效治疗方法，但像舍曲林这样的选择性5-羟色胺再摄取抑制剂（SSRIs）在急性治疗中有效。文拉法辛和去甲文拉法辛是用于缓解症状的5-羟色胺-去甲肾上腺素再摄取抑制剂。联合使用的SSRI和三环类抗抑郁药（TCA）在产后抑郁症中有预防作用。如今，与以往治疗抑郁症的药物疗法相比，女性更倾向于心理疗法、补充健康疗法以及像电休克疗法这样的神经调节干预措施。制成无菌溶液的别孕烯醇酮药物布雷沙诺龙可使产后抑郁症症状迅速减轻。产后抑郁症是一种常见且严重的病症，影响着许多产后母亲，但却被忽视且未得到足够重视。随后它会影响孩子的心理和智力能力以及母婴关系。通过对母亲进行早期诊断以及及时护理和管理，我们可以轻松预防这种病症。了解潜在的病理生理学在预防和管理该病症方面也将大有帮助。
