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Results for “Puerperal Disorders”

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PubMed1998

Estrogen, serotonin, and mood disturbance: where is the therapeutic bridge?

A growing body of literature describes the effects of estrogen and other gonadal steroids on the central nervous system. The ability of estrogen to modulate serotonergic function, in particular, raises the possibility that sex steroids may play a role in the mechanisms associated with depression and its treatment. This review will focus on those aspects of the estrogen-serotonin interaction that relate to possible increased vulnerability to affective disorders and on hormonal treatments that may be clinically applicable to women. After a discussion of the potential relationship between estrogen and mood disorders across the female life cycle, a model is proposed in which differential sensitivity to mood disorders explains the differential response by some women to periods of normal hormonal changes. Possible serotonin receptor-mediated and intracellular mechanisms by which estrogen may exert its effects on mood are also reviewed. These are compared to putative mechanisms of standard antidepressant effect. Lastly, treatment studies in which estrogen has been used as 1) monotherapy for depression, 2) an augmentation strategy, or 3) a prophylactic intervention against recurrence of depression are reviewed.

Antidepressive Agents↗
PubMed2002

Post-partum maternity 'blues' as a reflection of newborn nursing care in Japan.

OBJECTIVES: To investigate the prevalence of post-partum 'blues' in mothers whose babies are cared for in a newborn nursery, compared with mothers providing rooming-in care. METHODS: Japanese normal primiparous women were prospectively studied from 1998 to 1999. The newborns of these mothers were managed in the newborn nursery or by rooming-in care. To diagnose maternity 'blues' and 'depression', the Stein's Questionnaire and the Edinburgh Postnatal Depression Scale were used. RESULTS: Ninety-seven and 93 women were managed by newborn nursery care and by rooming-in care, respectively. Of these women, a total of 181 women were considered for analysis. 'Blues' was noted in 31 of 92 mothers (33.7%) receiving newborn nursery care and in 18 of 89 (20.2%) receiving rooming-in care with a significant difference (P<0.05), and in 49 of 181 (27.1%) as a whole. The daily Stein's scores changed significantly during the 10 days post-partum in each group (P<0.0001). Post-partum 'depression' was observed in three mothers (3.4%) in the newborn nursery care group and in four (4.8%) of the rooming-in care group, not a significant difference, and in seven (4.1%) as a whole. CONCLUSION: Maternity 'blues' is experienced by 25% or more of Japanese primiparous women delivering healthy babies via uncomplicated delivery. The system of newborn nursery infant care may be a potential causal factor for maternity 'blues', although it should be confirmed by a prospective randomized trial.

Adult↗
PubMed1984

Anaesthetic morbidity following caesarean section under epidural or general anaesthesia.

To find out whether morbidity in the first postoperative week is affected by type of anaesthetic technique, healthy patients who had caesarean sections under epidural anaesthesia were compared with those who were given a general anaesthetic. Epidural anaesthesia was associated with less pain (p less than 0.00001) and discomfort in the immediate postoperative period. By the second day fewer epidural patients had gastrointestinal stasis, pyrexia (p less than 0.05), and coughing (p less than 0.00001). Breastfeeding and mobilisation started earlier. Fewer mothers were coughing (p less than 0.005), had fever (p less than 0.01), or felt tired and depressed (p less than 0.005) by the sixth postoperative day after epidural caesarean section. The epidemiology of anaesthetic morbidity needs to be assessed in other surgical patients.

Anesthesia, Epidural↗
PubMed1998

An epidemiological and clinical investigation of postpartum psychiatric illness in Japanese mothers.

A case note study of postpartum psychiatric illness as defined by Research Diagnostic Criteria (RDC) was conducted in an epidemiologically defined large area of Japan. The admission rate was 0.34/1000 live births. The most frequent diagnostic category was affective disorder (53%). "Atypical" symptoms were observed in 31% of all cases and were more frequent (67%) in patients with schizoaffective disorder. Fifty six percent of mothers developed a psychiatric illness within two weeks of delivery. The patients with "atypical" symptoms were admitted much more quickly and their length of stay in hospital was shorter.

Adult↗
PubMed1976

The influence of childbirth on psychiatric morbidity.

The Camberwell Psychiatric Register was searched for contacts by the 2257 women resident in the register catchment area who were known to have had a child in 1970. Of these, 99 women (and 39 of their husbands) were found to have had a 'new episode' of psychiatric illness in the two years before or the two years after the birth of their child. The distribution of these 'new episodes' relative to the time of childbirth was then studied. In the women, both functional psychoses and depressive illnesses showed a sharp rise in the new episode rate in the three months immediately after delivery. There was also a suggestion of a secondary rise, less dramatic but more sustained, from the 10th to the 24th month after delivery. There was no comparable rise in the husbands. Women whose children were illegitimate had high new episode rates throughout the four-year study period, but not particularly so in the puerperium itself.

Adjustment Disorders↗