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Major depressive disorder (MDD), also known as clinical depression, is a mental disorder characterized by at least two weeks of pervasive low mood, low self-esteem, and loss of interest or pleasure in normally enjoyable activities. Introduced by a group of US clinicians in the mid-1970s, the term was adopted by the American Psychiatric Association for this symptom cluster under mood disorders in the 1980 version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), and has become widely used since.
Postpartum depression (PPD), also called postnatal depression, is a type of mood disorder associated with childbirth, which can affect both sexes. Symptoms may include extreme sadness, low energy, anxiety, crying episodes, irritability, and changes in sleeping or eating patterns. Onset is typically between one week and one month following childbirth. PPD can also negatively affect the newborn child.
The postpartum period begins within 6 weeks after childbirth as the mother's body, including hormone levels and uterus size, returns to a non-pregnant state. The terms puerperium, puerperal period, or immediate postpartum period are commonly used to refer to the first six weeks following childbirth. The World Health Organization (WHO) describes the postnatal period as the most critical and yet the most neglected phase in the lives of mothers and babies; most maternal and newborn deaths occur during this period.
Couvade syndrome, also called sympathetic pregnancy, is a proposed condition in which an expectant father experiences some of the same symptoms and behavior as his pregnant partner. These most often include major weight gain, altered hormone levels, morning nausea, and disturbed sleep patterns. In more extreme cases, symptoms can include labor pains, fatigue, postpartum depression, and nosebleeds. The labor pain symptom is commonly known as sympathy pain.
Postpartum blues, also known as baby blues and maternity blues, is a very common but self-limited condition that begins shortly after childbirth and can present with a variety of symptoms such as mood swings, irritability, and tearfulness. Mothers may experience negative mood symptoms mixed with intense periods of joy. Up to 85% of new mothers are affected by postpartum blues, with symptoms starting within a few days after childbirth and lasting up to two weeks in duration. Treatment is supportive, including ensuring adequate sleep and emotional support. If symptoms are severe enough to affect daily functioning or last longer than two weeks, the individual should be evaluated for related postpartum psychiatric conditions, such as postpartum depression and postpartum anxiety. It is unclear whether the condition can be prevented, however education and reassurance are important to help alleviate patient distress.
Psychoneuroendocrinology is the clinical study of hormone fluctuations and their relationship to human behavior. It may be viewed from the perspective of psychiatry, where in certain mood disorders, there are associated neuroendocrine or hormonal changes affecting the brain. It may also be viewed from the perspective of endocrinology, where certain endocrine disorders can be associated with negative health outcomes and psychiatric illness. Brain dysfunctions associated with the hypothalamus-pituitary-adrenal axis HPA axis can affect the endocrine system, which in turn can result in physiological and psychological symptoms. This complex blend of psychiatry, psychology, neurology, biochemistry, and endocrinology is needed to comprehensively understand and treat symptoms related to the brain, endocrine system (hormones), and psychological health..
Postpartum thyroiditis refers to thyroid dysfunction occurring in the first 12 months after pregnancy and may involve hyperthyroidism, hypothyroidism or the two sequentially. According to the National Institute of Health, postpartum thyroiditis affects about 8% of pregnancies. There are, however, different rates reported globally. This is likely due to the differing amounts of average postpartum follow times around the world, and due to humans' own innate differences. For example, in Bangkok, Thailand the rate is 1.1%, but in Brazil it is 13.3%. The first phase is typically hyperthyroidism. Then, the thyroid either returns to normal or a woman develops hypothyroidism. Of those women who experience hypothyroidism associated with postpartum thyroiditis, one in five will develop permanent hypothyroidism requiring lifelong treatment.
The Montgomery–Åsberg Depression Rating Scale (MADRS) is a ten-item diagnostic questionnaire which psychiatrists use to measure the severity of depressive episodes in patients with mood disorders. It was designed in 1979 by British and Swedish researchers as an adjunct to the Hamilton Rating Scale for Depression (HAMD) which would be more sensitive to the changes brought on by antidepressants and other forms of treatment than the Hamilton Scale was. There is, however, a high degree of statistical correlation between scores on the two measures.
A depression rating scale is a psychiatric measuring instrument having descriptive words and phrases that indicate the severity of depression for a time period. When used, an observer may make judgements and rate a person at a specified scale level with respect to identified characteristics. Rather than being used to diagnose depression, a depression rating scale may be used to assign a score to a person's behaviour where that score may be used to determine whether that person should be evaluated more thoroughly for a depressive disorder diagnosis. Several rating scales are used for this purpose.
Early intervention in psychosis is a clinical approach to those experiencing symptoms of psychosis for the first time. It forms part of a new prevention paradigm for psychiatry and is leading to reform of mental health services, especially in the United Kingdom and Australia.
A postpartum disorder or puerperal disorder is a disease or condition which presents primarily during the days and weeks after childbirth called the postpartum period. The postpartum period can be divided into three distinct stages: the initial or acute phase, 6–12 hours after childbirth; subacute postpartum period, which lasts two to six weeks, and the delayed postpartum period, which can last up to six months. In the subacute postpartum period, 87% to 94% of women report at least one health problem. Long term health problems are reported by 31% of women.
Trauma Screening Questionnaire abbreviated as (TSQ) is a questionnaire developed for screening of posttraumatic stress disorder. The TSQ was adapted from the PTSD Symptom Scale – Self-Report Version (PSS-SR). This self-reported assessment scale consists of 10 items, which cover one of the main signs of PTSD. Each item is answered with binary yes or no responses. Overall assessment is done by total score, and the total score higher than 5 indicates on likelihood of PTSD. The TSQ is considered as a valid assessment scale for screening of posttraumatic stress disorder.
The Patient Health Questionnaire (PHQ) is a multiple-choice self-report inventory that is used as a screening and diagnostic tool for mental health disorders of depression, anxiety, alcohol, eating, and somatoform disorders. It is the self-report version of the Primary Care Evaluation of Mental Disorders (PRIME-MD), a diagnostic tool developed in the mid-1990s by Pfizer Inc. The length of the original assessment limited its feasibility; consequently, a shorter version, consisting of 11 multi-part questions - the Patient Health Questionnaire was developed and validated.
Childbirth-related post-traumatic stress disorder is a psychological disorder that can develop in women who have recently given birth. This disorder can also affect men or partners who have observed a difficult birth. Its symptoms are not distinct from post-traumatic stress disorder (PTSD).
Antenatal depression, also known as prenatal or perinatal depression, is a form of clinical depression that can affect a woman during pregnancy, and can be a precursor to postpartum depression if not properly treated. It is estimated that 7% to 20% of pregnant women are affected by this condition. Any form of prenatal stress felt by the mother can have negative effects on various aspects of fetal development, which can cause harm to the mother and child. Even after birth, a child born from a depressed or stressed mother feels the affects. The child is less active and can also experience emotional distress. Antenatal depression can be caused by the stress and worry that pregnancy can bring, but at a more severe level. Other triggers include unplanned pregnancy, difficulty becoming pregnant, history of abuse, and economic or family situations.
The Mood Disorder Questionnaire (MDQ) is a self-report questionnaire designed to help detect bipolar disorder. It focuses on symptoms of hypomania and mania, which are the mood states that separate bipolar disorders from other types of depression and mood disorder. It has 5 main questions, and the first question has 13 parts, for a total of 17 questions. The MDQ was originally tested with adults, but it also has been studied in adolescents ages 11 years and above. It takes approximately 5–10 minutes to complete. In 2006, a parent-report version was created to allow for assessment of bipolar symptoms in children or adolescents from a caregiver perspective, with the research looking at youths as young as 5 years old. The MDQ has become one of the most widely studied and used questionnaires for bipolar disorder, and it has been translated into more than a dozen languages.
The Child Mania Rating Scales (CMRS) is a 21-item diagnostic screening measure designed to identify symptoms of mania in children and adolescents aged 9–17 using diagnostic criteria from the DSM-IV, developed by Pavuluri and colleagues. There is also a 10-item short form. The measure assesses the child's mood and behavior symptoms, asking parents or teachers to rate how often the symptoms have caused a problem for the youth in the past month. Clinical studies have found the CMRS to be reliable and valid when completed by parents in the assessment of children's bipolar symptoms. The CMRS also can differentiate cases of pediatric bipolar disorder from those with ADHD or no disorder, as well as delineating bipolar subtypes. A meta-analysis comparing the different rating scales available found that the CMRS was one of the best performing scales in terms of telling cases with bipolar disorder apart from other clinical diagnoses. The CMRS has also been found to provide a reliable and valid assessment of symptoms longitudinally over the course of treatment. The combination of showing good reliability and validity across multiple samples and clinical settings, along with being free and brief to score, make the CMRS a promising tool, especially since most other checklists available for youths do not assess manic symptoms.
The Pediatric Symptom Checklist (PSC) is a 35-item parent-report questionnaire designed to identify children with difficulties in psychosocial functioning. Its primary purpose is to alert pediatricians at an early point about which children would benefit from further assessment. A positive result on the overall scale indicates that the child in question would benefit from further evaluation. It is not a diagnostic tool. The PSC has subscales which measure inner distress and mood, interpersonal relations and behavior, and attention. The PSC is also used in pediatrics and other settings to measure changes in psychosocial functioning over time. Michael Jellinek, MD, created the PSC and has researched it over more than thirty years in collaboration with J. Michael Murphy, Ed.D. and other investigators. The PSC has been used in more than 200 studies in the US and other countries and has been endorsed by the American Academy of Pediatrics, the state of Massachusetts, the government of Chile and many other organizations.
Evolutionary approaches to postpartum depression examine the syndrome from the framework of evolutionary theory.
Post-adoption depression is shown though symptoms of depression in the adoptive mother or father, generally seen from one month after adoption, and is experienced by anywhere from 10% to 32% of adoptive parents. The symptoms of post-adoption depression are common to symptoms of depression, and include changes in sleeping pattern and appetite, feelings of hopelessness, fatigue, problems with concentration and restlessness, as well as suicidal thoughts. These symptoms are also similar to those of postpartum depression, which is a related syndrome. Postpartum depression, however, involves hormonal changes in pregnant woman, which are not present in women suffering from post-adoption depression. Despite this difference, there are still significant changes that new parents go through, even when the child is not biologically their own. These changes can have significant impacts on mental health. Post-adoption depression can also negatively impact the child.
References
- ↑ Cox J.L.; Holden J.M.; Sagovsky R. (1987). "Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale". Br J Psychiatry. 150: 782–6. doi:10.1192/bjp.150.6.782. PMID 3651732. S2CID 13841634.
- ↑ Cox J.L.; Holden J.M.; Sagovsky R. (1987). "Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale". Br J Psychiatry. 150: 782–6. doi:10.1192/bjp.150.6.782. PMID 3651732. S2CID 13841634.
- ↑ Bergink V, Kooistra L; Lambregtse-van, den Berg MP; Wijnen H; Bunevicius R; van Baar A; Pop V (Apr 2011). "Validation of the Edinburgh Depression Scale during pregnancy". J Psychosom Res. 70 (4): 385–9. doi:10.1016/j.jpsychores.2010.07.008. PMID 21414460.
- ↑ Garcia-Esteve L, Ascaso C, Ojuel J, Navarro P (Jun 2003). "Validation of the Edinburgh Postnatal Depression Scale (EPDS) in Spanish mothers". J Affect Disord. 75 (1): 71–6. doi:10.1016/s0165-0327(02)00020-4. PMID 12781353.
- ↑ Bergant AM, Nguyen T, Heim K, Ulmer H, Dapunt O (Jan 1998). "German language version and validation of the Edinburgh postnatal depression scale". Dtsch Med Wochenschr. 123 (3): 35–40. doi:10.1055/s-2007-1023895. PMID 9472218.
- ↑ Vivilaki VG, Dafermos V, Kogevinas M, Bitsios P, Lionis C (Sep 2009). "The Edinburgh Postnatal Depression Scale: translation and validation for a Greek sample". BMC Public Health. 9: 329. doi:10.1186/1471-2458-9-329. PMC 2748079 . PMID 19740443.
- ↑ http://www2.illinois.gov/hfs/MedicalProvider/MaternalandChildHealthPromotion/Pages/Edinburgh.aspx Archived 2015-06-15 at the Wayback Machine ,