Provjera postavki biopsihosocijalnoga modela u pojavi postpartalnih psihičkih smetnji [Settings of the biopsychosocial model in the postpartum mental disturbances]

Srkalović Imširagić, Azijada (2016) Provjera postavki biopsihosocijalnoga modela u pojavi postpartalnih psihičkih smetnji [Settings of the biopsychosocial model in the postpartum mental disturbances]. PhD thesis, Sveučilište u Zagrebu.

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Abstract

Aim: The aim was to identify predictors of postpartum depressive and posttraumatic stress disorder (PTSD) symptomatology 3-5 days, 6-9 weeks and 14-18 weeks after childbirth, according to a biopsychosocial model. Methods: Impact of Events Scale revised (IES-R), The Edinburgh Postnatal Depression Scale (EPDS) and other questionnaires were used at 3 study points. Results: Using multivariate levels of analysis, the predictors of acute stress disorder at the first study point were emergency caesarean section, severe and unbearable pain during childbirth and separation from a child. Predictors of depression were unsuccessful early establishment of breastfeeding, personality trait neuroticism and separation from a child. At the second study point the predictors of PTSD were baseline IES-R score and life in a nuclear family (negative connection). Predictors of depression were everyday fear of childbirth outcome during pregnancy, baseline EPDS score and personality trait openness (negative connection). Predictors of PTSD at the third study point were baseline IES-R score and life in a city (negative connection). Predictors of depression were severe and unbearable pain during childbirth and dissociation during childbirth. Conclusion: Biopsychosocial theory is applicable to postpartum psychiatric disorders symptomatology. Besides depression a need for other symptomatology investigation in routine practice exists.

Abstract in Croatian

Cilj: Glavni cilj je bio ustvrditi prediktore simptomatike poslijeporođajne depresije i posttraumatskog stresnog poremećaja (PTSP) tijekom 3-5 dana, 6-9 tjedana i 14-18 tjedana nakon porođaja prema biopsihosocijalnom modelu. Metode: Skala utjecaja događaja – revidirana (IES-R), Edinburška skala postnatalne depresije (EPDS) i drugi upitnici su korišteni u 3 točke studije. Rezultati: Na multivarijatnoj razini analize prediktori akutnog stresnog poremećaja u prvoj točki su bili: hitni carski rez, teška bol tijekom porođaja, nepodnošljiva bol tijekom porođaja, odvojenost od djeteta u rodilištu; prediktori depresije su bili: neuspješna rana uspostava dojenja, osobina ličnosti neuroticizam, odvojenost od djeteta u rodilištu. U drugoj točki prediktori PTSP-a su bili: IES-R zbroj u prvoj točki, život u nuklearnoj obitelji (negativna povezanost), dok su prediktori depresije bili: svakodnevni strah od ishoda porođaja tijekom trudnoće, EPDS zbroj u prvoj točki, osobina ličnosti otvorenost (negativna povezanost). U trećoj točki prediktori PTSP-a su bili: IES-R zbroj u prvoj točki, i život u gradu (negativna povezanost); prediktori depresije su bili: teška bol tijekom porođaja, nepodnošljiva bol tijekom porođaja, disocijacija tijekom porođaja. Zaključak: Biopsihosocijalna teorija je primjenjiva na simptomatiku poslijeporođajnih psihijatrijskih poremećaja. Osim depresije postoji potreba za ispitivanjem druge simptomatike u svakodnevnoj praksi.

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