ESTRATEGIAS DE INTERVENCIÓN PARA LA DEPRESIÓN POSPARTO: REVISIÓN BIBLIOGRÁFICA
Resumen
La depresión posparto (DPP) es una enfermedad que afecta significativamente a la salud mental de las madres y al desarrollo de sus hijos. Con múltiples enfoques terapéuticos disponibles, es crucial identificar los más efectivos para tratar y manejar esta condición. Objetivo: Este artículo tiene como objetivo revisar y sintetizar las estrategias de intervención para la depresión posparto, destacando las terapias basadas en la evidencia y explorando los enfoques farmacológicos, psicológicos y alternativos en el tratamiento de la DPP. Métodos: Se realizó una revisión bibliográfica de los últimos 20 años, que abarcó estudios sobre la eficacia de la terapia cognitivo-conductual (TCC), la terapia interpersonal (TIP), las intervenciones psicoeducativas, los tratamientos farmacológicos y las prácticas de mindfulness y yoga. Resultados y Discusión: Terapias como la TCC y la TIP han demostrado ser eficaces para aliviar los síntomas de la DPP y mejorar el ajuste psicológico. Las intervenciones online y psicoeducativas facilitan el acceso y la adherencia al tratamiento. Los antidepresivos requieren una cuidadosa consideración en cuanto a su seguridad durante la lactancia. Las prácticas complementarias como el yoga y la atención plena son beneficiosas para reducir la ansiedad y promover el bienestar, lo que subraya la importancia de un enfoque holístico e integrador del tratamiento. Conclusión: La combinación de tratamientos psicológicos, farmacológicos y holísticos, adaptados a las necesidades individuales, es esencial para el tratamiento eficaz de la DPP.
Biografía del autor/a
Acadêmica de Medicina.
Acadêmica de Medicina.
Acadêmica de Medicina.
Acadêmica de Medicina.
Acadêmica de Medicina.
Acadêmico de Medicina.
Acadêmico de Medicina.
Acadêmico de Medicina.
Acadêmico de Medicina.
Acadêmico de Medicina.
Referencias
ANDERSSON, Gerhard et al. Guided Internet‐based vs. face‐to‐face cognitive behavior therapy for psychiatric and somatic disorders: a systematic review and meta‐analysis. World psychiatry, v. 13, n. 3, p. 288-295, 2014. DOI: https://doi.org/10.1002/wps.20151
BRUGHA, Traolach S. et al. Universal prevention of depression in women postnatally: cluster randomized trial evidence in primary care. Psychological medicine, v. 41, n. 4, p. 739-748, 2011. DOI: https://doi.org/10.1017/S0033291710001467
BRUMMELTE, Susanne; GALEA, Liisa AM. Postpartum depression: Etiology, treatment and consequences for maternal care. Hormones and behavior, v. 77, p. 153-166, 2016. DOI: https://doi.org/10.1016/j.yhbeh.2015.08.008
CUIJPERS, Pim; BRÄNNMARK, Jessica G.; VAN STRATEN, Annemieke. Psychological treatment of postpartum depression: a meta‐analysis. Journal of clinical psychology, v. 64, n. 1, p. 103-118, 2008. DOI: https://doi.org/10.1002/jclp.20432
DENNIS, Cindy‐Lee; CHUNG‐LEE, Leinic. Postpartum depression help‐seeking barriers and maternal treatment preferences: A qualitative systematic review. Birth, v. 33, n. 4, p. 323-331, 2006. DOI: https://doi.org/10.1111/j.1523-536X.2006.00130.x
DENNIS, Cindy‐Lee; HODNETT, Ellen D. Psychosocial and psychological interventions for treating postpartum depression. Cochrane database of systematic reviews, n. 4, 2007. DOI: https://doi.org/10.1002/14651858.CD006116.pub2
DOĞAN, Reyhan Aydin; BEJI, Nezihe Kizilkaya. Quality of life and depression conditions of women with gestational diabetes during pregnancy and postpartum period. Revista Brasileira de Ginecologia e Obstetrícia, v. 45, p. 065-073, 2023. DOI: https://doi.org/10.1055/s-0043-1764494
DRYER, Rachel; BRUNTON, R. Pregnancy-Related Anxiety. Theory, Research, and Practice, 2021. DOI: https://doi.org/10.4324/9781003014003
DUNCAN, Larissa G.; BARDACKE, Nancy. Mindfulness-based childbirth and parenting education: promoting family mindfulness during the perinatal period. Journal of child and family studies, v. 19, p. 190-202, 2010. DOI: https://doi.org/10.1007/s10826-009-9313-7
EBERT, David Daniel et al. Prevention of mental health disorders using internet-and mobile-based interventions: a narrative review and recommendations for future research. Frontiers in psychiatry, v. 8, p. 232196, 2017. DOI: https://doi.org/10.3389/fpsyt.2017.00116
FRANK, Ellen; SWARTZ, Holly A.; KUPFER, David J. Interpersonal and social rhythm therapy: managing the chaos of bipolar disorder. Bipolar Disorder, p. 257-268, 2019. DOI: https://doi.org/10.4324/9781315054308-27
GIDÉN, Karin et al. Feeling better?–Identification, interventions, and remission among women with early postpartum depressive symptoms in Sweden: a nested cohort study. European Psychiatry, v. 67, n. 1, p. e14, 2024. DOI: https://doi.org/10.1192/j.eurpsy.2024.6
GRIGORIADIS, Sophie et al. Antidepressant exposure during pregnancy and congenital malformations: is there an association? A systematic review and meta-analysis of the best evidence. The Journal of clinical psychiatry, v. 74, n. 4, p. 903, 2013. DOI: https://doi.org/10.4088/JCP.12r07966
GROTE, Nancy K. et al. A randomized controlled trial of culturally relevant, brief interpersonal psychotherapy for perinatal depression. Psychiatric Services, v. 60, n. 3, p. 313-321, 2009. DOI: https://doi.org/10.1176/ps.2009.60.3.313
HOWARD, Louise M. et al. Non-psychotic mental disorders in the perinatal period. The Lancet, v. 384, n. 9956, p. 1775-1788, 2014. DOI: https://doi.org/10.1016/S0140-6736(14)61276-9
JORDAN, Sue et al. Antidepressant prescriptions, discontinuation, depression and perinatal outcomes, including breastfeeding: a population cohort analysis. PLoS one, v. 14, n. 11, p. e0225133, 2019. DOI: https://doi.org/10.1371/journal.pone.0225133
KOZHIMANNIL, Katy Backes et al. Racial and ethnic disparities in postpartum depression care among low-income women. Psychiatric Services, v. 62, n. 6, p. 619-625, 2011. DOI: https://doi.org/10.1176/ps.62.6.pss6206_0619
KUMAR, Vikram et al. The effectiveness of internet-based cognitive behavioral therapy in treatment of psychiatric disorders. Cureus, v. 9, n. 8, 2017. DOI: https://doi.org/10.7759/cureus.1626
LE, Huynh-Nhu; PERRY, Deborah F.; STUART, Elizabeth A. Randomized controlled trial of a preventive intervention for perinatal depression in high-risk Latinas. Journal of consulting and clinical psychology, v. 79, n. 2, p. 135, 2011. DOI: https://doi.org/10.1037/a0022492
LEVIS, Brooke et al. Accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression among pregnant and postpartum women: systematic review and meta-analysis of individual participant data. BMJ, v. 371, 2020. DOI: https://doi.org/10.1136/bmj.m4022
MILGROM, Jeannette et al. Antenatal risk factors for postnatal depression: a large prospective study. Journal of affective disorders, v. 108, n. 1-2, p. 147-157, 2008. DOI: https://doi.org/10.1016/j.jad.2007.10.014
MU, Ting‐Yu et al. Internet‐based interventions for postpartum depression: A systematic review and meta‐analysis. Nursing open, v. 8, n. 3, p. 1125-1134, 2021. DOI: https://doi.org/10.1002/nop2.724
MUZIK, Maria et al. Mindfulness yoga during pregnancy for psychiatrically at-risk women: Preliminary results from a pilot feasibility study. Complementary therapies in clinical practice, v. 18, n. 4, p. 235-240, 2012. DOI: https://doi.org/10.1016/j.ctcp.2012.06.006
O'HARA, Michael W.; MCCABE, Jennifer E. Postpartum depression: current status and future directions. Annual review of clinical psychology, v. 9, p. 379-407, 2013. DOI: https://doi.org/10.1146/annurev-clinpsy-050212-185612
O'MAHEN, Heather A. et al. Internet-based behavioral activation—Treatment for postnatal depression (Netmums): A randomized controlled trial. Journal of affective disorders, v. 150, n. 3, p. 814-822, 2013. DOI: https://doi.org/10.1016/j.jad.2013.03.005
O'MAHEN, Heather A.; FLYNN, Heather A. Preferences and perceived barriers to treatment for depression during the perinatal period. Journal of women's health, v. 17, n. 8, p. 1301-1309, 2008. DOI: https://doi.org/10.1089/jwh.2007.0631
PARK, Seong-Hi; KIM, Jeung-Im. Predictive validity of the Edinburgh postnatal depression scale and other tools for screening depression in pregnant and postpartum women: a systematic review and meta-analysis. Archives of Gynecology and Obstetrics, v. 307, n. 5, p. 1331-1345, 2023. DOI: https://doi.org/10.1007/s00404-022-06525-0
PAYNE, Jennifer L.; MAGUIRE, Jamie. Pathophysiological mechanisms implicated in postpartum depression. Frontiers in neuroendocrinology, v. 52, p. 165-180, 2019. DOI: https://doi.org/10.1016/j.yfrne.2018.12.001
PEARSON, R. M. et al. Depressive symptoms in early pregnancy disrupt attentional processing of infant emotion. Psychological medicine, v. 40, n. 4, p. 621-631, 2010. DOI: https://doi.org/10.1017/S0033291709990961
REYES, Jessica et al. Usability and acceptability of everhealthier women, a mobile application to enhance informed health choices. Journal of Obstetric, Gynecologic & Neonatal Nursing, v. 47, n. 6, p. 853-861, 2018. DOI: https://doi.org/10.1016/j.jogn.2018.04.139
SEGRE, Lisa S.; STUART, Scott; O'HARA, Michael W. Interpersonal Psychotherapy for Antenatal and Postpartum Depression. Primary Psychiatry, 2004.
SERATI, M. et al. Perinatal major depression biomarkers: a systematic review. Journal of affective disorders, v. 193, p. 391-404, 2016. DOI: https://doi.org/10.1016/j.jad.2016.01.027
SHARMA, Manoj; RUSH, Sarah E. Mindfulness-based stress reduction as a stress management intervention for healthy individuals: a systematic review. Journal of evidence-based complementary & alternative medicine, v. 19, n. 4, p. 271-286, 2014. DOI: https://doi.org/10.1177/2156587214543143
SOCKOL, Laura E. A systematic review and meta-analysis of interpersonal psychotherapy for perinatal women. Journal of affective disorders, v. 232, p. 316-328, 2018. DOI: https://doi.org/10.1016/j.jad.2018.01.018
SOCKOL, Laura E. A systematic review of the efficacy of cognitive behavioral therapy for treating and preventing perinatal depression. Journal of affective disorders, v. 177, p. 7-21, 2015. DOI: https://doi.org/10.1016/j.jad.2015.01.052
STEIN, Alan et al. Effects of perinatal mental disorders on the fetus and child. The Lancet, v. 384, n. 9956, p. 1800-1819, 2014. DOI: https://doi.org/10.1016/S0140-6736(14)61277-0
STEWART, Donna E.; VIGOD, Simone N. Postpartum depression: pathophysiology, treatment, and emerging therapeutics. Annual review of medicine, v. 70, p. 183-196, 2019. DOI: https://doi.org/10.1146/annurev-med-041217-011106
SUFREDINI, Francieli et al. The effects of social support on depression and anxiety in the perinatal period: A mixed-methods systematic review. Journal of Affective Disorders, v. 319, p. 119-141, 2022. DOI: https://doi.org/10.1016/j.jad.2022.09.005
UDECHUKU, Adaobi et al. Antidepressants in pregnancy: a systematic review. Australian & New Zealand Journal of Psychiatry, v. 44, n. 11, p. 978-996, 2010.
VELDERS, Fleur P. et al. Prenatal and postnatal psychological symptoms of parents and family functioning: the impact on child emotional and behavioural problems. European child & adolescent psychiatry, v. 20, p. 341-350, 2011. DOI: https://doi.org/10.1007/s00787-011-0178-0
VIDHYALAKSHMI, R. Effect of IAYT (Integrated Approach of Yoga Therapy) on motor nerve conductivity in spastic hemiplegic men. 2018. Tese (Doutorado) - Government Yoga and Naturopathy Medical College, Chennai, 2018.
WALLACE, Maeve E. et al. Joint effects of structural racism and income inequality on small-for-gestational-age birth. American journal of public health, v. 105, n. 8, p. 1681-1688, 2015. DOI: https://doi.org/10.2105/AJPH.2015.302613
WEISSMAN, Alicia M. et al. Pooled analysis of antidepressant levels in lactating mothers, breast milk, and nursing infants. American Journal of Psychiatry, v. 161, n. 6, p. 1066-1078, 2004. DOI: https://doi.org/10.1176/appi.ajp.161.6.1066
WOOLHOUSE, Hannah et al. Antenatal mindfulness intervention to reduce depression, anxiety and stress: a pilot randomised controlled trial of the MindBabyBody program in an Australian tertiary maternity hospital. BMC pregnancy and childbirth, v. 14, p. 1-16, 2014. DOI: https://doi.org/10.1186/s12884-014-0369-z
Licencia
Derechos de autor 2024 RECIMA21 - Revista Científica Multidisciplinar - ISSN 2675-6218
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
Os direitos autorais dos artigos/resenhas/TCCs publicados pertecem à revista RECIMA21, e seguem o padrão Creative Commons (CC BY 4.0), permitindo a cópia ou reprodução, desde que cite a fonte e respeite os direitos dos autores e contenham menção aos mesmos nos créditos. Toda e qualquer obra publicada na revista, seu conteúdo é de responsabilidade dos autores, cabendo a RECIMA21 apenas ser o veículo de divulgação, seguindo os padrões nacionais e internacionais de publicação.