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Yıl:2012; Cilt: 13; Sayı: 1>> Özet
Anadolu Psikiyatri Dergisi; 2012;13(1):16-23
Erzurum il merkezinde doğum sonrası depresyonlarının sıklık ve yaygınlığı ile DSM-IV tanısal dağılımı: İleriye dönük bir çalışma
İ Kirpinar, IÖ Tepeli, S Gözüm, T Pasinlioğlu
Bezmi Alem Vakıf Üniversitesi Tıp Fakültesi Psikiyatri ABD, İstanbul
Amaç: Doğum sonrası depresyonlarının (DSD) sıklık ve yaygınlığı ile tanısal durumunu inceleyen çalışmalar çelişkili sonuçlar bildirmektedir. Erzurum il merkezinde doğum sonrası depresyonlarının gelişimini inceleyen ileriye dönük, epidemiyolojik bir çalışmanın bir kısmını oluşturan bu yazı, doğum sonrası altıncı haftada depresyonların sıklık ve yaygınlığı ile DSM-IV'e göre tanısal dağılımını incelemeyi amaçlamaktadır. Yöntem: Üçüncü trimestrde saptanan 479 kadın, gebelikte ve doğumdan sonraki 7-10 gün ile altıncı haftada eğitimli ebeler tarafından evlerinde ziyaret edildi. Her ziyaret sırasında sosyodemografik ve sağlık değişkenlerine ilişkin sorguluklar ile doğum sonrası altıncı haftada Edinburgh Doğum Sonrası Depresyon Ölçeği (EDSDÖ) dolduruldu. EDSDÖ ile DSD saptanan anneler psikiyatrist tarafından ziyaret edilerek depresyonların zamansal durumları ve SCID ile tanı-ları belirlendi. Sonuçlar: Bu anne grubunda EDSDÖ ile altıncı haftada saptanan DSD yaygınlığı %14 olarak belirlendi. Klinik görüşme sonucu sıklık %6 olarak hesaplandı. SCID'le belirlenen DSM-IV tanı dağılımına göre depresif annelerin %74'ü nde belirtiler majör depresif bozukluk tanı ölçütlerini karşılamakla birlikte, başka depreş-yon tanıları konan anneler de oldu. Tartışma: DSD için bu grupta saptanan sıklık ve yaygınlık oranları, başka dönemdeki kadınlardan anlamlı farklılıklar göstermemektedir. Tanısal dağılımı değerlendirildiğinde DSD özgül bir klinik tanı olarak görülmemektedir. (Anadolu Psikiyatri Derg 2012; 13:16-23) Anahtar sözcükler: Doğum sonrası depresyonu, sıklık, yaygınlık, Edinburgh Doğum Sonrası Depresyon Ölçeği
Is postpartum depression a specific diagnosis? A prospective study
Objective: The studies investigating the prevalence and incidence of postpartum depression (PPD), as well as its nosologic status have controversial results. This article is part of a prospective, epidemiological study concerning postpartum depression in Erzurum City, Eastern Turkey. The present study focuses on the prevalence and incidence of PPD at sixth weeks after delivery and its diagnostic distribution according to DSM-IV. Methods: Four hundred and seventy-nine pregnant women in their third trimester were arranged to be visited by trained community midwives at 7-10 days and sixth weeks after delivery. Data were collected by use of the questionnaires on detailed sociodemographic and health information at each visit and the participitants filled out the Edinburgh Postpartum Depression Scale (EPDS) at six weeks after delivery. Finally, mothers who had PPD diagnosis according to EPDS were visited by a psychiatrist in their homes where the SCID was administered to make a DSM-IV diagnosis and determine whether the depression occurred before or after delivery. Results: The prevalence rate of PPD measured by EPDS was 14% in this population. The incidence of PPD was estimated as 6% with clinical interviews. Most of the depressed mothers (74.0%) were diagnosed as major depressive disorder according to DSM-IV, but there were some other depressive states too. Conclusion: The prevalence and incidence rates of PPD do not appear to be significantly different from those of non-childbearing women. PPD should not be seen as a specific clinical entity as far as its diagnostic distribution is concerned.

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