Zum Hauptinhalt springen

Schwangerschafts- und Wochenbettdepression

Zuletzt bearbeitet: Zuletzt revidiert:
Zuletzt revidiert von:


Definition:
Peripartale Depressionen umfassen die antenatale, in der Schwangerschaft auftretende, sowie die postpartale Depression, die meist innerhalb von 4 Wochen nach der Geburt auftritt.
Häufigkeit:
Prävalenz ca. 10–15 % aller Schwangeren/Gebärenden.
Symptome:
Niedergeschlagenheit, Weinanfälle, Freudlosigkeit, Schlaflosigkeit, Erschöpfung, Essstörungen, Suizidgedanken sowie wiederkehrende Gedanken an den Tod.
Befunde:
Die klinischen Befunde sind sehr vielfältig und meist Folge der psychischen Belastung.
Diagnostik:
Insbesondere eingehende Anamnese, ggf. gestützt durch Fragebögen, sowie klinische Untersuchung. Weitere Untersuchungen sind insbesondere zum Ausschluss von Differenzialdiagnosen von Bedeutung.
Therapie:
Entlastung und Unterstützung, ggf. Psychotherapie und Antidepressiva. Stationäre Behandlung bei schwerer Depression.
  • Gesellschaft für Neonatologie und pädiatrische Intensivmedizin e.V. (GNPI). Psychosoziale Betreuung von Familien mit Früh- und Neugeborenen. AWMF-Leitlinie Nr. 024-27. S2k, Stand 2018. www.awmf.org .
  • NVL-Programm von BÄK, KBV, AWMF. Nationale VersorgungsLeitlinie. Unipolare Depression. S3, Stand 2017. www.awmf.org .
  1. NVL-Programm von BÄK, KBV, AWMF. Nationale VersorgungsLeitlinie Unipolare Depression. AWMF-Register-Nr.: nvl-005. Stand 2017 www.awmf.org  
  2. Wisner KL, Parry BL, Piontek CM. Postpartum depression. N Engl J Med 2002; 347: 194-9. PubMed  
  3. Langan RC, Goodbred AJ. Identification and management of peripartum depression. Am Fam Physician. 2016 May 15;93(10):852-858 PubMed  
  4. Brockington I. Postpartum psychiatric disorders. Lancet 2004; 363: 303-10. PubMed  
  5. Palladino CL, Singh V, Campbell J, Flynn H, Gold KJ. Homicide and suicide during the perinatal period: findings from the National Violent Death Reporting System. Obstet Gynecol 2011; 118(5): 1056-63. pmid:22015873 PubMed  
  6. Wisner Kl, Peindl KS, Hanusa BH. Symptomatology of affective and psychotic illnesses related to childbearing. J Affect Disord 1994; 30: 77-87. PubMed  
  7. Psychosoziale Betreuung von Familien mit Früh- und Neugeborenen. Registernummer 024-027. S2k, Stand 2018. www.awmf.org  
  8. MMWR. Prevalence of Self-Reported Postpartum Depressive Symptoms-17 States, 2004-2005. JAMA 2008. 19: 2268-70. pubmed.ncbi.nlm.nih.gov  
  9. Kumar R. Postnatal mental illness: a transcultural perspective. Soc Psychiatry Psychiatr Epidemiol 1994; 29: 250-64. PubMed  
  10. Eberhard-Gran M, Tambs K, Opjordsmoen S, Skrondal A, Eskild A. Depression during pregnancy and after delivery: A repeated measurement study. J Psychosom Obstet Gynecol 2004; 25: 15-21. PubMed  
  11. Lancaster CA, Gold KJ, Flynn HA, Yoo H, Marcus SM, Davis MM. Risk factors for depressive symptoms during pregnancy: a systematic review. Am J Obstet Gynecol 2010 Jan; 202(1): 5-14. pmid:20096252 PubMed  
  12. Swendsen JD, Mazure CM. Life stress as a risk factor for pastpartum depression: current research and methodological issues. Clin Psychol Sci Pract 2000; 7: 17-31. onlinelibrary.wiley.com  
  13. O'Hara MW, Swain AM. Rates and risks of postpartum depression: a meta-analysis. Int Rev Psychiatry 1996; 8: 37-54. psycnet.apa.org  
  14. Beck CT. A meta-analysis of predictors of postpartum depression. Nurs Res 1996; 45: 297-303. PubMed  
  15. Wilson LM, Reid AJ, Midmer DK, et al. Antenatal psychosocial risk factors associated with adverse postnatal family outcomes. CMAJ 1996; 154: 785-99. pubmed.ncbi.nlm.nih.gov  
  16. Ludermir AB, Lewis G, Valongueiro SA et al. Violence against women by their intimate partner during pregnancy and postnatal depression: a prospective cohort study. Lancet 2010; 376: 903-10. PubMed  
  17. Wisner KL, Stowe ZN. Psychobiology of postpartum mood disorders. Semin Reprod Endocrinol 1997; 15: 77-89. PubMed  
  18. Bjørk MH, Veiby G, Reiter SC, et al. Depression and anxiety in women with epilepsy during pregnancy and after delivery: A prospective population-based cohort study on frequency, risk factors, medication, and prognosis. Epilepsia 2015; 56: 28-39. doi:10.1111/epi.12884 DOI  
  19. Ferber SG, Granot M, Zimmer EZ. Catastrophizing labor pain compromises later maternity adjustments. Am J Obstet Gynecol 2005; 192: 826-31. PubMed  
  20. Roy-Byrne PP. Postpartum blues and unipolar depression: Epidemiology, clinical features, assessment, and diagnosis. UpTpDate, sist oppdatert Juli 2014 www.uptodate.com  
  21. Stewart DE. Psychiatric admission of mentally ill mothers with their infants. Can J Psychiatry 1989; 34: 34 - 8. PubMed  
  22. Mavrogiorgou P, Brüne M, Juckel G. Ärztlich-therapeutisches Vorgehen bei psychiatrischen Notfällen. Deutsches Ärzteblatt 2011; 108 (13): 222-230. www.aerzteblatt.de  
  23. Musters C, McDonald E, Jones I. Management of postnatal depression. BMJ 2008; 337: a736. pubmed.ncbi.nlm.nih.gov  
  24. Embryotox. Pharmakovigilanz - und Beratungszentrum für Embryonaltoxikologie der Charité-Universitätsmedizin Berlin. Stand 2021. https://www.embryotox.de/. www.embryotox.de  
  25. Hirst KP, Moutier CY. Postpartum major depression. Am Fam Physician 2010; 82: 926-33. pubmed.ncbi.nlm.nih.gov  
  26. Huybrechts KF, Palmsten K, Avorn J, et al. Antidepressant Use in Pregnancy and the Risk of Cardiac Defects. N Engl J Med 2014; 370: 2397-407. doi:10.1056/NEJMoa1312828 DOI  
  27. Furu K, Kieler H, Haglund B, et al. Selective serotonin reuptake inhibitors and venlafaxine in early pregnancy and risk of birth defects: population based cohort study and sibling design. BMJ 2015. www.bmj.com  
  28. Lund N, Pedersen LH, Henriksen TB. Selective serotonin reuptake inhibitor exposure in utero and pregnancy outcomes. Arch Pediatr Adolesc Med 2009; 163: 949-54. PubMed  
  29. Deutsche Apotheker-Zeitung. Keine Therapie ist auch keine Lösung. Stand 2021. www.deutsche-apotheker-zeitung.de  
  30. Lee A, Minhas R, Ito S. Safety of St. John's wort during breast-feeding. Clin Pharmacol Ther 2000; 67: 130. pubmed.ncbi.nlm.nih.gov  
  31. McCurdy AP, Boulé NG, Sivak A, Davenport MH. Effects of Exercise on Mild-to-Moderate Depressive Symptoms in the Postpartum Period: A Meta-analysis. Obstet Gynecol 2017 Jun; 129(6): 087-1097. pmid:28486363 PubMed  
  32. O´Hara MW, Stuart S, Gorman LL, Wenzel A. Efficacy of interpersonal psychotherapy for postpartum depression. Arch Gen Psychiatry 2000; 57: 1039 - 45. PubMed  
  33. Sonnenmoser, M. (2007). Postportale Depression: Vom Tief nach der Geburt. Deutscher Ärzte Verlag. http://www.aerzteblatt.de/archiv/54466. www.aerzteblatt.de  
  34. Kühner, C. Mental disorders in pregnancy and postpartum: Prevalence, course, and clinical diagnostics. Nervenarzt. 2016. https://link.springer.com/article/10.1007%2Fs00115-016-0175-0. link.springer.com  
  35. Leiknes KA, Cooke MJ, Jarosch-von Schweder L, Harboe I, Høie B. Electroconvulsive therapy during pregnancy: a systematic review of case studies. Archives of Women's Mental Health, November 2013. pubmed.ncbi.nlm.nih.gov  
  36. Wisner KL, Perel JM, Peindl KS, Hanusa BH et al. Prevention of postpartum depression: a pilot randomized clinical trial. Am J Clin Psychiatry 2004; 161: 1290-2. pubmed.ncbi.nlm.nih.gov  
  37. Gamble J, Creedy D, Moyle W, Webster J, McAllister M, Dickson P. Effectiveness of a counseling intervention after traumatic childbirth: A randomized trial. Birth 2005; 32: 11-19. PubMed  
  38. Glavin K, Smith L, Sørum R, Ellefsen B. Redesigned community postpartum care to prevent and treat postpartum depression in women - a one-year follow-up study. J Clin Nurs 2010; : PMID: 20726926. PubMed  
  39. Dennis CL, Dowswell T. Psychosocial and psychological interventions for preventing postpartum depression. Cochrane Database Syst Rev 2013 Feb 28; 2: CD001134. Cochrane (DOI)  
  40. Dennis C-L, Hodnett E, Reisman HM, et al. Effect of peer support on prevention of postnatal depression among high risk women: multisite randomised controlled trial. BMJ 2009; 338: a3064. BMJ (DOI)  
  41. Miller BJ, Murray L, Beckmann MM, et al. Dietary supplements for preventing postnatal depression. Cochrane Database Syst Rev. 2013; 10:CD009104. (Review) PMID: 24158923 PubMed  
  42. O'Hara MW, Stuart S, Gorman LL, Wenzel A. Efficacy of interpersonal psychotherapy for postpartum depression. Arch Gen Psychiatry 2000; 57: 1039-45. PubMed  
  43. Cooper PJ, Murray L. Course and recurrence of postnatal depression. Evidence for the specificity of the diagnostic concept. Br J Psychiatry 1995; 166: 191-5. British Journal of Psychiatry  
  44. Kumar R, Robson KM. A prospective study of emotional disorders in childbearing women. Br J Psychiatry 1984; 144: 35-47. British Journal of Psychiatry  
  45. Murray L, Cooper PJ. The impact of postpartum depression on child development. Int Rev Psychiatry 1996; 8: 55-63. www.tandfonline.com  
  46. Carter AS, Garrity-Rokous EF, Chazan-Cohen R, et al. Maternal depression and comorbidity: Predicting early parenting, attachment security, and toddler social-emotional problems and competencies. J Am Acad Child Adolesc Psychiatry 2001; 40: 18-26. PubMed  
  47. Hay DF, Pawlby S, Sharp D, et al. Intellectual problems shown by 11-year-old children whose mothers had postnatal depression. J Child Psychol Psychiatry 2001; 42: 871-89. PubMed  
  48. Appleby L. Suicide during pregnancy and in the first postnatal year. BMJ 1991; 302: 137-40. pubmed.ncbi.nlm.nih.gov  
  49. American Psychiatric Association. Guidelines for the treatment of patients with major depressive disorder (revision). Am J Psychiatry 2000; 157 (Suppl): 1-45. pubmed.ncbi.nlm.nih.gov  
  • Moritz Paar, Dr. med., Facharzt für Allgemeinmedizin, Münster/W.

Frühere Autor*innen

  • Die ursprüngliche Version dieses Artikels basiert auf einem entsprechenden Artikel im norwegischen hausärztlichen Online-Handbuch Norsk Elektronisk Legehåndbok(NEL, https://legehandboka.no/).