Evidence Based Practice Project Nursing 2050 – Spring 2016 - Lisa S. Gebler Article Title: Using Short-Term Group Psychotherapy as an Evidence-Based Intervention for First-Time Mothers at Risk for Postpartum Depression Authors: Richard A. Pessagno, DNP, RN, APN-C, CGP, and Diane Hunker, PhD, MBA, RN As Published in: Perspectives in Psychiatric Care ISSN 0031-5990, a journal for advanced psychiatric nursing. The problem this article looks at is postpartum depression, specifically with first-time mothers at risk. First time mothers may have a greater risk because of their expectations coupled with lack of experience. First time mothers also may have a “Super Mom” attitude toward motherhood and may not ask for or admit to needing help, they will try to do it all. Many women suffer from postpartum depression after the birth of a child. Postpartum depression is a serious medical condition which can stem from hormonal changes, the psychological adjustment to motherhood, fatigue, as well as a host of other factors. The purpose of this study was to look at non-pharmacological evidence based treatment as an intervention against postpartum depression. Also to see if this intervention, short-term group psychotherapy, improved the participating mothers scores on the Edinburgh Postnatal Depression Scale or EPDS. The Edinburgh Postnatal Depression Scale is a ten question questionnaire with a self-rating scale. It is a way of identifying women at risk for postpartum depression and
Postpartum depression is one of the most common complications of childbearing with an estimated prevalence of 19.2% in the first three months after delivery (1). Depressive episodes (major and mild) may be experienced by approximately half of women during the first postpartum year (1). Characterized by depressed mood, loss of pleasure or interest in daily activities, feelings of worthlessness and guilt, irritability, sleep and eating disturbances (2), its etiology is multi-faceted and complex (3;4).
Thesis: Postpartum depression is a mood disorder that can greatly effect new mothers. Knowing how to recognize their symptoms and treating it can greatly increase chances of a healthy, happy living.
Postpartum psychiatric disorders, particularly depression, has become the most underdiagnosed complication in the United States. It can lead to increased costs of medical care, inappropriate medical care, child abuse and neglect, discontinuation of breastfeeding, and family dysfunction and adversely affects early brain development (Earls, 2010). Over 400,000 infants are born to mothers that are depressed. One of 7 new mothers (14.5%) experience depressive episodes that impair maternal role function. An episode of major or minor depression that occurs during pregnancy or the first 12 months after birth is called perinatal or postpartum depression (Wisner, Chambers & Sit, 2006). Mothers with postpartum depression experience feelings of extreme sadness, anxiety, and exhaustion that may make it difficult for them to complete daily care activities for themselves or for others (Postpartum Depression). The six stages of postpartum are denial, anger, bargaining, depression, acceptance and PTSD. These stages may affect any women regardless of age, race, ethnicity, or economic status. However only a physician can diagnose a woman with postpartum depression. It does not occur because of something a mother does or does not do, it’s a combination of physical and emotional factors. After childbirth, the levels of hormones in a woman’s body quickly drop; which may lead to chemical changes in her brain (Postpartum Depression). Unbalanced hormones may trigger mood swings.
Postpartum depression, which is the most prevalent of all maternal depressive disorders, is said to be the hidden epidemic of the 21st century. (1) Despite its high prevalence rate of 10-15% and increased incidence, postpartum depression often goes undetected, and thus untreated. (2) Nearly 50% of postpartum depression cases are untreated. As a result, these cases are put at a high risk of being exposed to the severe and progressive nature of their depressive disorder. (3) In other words, the health conditions of untreated postpartum depression cases worsen and progress to one of their utmost stages, and they are: postpartum obsessive compulsive disorder, postpartum panic disorder, postpartum post traumatic stress, and postpartum psychosis.
The birthing process generally leaves women with overwhelming joy and happiness. However, some women do experience a period of postpartum blues lasting for a few days or at most a couple of weeks but goes away with the adjustment of having a baby (Postpartum Depression, 2013). A condition called Postpartum Depression Disorder (PPD) leaves a dark gray cloud over 10-20% of woman after birth that is recognized in individuals 3 weeks to a year after the delivery of their baby (Bobo & Yawn, 2014). PPD leaves new mothers feeling lonely, anxious, and hopeless (Bobo at el, 2014). Postpartum Depression is a cross cutting disorder that can affect any woman after the delivery of a baby regardless of race, socioeconomic status, age, or education level (Postpartum Depression, 2013). Although this disorder affects more than 10% of women the article Concise Review for Physicians and Other Clinicians: Postpartum Depression reports that less than half of women with PPD are actually diagnosed with this condition (Bobo at el, 2014). It is important that postpartum women and their support systems receive education on what PPD consist of and ways to recognize the signs and symptoms of PPD so that a diagnosis is not overlooked. Early diagnosis is important because early recognition and treatment of the disorder yields for better results when treating individuals with PPD. In this paper I will deliver information about PPD based on recent literature,
Of those women, 1053 completed both the initial assessment as well as the follow-up 6-8 weeks after giving birth. The patients self-reported their “height, pre pregnancy weight, and pregnancy weight gain immediately postpartum; their body mass index (BMI) before pregnancy was also calculated.”7 Six to eight weeks later and using the Edinburgh Postnatal Depression Scale (EPDS), patients again self-reported their postpartum weight along with their answers to the questionnaire. The well validated standard for the EPDS is a score of ≥12 to predict PPD. Those that screened positive were referred to other support services and more information regarding whether or not they had support services for PPD was also
The Center for Disease Control estimates that 1 in 20 people suffer from depression (2014). Although widely recognized and somewhat easy to diagnose, depression is an ignored and almost hidden, disease. In women, the statistics are especially grim for those who are pregnant or were recently pregnant. A great number of women suffer from postpartum depression; an illness which is often overlooked, misdiagnosed and untreated. Postpartum depression (PPD) has been defined as an emotional disorder that occurs in an estimated 10-15% of all women after childbirth (Liberto, 2010). Postpartum depression not only impacts the mother, but can cause long-term psychological challenges for the baby and create emotional turmoil for all family members.
Postpartum Depression is important because too often it affects the mother, her spouse, and the newborn child. This affects the relationship between the mother and child based on Erikson’s Psychosocial developmental Theory and the idea of trust vs. mistrust. If the child’s basic needs are not met that could lead to mistrust, anxiety, and insecurities. This could also lead to Reactive Attention Disorder, where the neglect a child experiences leads to difficulty making relationships. It’s also found to be more likely in mothers of colicky babies because if the child cries a lot the mothers are less likely to make an emotional connection.
Depression is a major public health problem that is twice as common in women as men during the childbearing years. Postpartum depression is defined as an episode of non-psychotic depression according to standardized diagnostic criteria with onset within 1 year of childbirth (Stewart D., et. al, 2003, p. 4). For women aged 15 to 44 years around the world, Postpartum Depression is second to HIV/AIDS, in terms of total disability (World Health Organization, 2001). Depression has a profound impact on parameters of interpersonal behavior. Post-Partum depression
What is Postpartum Depression (PPD)? How would you know if you had it? Is it unavoidable, something you just have to endure? Fortunately, Postpartum depression is more akin to a temporary condition that can be managed and counterbalanced with insight, sensitivity, and support. What begins as the “baby blues” is estimated to affect as many as upwards of 80% of women after a birth. Although some purport it is caused by hormonal changes, there remains a lack of consensus as to
"Why do so many women continue to suffer?" Asked Psychotherapist Karen Kleimen in her recent article on postpartum depression in a well-known medical magazine, Psychology Today. "Why is it that postpartum depression and its related conditions continue to be misunderstood by so many healthcare professionals?" Followed Karen. After being constantly bombarded with terrifying effects and the rising number of cases of postpartum depression, many women are raising similar questions as those of Karen and are demanding satisfactory answers from healthcare providers. As a result, healthcare providers have conducted several research and concluded a number of potential causes for postpartum depression.
There is need for people to understand what postpartum depression is and learn how to deal efficiently and effectively with it. According to the national health science (NHS), postpartum depression is defined as a depression that normally occurs after childbirth. To help deal with this issue, a lot of investment has been made for public sensitization on how to handle the issue. However, this effort of public sensitization may yield little results because many people view this problem as a problem of others. This literature review therefore focused on trying to understand the various issues surrounding or leading to postpartum depression and the effects that it has on family experience, starting from the mother, the child, the father and the whole society in general. The study was majorly centered on trying to understand to what extent the depression either directly or indirectly affects the mother, the father and the whole society, in general. The objective of this literature review was to examine and decode a considerable number of relevant articles that had researched and arrived at conclusions that related to postpartum depression. After rigorous review of the literature, it was found out that postpartum depression had a direct effect on the family experience. The findings show how exactly postpartum depression affects the mother, the father/family, the child and the whole society in general. This
Only in recent history have significant strides been made to understand and treat postpartum depression. While the psychiatric disorder was written as long ago as 700 BC, by Hippocrates, it was not officially recognized as a medical diagnosis until the nineteenth century. Even in today’s society, individuals tend to harbor ill feelings toward postpartum depression, likely due to cultural beliefs and miseducation. According to the U.S National library of medicine postpartum depression is “moderate to severe depression in a woman after she has given birth, occurring soon after delivery or up to a year later”, (U.S National Library of Medicine, 2014). Women have been most widely identified as being impacted by postpartum depression, and for decades, research has focused on them, with limited data related to males. However, recent studies focusing on male postpartum depression, not only prove that men are affected by the disorder; potentially to the same extent as women, but also suggest that there is a likely correlation between either parent having the condition, and it consequently affecting both parents. Recent studies have found that, “prenatal and postpartum depression was evident in about 10% of men in the reviewed studies and was relatively higher in the 3- to 6-month postpartum period. Paternal depression also showed a moderate positive correlation with maternal depression” (Paulson and Bazemore, 2010, p. 1961). Given this
Postpartum depression is a significant problem as it is one of the leading causes of maternal morbidity. Developing a screening tool to address the issue early can provide the necessary interventions to avoid further undesirable problems down the road. As we know, early detection is key in prevention. Developing questionnaires that can identify multiple risk factors can help better identify women who are more likely to be at risk. The following study addresses the following risk factors in the categories of socio demographics, biological, pregnancy related factors, life stressors, social support, obstetric, and maternal adjustment.
The birth of a baby can provoke a lot of emotions. Mothers particularly can have a range of emotions, including depression. Many mothers experience postpartum “baby blues”. Baby blues include symptoms of crying, anxiety, mood swings, and problems sleeping for about two weeks (Postpartum, n.d.). However, postpartum depression (PPD) is more severe and long-term. Mothers with postpartum depression experience similar symptoms of baby blues, however these symptoms are more intense and extreme. This disorder not only makes it difficult for them to complete daily care activities for themselves, but also for their baby and others. The purpose of