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Postpartum Depression Younglee KIM, RN, PHN, MSN.

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Presentation on theme: "Postpartum Depression Younglee KIM, RN, PHN, MSN."— Presentation transcript:

1 Postpartum Depression Younglee KIM, RN, PHN, MSN

2 2 Today class objectives  To understand importance of PPD care  To verbalize correct symptoms of PPD  To understand how to use the EPDS screening tool

3 Introduction  Over the centuries, normal thought is that the moment when a pregnant woman delivers her child that it will be a special and precious moment for her, but studies show that is not always so.  Unfortunately, all of women have not felt joy and feeling of pleasure normally associated with bring a new life into this world.

4  Many of women have reported depressed mood, fatigue, and feeling of worthless or excessive.  Family members easily ignore mothers’ feelings of unhappiness and sandiness during postpartum period  Medical attention has tended to ignore the seriousness of PPD, too.

5 The broad meaning of depression  Depression is probably the most common psychiatric complaint, and it was called melancholia.  The course of the disorder is extremely variable from persons to persons.  It may be mild or severe, acute or chronic.  In psycho logy, it is about feelings of low self – worth or guilt and a reduced ability to enjoy life.

6  Hormonal change decrease the levels of progesterone and estrogen after placental delivery cause a change in the neurotransmitter levels in leading to symptoms of depression (Cohen & Nonacs, 2005)  Three terms of depression during the postpartum period; postpartum blues (the baby blues), postpartum depression (PPD), and postpartum psychosis.

7 Postpartum blues (baby blues) Incidence 50% -80% Onset Day 2-5 Duration Few days Symptoms Changed mood Episodic tearfulness Episodic tearfulness Irritability, Anxiety Irritability, Anxiety Overwhelming Overwhelming Lost appetite Lost appetite Sleeping problem Sleeping problem

8 Postpartum depression (PPD) Incidence 5-15% Onset the first 2 weeks-3 months Duration Up to 1 year Symptoms Depressed mood, Sleep changes Sleep changes Anxiety Anxiety Fatigue Fatigue Feeling worthless Feeling worthless Inability to concentrate Inability to concentrate Suicide plan or attempt Suicide plan or attempt

9 Postpartum psychosis Incidence 0.1% Onset the first 2 weeks-6 weeks Duration Weeks to months Symptoms Irritability Confusion Confusion Psychotic symptoms Psychotic symptoms Delusion Delusion Hallucination Hallucination

10 The symptoms of PPD 1. D epressed mood. 2. L oss of interest or pleasure in activities of life. 3. S leep changes. 4. A gitation or retardation in movements. 5. F atigue or loss of energy. 6. F eeling worthless or excessive inappropriate guilt. 7. I nability to concentrate or think; being indecisive every day. 8. T hought of death, suicidal ideation without a plan or a suicide plan or attempt. 9. S omatic symptoms, including headache, constipation, diarrhea and severe anxiety. 10. S hame and low self-esteem. the American Psychiatric Association (APA)

11 The significant predicators of PPD 1. History of prenatal anxiety 2. Occurrence of postpartum blues 3. Low self-esteem 4. A stressful life resulting in excessive demands 5. Lack of social support from family and friends 6. A strained material relationship 7. The nature of the infant’s temperament 8. Childcare stress (Lintner & Gray, 2006) (Lintner & Gray, 2006)

12 Screening tools  Center of Epidemiological Studies-Depression Scale (CES-D)  Edinburgh Postnatal Depression Scale (EPDS)  Postpartum Depression Screening Scale (PDSS)  Beck Depression Inventory Second Edition (BDI- II)

13  The CES-D ---The scale consists 20 items, with four responses ranging from “rarely” to “most of the time”, and measure depressive symptoms occurring during the past week  The PDSS --- It consists 35 items and assesses for dimensions of depression related to sleeping/ eating disturbances, anxiety/ insecurity, emotional liability, loss of self, guilty/ shame, cognitive impairment, contemplating harming oneself and thoughts of suicide.  The BDI-II--- It includes a 21 –items, multiple-choice screening tool that assesses for the presence of depression, as well as the severity of depression, and corresponds well with DSM-IV-TR.

14 The EPDS  A commonly recommended screening tool of PPD.  The question based on mother’s feelings over the past 7 days  10 items to detect prenatal and postnatal depression.  The English and Spanish versions  The total score is ranged from 0 to 30.  The bigger score means a more severely depressed  Possible Depression: 10 or greater  Severe condition: 13 or greater  Always look at item 10 (suicidal thoughts)

15 The practice

16 Thank you! Thank you!

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