Cross-cultural adaptation of the City Birth Trauma Scale for the Brazilian context

Background: Posttraumatic stress disorder consists of a set of symptoms that occurs in response to one or more traumatic events and can occur in postpartum, from traumatic situations related to the birth or to the baby’s health in the first days of life. It is important tracking the presence of birth trauma, but there is not available instruments in the Brazilian context for this purpose. Objectives: To present the cross-cultural adaptation of City Birth Trauma Scale (BiTS) into Brazilian portuguese. Methods: Cross-cultural adaptation involved independent translations, synthesis,back-translation, and submission to the original author’s appreciation. After the scale was subjected to face validity, followed by a pilot study with postpartum mothers. Results: All steps were performed for the cross-cultural adaptation. Regarding face validity, items evaluated concerning different types of equivalence, presented satisfactory agreement values (≥4.20). Most of the expert’s suggestions were followed, being the main ones related to adjustments in prepositions, pronouns and verbal subjects. Pilot study showed that the mothers had been able to understand and respond to the instrument without adjustments. Discussion: BiTS’s Brazilian version proved to be cross-culturally adapted, ensuring the possibility of intercultural data comparison from the semantic, idiomatic, cultural, and conceptual perspectives. New studies are being conducted to attest its psychometric adequac

Evaluación del impacto de la prematuridad en la salud mental de puérperas

O presente estudo tem como objetivo comparar a ocorrência de sintomas de ansiedade e depressão em mães de bebês prematuros e mães de bebês a termo. Trata-se de um estudo transversal, descritivo, de abordagem quantitativa. As participantes (n=40) foram submetidas à avaliação de rastreamento executada como rotina pelo Serviço de Psicologia de um hospital filantrópico do interior paulista mediante a aplicação da Escala Hospitalar de Ansiedade e Depressão (HAD). Constatou-se que, entre as mães de bebês prematuros, 75% apresentavam sintomas clinicamente significativos de ansiedade e 50% apresentavam sintomas clinicamente significativos de depressão. Já entre as mães de bebês a termo, 65% não apresentavam sintomas clinicamente significativos de ansiedade e tampouco depressão. Ademais, a superioridade da pontuação média obtida pelas primeiras alcançou significância estatística. Os resultados corroboram a literatura, que sugere que a prematuridade tende a ter impacto negativo na saúde mental da mulher que vivencia essa situação

Influence Of Body Posture On The Association Between Postpartum Depression And Pain [influência Do Tipo Postural Na Associação Entre Depressão Pós-parto E Dor]

Objective: To determine the association between postpartum depression (PPD), intensification of back pain and exacerbation of changes in postural alignment intrinsic to puerperium. Methods: Eighty women at 2 to 30 weeks postpartum were included in the study according to the following criteria: lite-rate mothers, gestation of 34 to 42 weeks, and healthy live-born infants. All mothers agreed to participate in the study. Depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS). Pain was assessed using a visual analogue scale (VAS) and the Nordic Musculoskeletal Questionnaire (NMQ), and posture, using real time naturalistic observation. Results: There was a statistically significant association between PPD and pain intensity (p = 0.002). The upper back was the most frequent pain site among depressed women, both before (p = 0.04) and after delivery (p = 0.01). There were no associations between PPD and type of posture (p = 0.328). However, pain intensity was greater among depressed women in the swayback group (p < 0.001). Conclusion: The intensification of puerperal pain is closely associated with PPD. Our results suggest that back pain may be both a risk factor and a comorbidity of PPD among puerperal women and that pain and type of posture are interdependent. © APRS.3613239Horak, F.B., Macpherson, J.M., Postural orientation and equilibrium (1996) Handbook of Physiology: A Critical, Comprehensive Presentation of Physiological Knowledge and Concepts, pp. 255-292. , In: Rowell LB, Sherpherd JT, editors, New York: Oxford American Physiological SocietyOstgaard, H.C., Andersson, G.B., Postpartum low-back pain (1992) Spine (Phila Pa 1976), 17, pp. 53-55Borg-Stein, J., Dugan, S.A., Musculoskeletal disorders of pregnancy, delivery and postpartum (2007) Phys Med Rehabil Clin N Am, 18, pp. 459-476To, W.W., Wong, M.W., Factors associated with back pain symptoms in pregnancy and the persistence of pain 2 years after pregnancy (2003) Acta Obstet Gynecol Scand, 82, pp. 1086-1091Gaudet, C., (2011) The Association of Acute and Chronic Postpartum Pain With Postpartum Depression In a Nationally Representative Sample of Canadian Women [dissertation], , Ottawa: University of OttawaWebb, D.A., Bloch, J.R., Coyne, J.C., Chung, E.K., Bennett, I.M., Culhane, J.F., Postpartum physical symptoms in new mothers: Their relationship to functional limitations and emotional well-being (2008) Birth, 35, pp. 179-187Gutke, A., Josefsson, A., Oberg, B., Pelvic girdle pain and lumbar pain in relation to postpartum depressive symptoms (2007) Spine (Phila Pa 1976), 32, pp. 1430-1436McGovern, P., Dowd, B., Gjerdingen, D., Gross, C.R., Kenney, S., Ukestad, L., Postpartum health of employed mothers 5 weeks after childbirth (2006) Ann Fam Med, 4, pp. 159-167Cooper, P.J., Tomlinson, M., Swartz, L., Woolgar, M., Murray, L., Molteno, C., Post-partum depression and the mother-infant relationship in a South African peri-urban settlement (1999) Br J Psychiatry, 175, pp. 554-558Moraes, I.G., Pinheiro, R.T., Silva, R.A., Horta, B.L., Sousa, P.L., Faria, A.D., Prevalence of postpartum depression and associated factors (2006) Rev Saude Publica, 40, pp. 65-70Cantilino, A., Zambaldi, C.F., Albuquerque, T.L.C., Paes, J.A., Montenegro, A.C.P., Sougey, E.B., Postpartum depression in Recife-Brazil: Prevalence and association with bio-socio-demographic factors (2010) J Bras Psiquiatr, 59, pp. 1-9Pawar, G., Wetzker, C., Gjerdingen, D., Prevalence of depressive symptoms in the immediate postpartum period (2011) J Am Board Fam Med, 24, pp. 258-261Morari-Cassol, E.G., (2007) Amamentação E Desconforto Músculoesquelético Da Mulher [tese], , Brasília: Universidade do Estado de BrasíliaAbou-Saleh, M.T., Ghubash, R., The prevalence of early postpartum psychiatric morbidity in Dubai: A transcultural perspective (1997) Acta Psychiatr Scand, 95, pp. 428-432Lowen, A.O., (1983) Corpo Em Depressão: As Bases Biológicas Da Fé E Da Realidade, , 4a ed. São Paulo: SummusTeixeira, M.J., (2003) Dor: Contexto Interdisciplinar, , Curitiba: MaioSimon, G.E., Vonkorff, M., Piccinelli, M., Fullerton, C., Ormel, J., An international study of the relation between somatic symptoms and depression (1999) N Engl J Med, 341, pp. 1329-1335Canales, J.Z., Cordás, T.A., Fiquer, J.T., Cavalcante, A.F., Moreno, R.A., Posture and body image in individuals with major depressive disorder: A controlled study (2010) Rev Bras Psiquiatr, 32, pp. 375-380Cox, J.L., Holden, J.M., Sagovsky, R., Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale (1987) Br J Psychiatry, 150, pp. 782-786Kuorinka, I., Jonsson, B., Kilbom, A., Vinterberg, H., Biering-Sørensen, F., Andersson, G., Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms (1987) Appl Ergon, 18, pp. 233-237Huskisson, E.C., Measurement of pain (1974) Lancet, 2, pp. 1127-1131Kendall, F.P., McCreary, E.K., Provance, P.G., Rod, M.M., (2007) Músculos: Provas E Funções, , 5a ed. São Paulo: ManoleJardri, R., Maron, M., Delion, P., Thomas, P., Pain as a confounding factor in postnatal depression screening (2010) J Psychosom Obstet Gynaecol, 31, pp. 252-255Kirmayer, L.J., Robbins, J.M., Dworkind, M., Yaffe, M.J., Somatization and the recognition of depression and anxiety in primary care (1993) Am J Psychiatry, 150, pp. 734-741Rajala, U., Keinänen-Kiukaanniemi, S., Uusimäki, A., Kivelä, S.L., Musculoskeletal pains and depression in a middle-aged Finnish population (1995) Pain, 61, pp. 451-457Breen, T.W., Ransil, B.J., Groves, P.A., Oriol, N.E., Factors associated with back pain after childbirth (1994) Anesthesiology, 81, pp. 29-34Morari-Cassol, E.G., Campos, J.D., Haeffner, L.S.B., Musculoskeletal discomfort post-partum and breastfeeding (2008) Fisioter Bras, 9, pp. 9-16Gilleard, W.L., Crosbie, J., Smith, R., Static trunk posture in sitting and standing during pregnancy and early postpartum (2002) Arch Phys Med Rehabil, 83, pp. 1739-1744Keleman, S., (1992) Anatomia Emocional, , 5a ed. São Paulo: Summu

Use of psychotropic medications during pregnancy: perception of teratogenic risk among physicians in two Latin American countries

Objective: Pregnant women and their health care professionals commonly believe that use of medications during pregnancy may be harmful to the unborn fetus. The objective of this study was to evaluate the risk perception of psychotropic drug use in pregnancy among physicians in different medical specialties. Method: This was a convenience survey conducted at outpatient clinics in the cities of Recife, Brazil, and La Plata, Bahía Blanca, and Buenos Aires, Argentina. Physicians who agreed to participate were asked to rate their perception of teratogenic risk among different classes of drugs, which included antidepressants, antipsychotics, anticonvulsants, and benzodiazepines. Results: Two hundred and thirty-eight physicians completed the survey (response rate, 98%). These included psychiatrists, obstetricians, neurologists, cardiologists, gastroenterologists, and general practitioners. Among different specialties, a minority of psychiatrists perceived psychotropic drugs to be highly teratogenic (antidepressants, 12.5%; antipsychotics, 15%; benzodiazepines, 25%) as compared with other specialties (p < 0.003 for each drug class). There was no difference in perceived risk of antiepileptic drugs among specialties, including psychiatrists. Conclusion: The risk associated with use of psychotropic drugs in pregnancy was overestimated by physicians of all medical specialties, except psychiatry. All physicians should be aware of the safety/risk of psychotropic agents in pregnancy, as they may be required to give advice and/or prescribe these drugs to pregnant women