A praeeclampsia pszichoszociális vonatkozásai

Distress conditions during pregnancy may contribute to the development of preeclampsia by altering functions of the neuroendocrine and immune systems, e.g. activation of the hypothalamic-pituitary-adrenal axis and increase in plasma proinflammatory cytokines. Preeclampsia may also precipitate mental health problems due to long-term hospitalization or unpredictable and uncontrollable events such as preterm labor and newborn complications. Besides, preeclampsia may induce persistent neurocognitive complaints with a negative impact on patients' quality of life. As growing evidence indicates that poor maternal mental health has an adverse effect on pregnancy outcome and fetal development, psychosocial interventions may be beneficial for women with preeclampsia. Orv. Hetil., 2015, 156(50), 2028-2034

Effects of assisted reproductive treatments on pregnant women’s mental health

Introduction. Childbirth is one of the most important period in women's life. It gets an even bigger emphasis, if parents have to take some kind of assisted reproductive treatment for the conception. The number of cases when assisted reproductive treatments (ART) are used, is increasing, infertility affects 15-20% of couples. Premature birth and low birth weight is more frequent among pregnant women suffering from major depressive disorder (MDD). The literature does not have a uniform view on the mental health of artificially fertilized women. Aim. The aim of our research is to submit and analyse particular mental health of women who become pregnant due to ART (ART group), and to compare ART group with spontaneously conceived group. Material and methods. 985 pregnant women were examined between 01. October 2012 and 31. August 2013 at the 1st Department of Obstetrics and Gynaecology of Semmelweis University (Budapest, Hungary) with self-rated questionnaires. We measured depression using EPDS test, the level of anxiety by the STAI test. We measured the quality of life with the WHO Quality of life Bref questionnaire. We used our self-designed questionnaire to gather the socio-demographic data. Results. 100 pregnant women out of 985 were conceived with help of the ART. The mean age was 35 years, their average gestational week was 32 weeks and about half of them (47%) had multiple pregnancy. 20.8% of the ART group reached the clinical level of depression, and 9% had a high anxiety level. Conclusions. The frequency of mental disorders in the ART group does not show a big difference from the frequency of mental problems in case of spontaneously conceived group. © Borgis

The effects of previous spontaneous abortion on the mental problems of current pregnancy

Introduction. The risk of developing mental illness is significantly increased during pregnancy. The most common obstetric complication is spontaneous abortion. Women with a history of previous spontaneous abortion are at higher risk of developing mental problems during their subsequent pregnancy. Aim. We examined the effects of a history of previous spontaneous abortion on emotional problems during subsequent pregnancy. We examined 987 pregnant women at the 1st Department of Obstetrics and Gynecology of semmelweis university in budapest, Hungary between 01-10-2012 and 31-08-2013. among them there were 265 pregnant women who had at least one episode of previous spontaneous abortion. Material and methods. We measured depression using the EPDS test. anxiety was measured using the spielberger (STAI) tests. We designed a questionnaire to gather socio-demographic data. We used the chi-square test and Wald-Wolfovitz test to test for the statistical significance of associations. Results. We found that 24.21% of the sample had depression, and 8.61% of the sample had anxiety. According to the number of previous spontaneous abortions we compared 3 groups: 722 women had no spontaneous abortion previously, 169 women had one previous spontaneous abortion and 96 women had 2 or more spontaneous abortions before. Depression, anxiety and previous mental illness were examined in these groups. Those women who had spontaneous abortion 2 or more times before got significantly higher scores in the EPDS test, than those who had no or just one spontaneous abortion. among them 28.1% had mental illness previously. We found that prior mental illness and spontaneous abortions are independent predictors of antenatal depression. Among those women who had 2 or more spontaneous abortions before, the mean age and the number of single women was significantly higher, while the average level of education was significantly lower than in the other two groups. Conclusions. Higher age, lower level of education and the lack of partner relationship can be associated with the number of spontaneous abortions. The number of episodes of spontaneous abortion and a history of mental illness are risk factors for depression during a subsequent pregnancy

Assessing quality of life: mother–child agreement in depressed and non-depressed Hungarian

Purpose: An important question in child psychiatry is the agreement between parents and children. We studied mother–child concordance about the quality of life of children (QoL). We hypothesized that mothers of depressed children rate lower QoL than children for themselves while mothers of non-depressed children rate better QoL; that inter-informant agreement is higher in the non-depressed sample; and finally that agreement increases with age of the child. Methods: QoL of depressed children (N = 248, mean age 11.45 years, SD 2.02) were compared to that of non-depressed children (N = 1695, mean age 10.34 years, SD 2.19). QoL was examined by a 7 item questionnaire (ILK). Results: Mothers of depressed children rated lower QoL than their children while mothers of nondepressed children rated higher QoL than their children. Agreement was low in both samples but higher in the controls. Inter-informant agreement was only influenced by depression. Conclusions: Our results show that mothers relate more serious negative effects to childhood depression than their children and rate less problems for their non-depressed children compared to self-reports. Mother–child agreement is negatively influenced by depression which further stresses the importance of obtaining reports from the child and at least one parent in order to understand the subjective experiences caused by the illness

BDNF Val66Met polymorphism and stressful life events in melancholic childhood-onset depression

INTRODUCTION: Brain-derived neurotrophic factor (BDNF) polymorphisms have been examined for their contribution toward depression with equivocal results. More homogeneous phenotypes might be used to improve our understanding of genetic liability to depression. The aim of our study was to (a) test for an association between the BDNF Val66Met polymorphism and childhood-onset melancholic depression and (b) to examine the interactive effects of stressful life events (SLE) and the Val66Met polymorphism on the risk of childhood-onset melancholic depression. MATERIALS AND METHODS: A total of 583 depressed probands were involved in this study (162 of the melancholic subtype). Diagnoses were derived through the Interview Schedule for Children and Adolescents - Diagnostic Version and life event data were collected using an Intake General Information Sheet. RESULTS: Overall, 27.8% of the participants fulfilled the criteria for melancholy. In the melancholic group, the proportion of females was higher (53.1%), although there were more males in the overall depressed sample. We detected no significant differences in genotype or allele frequency between the melancholic and the nonmelancholic depressed group. The BDNF Val66Met polymorphism and SLE interaction was not significantly associated with the melancholy outcome. CONCLUSION: In our study, females were more prone to developing the early-onset melancholic phenotype. To our knowledge, this is the first study to investigate the differentiating effect of the genotype and the GxE interaction on the melancholic phenotype in a large sample of depressed young patients. We did not find an association between the melancholic subtype of major depression and the BDNF genotype and SLE interaction in this sample, which is representative of the Hungarian clinic-referred population of depressed youths

Familiality of mood repair responses among youth with and without histories of depression

Affect regulation skills develop in the context of the family environment, wherein youths are influenced by their parents', and possibly their siblings', regulatory responses and styles. Regulatory responses to sadness (mood repair) that exacerbate or prolong dysphoria (maladaptive mood repair) may represent one way in which depression is transmitted within families. We examined self-reported adaptive and maladaptive mood repair responses across cognitive, social and behavioural domains in Hungarian 11- to 19-year-old youth and their parents. Offspring included 214 probands with a history of childhood-onset depressive disorder, 200 never depressed siblings and 161 control peers. Probands reported the most problematic mood repair responses, with siblings reporting more modest differences from controls. Mood repair responses of parents and their offspring, as well as within sib-pairs, were related, although results differed as a function of the regulatory response domain. Results demonstrate familiality of maladaptive and adaptive mood repair responses in multiple samples. These familial associations suggest that relationships with parents and siblings within families may impact the development of affect regulation in youth

The Characteristics of Childhood Onset Depression According to Depressive Symptoms, Comorbidities and Quality of Life

Childhood and adolescence major depression is an under-diagnosed mental disorder, which can be traced back to several causes: 1. the DSM-IV diagnostic system is not specific enough considering the age. 2. Comorbidities frequently co-occurring with major depression, may overlap symptoms, thus they are rarely or not at all recognised. A small number of studies have examined developmental differences in rates of specific symptoms across depressed children and adolescents. These studies do not show a uniform picture. Some researchers reported m ore somatic complaints among depressed children. The gender has an influence on the symptoms of major depression. Anxiety comorbidities co-occurs with major depressive episode in 40%, while disruptive comorbidies 10-80%. The mental disorders have the negative effect on the quality of life of children. QoL is the combination of objectively and subjectively indicated well being in multiple domains of life. The stressful life events contribution to depression. 1. I hypothesized that there are some developmental and gender differences in depressive symptom presentation. 2. The somatic symptoms are more frequent in earlier life. 3. The frequency of depressive symptoms is increased by psychiatric comorbidities. 4. Stressful life events affect quality of life adversely, and it is worsened by depression. Methodes: We examined the above hypothesis in three samples. Participants were children (ages 7–14) with MDD, and community control kids from elementary schools. Diagnoses (via DSM-IV criteria) and onset dates of disorders were finalized “best estimate” psychiatrists, and based on multiple information sources. The depressive symptoms and effects of comorbidities were examinedin depressive sample, and the quality of life was examined in the community sample. Results: Six symptoms increased with age, namely: depressed mood, hypersomnia, psychomotor retardation, fatigue, thoughts of death, and suicidal ideation. Only psychomotor agitation was more frequent in younger children. Anhedonia, insomnia, hypersomnia, and somatic complaints were more frequent among girls, and psychomotor agitation was more frequent among boys. Depressed mood, sleeping problems, psychomotor retardation, suicidal symptoms are significantly more frequent in anxiety group. Irritability and psychomotor agitation is significantly more frequent in the disruptive group. Worthlessness is the most frequent in the disruptive group, and in this group it is the third most frequent symptom. The clinical depression influences the quality of life the most strongly, and the higher depression score goes together with a lower quality of life. Stressful life events influence the quality 6 of life directly and through the depressive symptoms indirectly. Conclusionsthere are some developmental and gender differences in depressive symptom presentation. Irritability is the most frequent criterion symptom. We also observed stable and elevated rates of irritability, which were concurrent with stable and low rates of anhedonia across all age groups. Somatic complaints should be considered an associated feature of the symptom profile of MDD in pediatric populations. Depressive symptoms are reported to have more negative effects on the quality of life than do stressful life events