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

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

A Collins–Read Felnőtt Kötődési Skála pszichometriai jellemzőinek vizsgálata

A Collins–Read-féle Fel­nőtt Kötődési Skála (Adult Attachment Scale, AAS) megbízható­sá­gának és pszichometriai jellemzőinek vizsgálatát tűztük ki vizsgálatunk céljául. Az AAS-t nemzetközileg szé­les­körűen használják a felnőtt kötődés jellemzőinek vizsgálatára, azonban érvényességét magyar populáción még nem vizsgálták. Az önkitöltős kérdőív folytonos változóként vizsgálja a kötődési jellemzőket: az eredeti hármas (közelség, füg­­gőség, szorongás) és az alternatív kettes (szoron­gás és elkerülés) felosztás szerint. A pszichometriai mérést 508 fős populáción végeztük, melyben depressziós anamnézisű személyek (n = 264, medián életkor = 25,7 év) és azok nem dep­ressziós testvérei (n = 244, medián életkor = 24,0 év) szerepeltek. A kérdőív belső megbízhatósága a kö­zel­ség, szorongás és az elkerülés dimenziók esetében elfogadható tartományba esett (Cronbach-α > 0,7), a függő­ségskála kevéssé bizonyult konzisztensnek (Cronbach-α = 0,62). A kitöltést 14 hónap után ismételve, a teszt-re­teszt reliabilitás a teszt minden skáláján megfelelő volt (0,73 és 0,78 között változott). A depressziós és nem dep­ressziós csoport a kérdőív közelség és szorongás dimenzióiban szignifikánsan különbözött egymástól (p < 0,01). Feltáró és megerősítő faktoranalízissel vizsgálva a skála közelség és szorongás dimenziói különültek el egymástól, a függőségskála itemei szórtan helyezkedtek el, a háromfaktoros elgondolás nem nyert megerősítést. Az AAS közelség- és szorongásskálája alkalmazható a kötődési jellemzők vizsgálatára, azonban a kérdőív háromdimenziós struktúrája nem megerősíthető. Eredményeink rámutatnak arra is, hogy a kötődési jel­lem­zők felnőttkorban összefüggést mutatnak a depressziós epizódokkal