RESUMO
BACKGROUND: The diagnosis of mood disorders (MD) during pregnancy is challenging and may bring negative consequences to the maternal-fetal binomial. The long waitlist for specialized psychiatric evaluation in Brazil contributes to the treatment omission. Almost 20.0% of women treated with antidepressants have a positive screening for bipolar disorder. Therefore, it has been recommended the investigation of depressive and bipolar disorder during prenatal care. Unfortunately, the screening for mood disorders is not a reality in Brazil and many childbearing women remain undiagnosed. The objective of this study is to observe the frequency of MD and the effectiveness of screening scales for routine use by health professionals during prenatal care in high-risk pregnancies. METHODOLOGY/PRINCIPAL FINDINGS: This cross-sectional study included 61 childbearing women in their second trimester who were interviewed using the Edinburgh Postnatal Depression Scale (EPDS) and the Mood Disorder Questionnaire (MDQ). The cut-off point was EPDS ≥ 13 and MDQ ≥ 7 and the SCID-5 was the gold standard diagnosis. MD were diagnosed in 24.6% of the high-risk pregnancies. EDPS was positive in 19.7% and the frequency of major depression was 8.2%. 16.4% of the childbearing women were diagnosed with bipolar disorder, while MDQ was positive in 36.1%. 11.5% of the women had EPDS and MDQ positive. EPDS sensitivity was 80.0% and specificity 92.1%, whereas MDQ presented a sensitivity of 70.0% and specificity of 70.6%. CONCLUSION/SIGNIFICANCE: There is a high prevalence of MD in high-risk pregnancies. The routine use of EPDS simultaneously to MDQ during antenatal care is effective and plays an important role in early diagnosis, counselling, and promotion of perinatal mental health.
Assuntos
Transtorno Bipolar/complicações , Transtorno Bipolar/diagnóstico , Complicações na Gravidez/diagnóstico , Diagnóstico Pré-Natal/métodos , Adulto , Brasil , Estudos Transversais , Depressão/complicações , Depressão/diagnóstico , Feminino , Humanos , Mania/complicações , Mania/diagnóstico , Programas de Rastreamento/métodos , Valor Preditivo dos Testes , Gravidez , Segundo Trimestre da Gravidez , Cuidado Pré-Natal , Prevalência , Escalas de Graduação Psiquiátrica , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Inquéritos e Questionários , Adulto JovemRESUMO
Introdução: A experiência maníaco-melancólica é marcada pelo sofrimento, restrição e perda da liberdade em seu modo-de-ser-no-mundo. É comum atitudes de estranhamento, afastamento não só da pessoa que vive essa experiência, como dos entes ao seu redor. Objetivos: Buscar uma aproximação entre a Mania e a Melancolia, considerando algumas similaridades na vivência dos existenciais como a espacialidade, a temporalidade, a corporeidade e a afinação. Métodos: Realizou-se uma revisão bibliográfica acerca da vivência maníaco-melancólica, pautada nos pressupostos do referencial Fenomenológico-Existencial. Resultados: Percebemos em ambas experiências um não desdobramento do tempo, uma não realização das possibilidades futuras, um não relacionamento com as coisas do mundo e uma perda de projeção da corporeidade no mundo.Conclusão: A Mania e a Melancolia são compreendidas não como uma doença, mas como um modo de ser no mundo em que a liberdade de escolhas de vir a ser encontra-se limitada.
Introduction: The manic-melancholic experience is marked by suffering, loss of freedom and constraint in their way-of-being in the world. It is common attitudes of estrangement, isolation not only the person living that experience, as the beings around him. Objectives: To find a rapprochement between mania and melancholy, considering some similarities in the experience of existential as spatiality, temporality, corporeality and tuning. Methods: We conducted a literature review about the manic-melancholic experience, based on the assumptions of the phenomenological approach: Existential. Results: We noticed in both experiments a non-split time, not a realization of future possibilities, not a relationship with things in the world and a loss of projection of embodiment in mundo.Conclusão: mania and melancholia are understood not as a disease, but as a way of being in the world where freedom of choice of being is limited.