Psychiatric Disorders in Pregnancy and Postpartum Period

.: PREFACE
ÖN SÖZ
PREFACE
Prof. Dr. Engin Emrem BEŞTEPE
Sağlık Bilimleri Üniversitesi Erenköy Ruh ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, Ruh Sağlığı ve Hastalıkları ABD, İstanbul, Türkiye
Article Language: TR
Gebelik kadınların hayatında önemli yere sahip, genellikle mutlu olunması beklenen bir süreçtir. Yeni bir yaşamı başlatma, sadece kadın için değil bütün aile için heyecana neden olur. Ne yazık ki işler her zaman bu şekilde gitmez. Gebelik anne için aynı zamanda endişenin, kaygının arttığı, kimi zaman yetersizlik hislerinin ön plana geçtiği bir süreç olabilir. Özellikle istenmeyen, planlanmayan gebeliklerde, anneye desteğin az olduğu durumlarda psikiyatrik hastalıklara yatkınlık artar. Değişen hormonlar, değişen beden algısı, annenin gebelikte karşılaşabileceği organik hastalıklar da psikiyatrik hastalıklara neden olabilir.

Eskiden gebeliğin var olan psikiyatrik hastalıklara karşı koruyucu olacağına dair bir inanış varken bunun artık doğru olmadığı anlaşılmıştır. Aksine gebelik var olan psikiyatrik hastalığın alevlenmesine yol açabilir. Postpartum dönem ise kesinlikle kadıların psikiyatrik hastalıklara karşı korunmasız oldukları bir dönemdir. Hormonların ani değişimi, yeni bebeğin ihtiyaçlarına cevap verme zorluğu, emzirmek için uykusuz kalma, hastalıkların alevlenmesini ve yeni hastalık gelişimini artırır. Eşinden ve ailesinden yeterli desteği göremeyen, yalnız kalan annelerde risk daha fazladır.

Postpartum dönemde bütün psikiyatrik hastalıkların ortaya çıkma ve alevlenme riski vardır. Postpartum depresyon doğum sonrası dönemde en sık görülen hastalıktır. Tedavi edilmezse, hem anne hem de bebeği için yıkıcı etkileri olur. Doğum sonrası postpartum psikoz görülme sıklıkları artar. Psikoz, suisid ve infatisid riskini artırmaktadır. Postpartum psikoz görülen olguların bir kısmı sonradan bipolar bozukluk geliştirmektedir. Bipolar bozukluğu olan annelerde doğum sonrası atak riski artmaktadır.

Gebelikte alkol ve madde kullanımı ülkemizde ne yazık ki son yıllarda ciddi bir sorun oluşturmaya başlamıştır. Alkol ve madde kullanan kadın sayısı, erkeklere göre daha az olsa da gebelik döneminde kullanım geri dönüşsüz sonuçlara yol açabilir.

Anksiyete bozuklukları ve obsesif kompulsif bozukluk da gebelik ve postpartum dönemde sıklığı artan hastalıklardandır. Gebelik sırasındaki normal kaygı durumlarından ayrılması gerekir. Uykusuzluk doğum sonrası bebeğin beslenmesi için gelişen zorunlu bir durumdur ancak iyi yönetilemezse uyku bozukluklarına yol açabilir. Gebelik daha önce var olan yeme bozukluklarını da alevlendirebilir.

Gebelikte ve doğum sonrasında cinsellik de üzerinde durulması gereken konulardan biridir. Eş rolünden ebeveyn rolüne geçiş cinselliği karmaşıklaştırabilir.

Bu kitapta, gebelik döneminde ve postpartum dönemde sıklıkla karşılaşılan hastalıklar, önleme yolları ve tedaviler anlatılmıştır. Tüm annelere ve anne olmak isteyenlere saygıyla.

Prof. Dr. Engin Emrem BEŞTEPE
Editör
Pregnancy is an important part of a woman's life and is generally expected to be a happy time. Starting a new life causes excitement not only for the woman but for the whole family. Unfortunately, things do not always go this way. Pregnancy can also be a time of increased anxiety and worry for the mother, and sometimes feelings of inadequacy come to the fore. Especially in unwanted, unplanned pregnancies, when there is little support for the mother, susceptibility to psychiatric illnesses increases. Changing hormones, changing body perception, organic diseases that the mother may encounter during pregnancy can also cause psychiatric disorders.

While there used to be a belief that pregnancy would be protective against existing psychiatric illnesses, this is no longer true. On the contrary, pregnancy can lead to exacerbation of existing psychiatric illness. The postpartum period is definitely a time when women are vulnerable to psychiatric illnesses. The sudden change in hormones, the difficulty in responding to the needs of the new baby, sleep deprivation for breastfeeding increase the exacerbation of illnesses and the development of new illnesses. The risk is higher in single mothers who do not receive adequate support from their husbands and families.

There is a risk of emergence and exacerbation of all psychiatric diseases in the postpartum period. Postpartum depression is the most common illness in the postpartum period. If left untreated, it has devastating effects for both the mother and her baby. The incidence of postpartum psychosis increases after delivery. Psychosis increases the risk of suicide and infanticide. Some of the cases with postpartum psychosis later develop bipolar disorder. The risk of postpartum attacks increases in mothers with bipolar disorder.

Alcohol and substance abuse during pregnancy has unfortunately become a serious problem in our country in recent years. Although the number of women who use al- cohol and drugs is lower than men, use during pregnancy can lead to irreversible consequences.

Anxiety disorders and obsessive-compulsive disorder are also among the disorders whose frequency increases during pregnancy and postpartum period. Insomnia is a necessary condition that develops after birth for the baby's nutrition, but if not managed well, it can lead to sleep disorders. Pregnancy can also exacerbate pre-existing eating disorders.

Sexuality during pregnancy and postpartum is one of the issues that should be emphasized. The transition from the role of spouse to that of parent can complicate sexuality.

In this book, common diseases during pregnancy and the postpartum period, prevention methods and treatments are described. With respect to all mothers and wouldbe mothers.

Prof. Dr. Engin Emrem BEŞTEPE
Editor

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