Management of psycho-emotional disorders in internally displaced women with the threatened interruption of pregnancy in history | Ukrainian Medical Journal

The purpose of the research — to evaluate the effectiveness of treatment strategies using psychotherapy in pregnant women in the I and II trimesters with psycho-emotional disorders and threatened interruption of this pregnancy in history, living in the Luhansk region and have the status of internally displaced persons to improve treatment and preventive measures and prevent obstetric and perinatal complications. The object and methods. The study included 39 pregnant women in the I and II trimesters with threatened interruption of this pregnancy in anamnesis. Patients were randomly divided into groups: psychotherapeutic treatment (1a) and a control group 1b. Clinical-obstetric and psychometric examination were carried out before and after treatment. Spielberger State-Trait Anxiety Inventory was used to assess the level of anxiety, Beck’s depression Inventory — to asses the level of depression, the Sleep Quality Survey Questionnaire — to assess the quality of sleep and questionnaires for evaluating the autonomous nervous system disorders. Results. After the treatment in group 1a, a statistically significant decrease in state and trait anxiety, depressive manifestations, autonomic disorders were noted, and sleep quality indicators improved, while no significant changes were recorded in the control group. Conclusion. Psychotherapeutic treatment was effective in reducing the severity and frequency of psycho-emotional disorders in women with threatened interruption of this pregnancy in history, achieving emotional balance, relieving anxiety, fears associated with pregnancy and childbirth. Reduction of state and trait anxiety, depression, autonomic disorders, improvement of sleep quality parameters can serve as criteria for the effectiveness of the treatment.

Published: 19.04.2019

References:

Veyn A.M. (red.) (2003) Vegetativnyie rasstroystva. Klinika, diagnostika, lechenie. Meditsinskoe informatsionnoe agentstvo, Moskva, 752 s.
Veyn A.M., Eligulashvili T.S., Poluektov M.G. (2002) Sindrom apnoe vo sne i drugie rasstroystva dyihaniya, svyazannyie so snom: klinika, diagnostika, lechenie. Eydos Media, Moskva, 310.
MOZ Ukrainy (2008) Nakaz MOZ Ukrainy vid 03.11.2008 r. № 624 «Pro vnesennia zmin do nakazu MOZ Ukrainy vid 15 hrudnia 2003 roku № 582 «Pro zatverdzhennia klinichnykh protokoliv z akusherskoi ta hinekolohichnoi dopomohy», nakazu MOZ vid 31.12.2004 roku № 676 «Pro zatverdzhennia klinichnykh protokoliv z akusherskoi ta hinekolohichnoi dopomohy» (https://zakon.rada.gov.ua/rada/show/v0624282-08).
MOZ Ukrainy (2017) Nakaz MOZ Ukrainy vid 15.07.2011 r. № 417 «Pro orhanizatsiiu ambulatornoi akushersko-hinekolohichnoi dopomohy v Ukraini» (https://zakon.rada.gov.ua/rada/show/v0417282-11).
Hanin Yu.L. (1978) Issledovanie trevogi v sporte. Vopr. psihologii, 6: 72–75.
Alder J., Fink N., Bitzer J. et al. (2007) Depression and anxiety during pregnancy: a risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. J. Matern. Fetal. Neonatal. Med., 20(3): 189–209.
Beck A.T., Ward C.H., Mendelson M. et al. (1961) An inventory for measuring depression. Arch. Gen. Psychiatr., 4:.561–571.
Biaggi A., Conroy S., Pawlby S., Pariante C.M. (2016) Identifying the women at risk of antenatal anxiety and depression: a systematic review. J. Affect. Disord., 191: 62–77.
Da Costa D., Dritsa M., Larouche J., Brender W. (2000) Psychosocial predictors of labor/delivery complications and infant birth weight: a prospective multivariate study. J. Psychosom. Obstet. Gynaecol., 21: 137–148.
Dalke K.B., Wenzel A., Kim D.R. (2016) Depression and Anxiety During Pregnancy: Evaluating the Literature in Support of Clinical Risk-Benefit Decision-Making. Curr. Psychiatr. Rep., 18(6): 59.
Hashmi A.M., Bhatia S.K., Bhatia S.K., Khawaja I.S. (2016) Insomnia during pregnancy: diagnosis and rational Interventions. Pak. J. Med. Sci., 32(4): 1030–1037.
Ibanez G., Blondel B., Prunet C. et al. (2015) Prevalence and characteristics of women reporting poor mental health during pregnancy: findings from the 2010 French National Perinatal Survey. Rev. Epidemiol. Sante Publique, 63: 85–95.
IDCP (2015) Global Overview 2015: People Internally Displaced by Conflict and Violence (http://www.internal-displacement.org/sites/default/files/inline-files/20150506-global-overview-2015-en.pdf).
Johnson R.C., Slade P. (2003) Obstetric complications and anxiety during pregnancy: is there a relationship? J. Psychosom. Obstet. Gynaecol., 24(1): 1–14.
Kaczkurkin A.N., Foa E.B. (2015) Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence. Dialogues Clin. Neurosci., 17(3): 337–346.
Kay-Stacey M., Attarian H.P. (2017) Managing Sleep Disorders during Pregnancy. Gender and the Genome, 1(1): 34–45.
Lee A.M., Lam S.K., Sze Mun Lau S.M. et al. (2007) Prevalence, course, and risk factors for antenatal anxiety and depression. Obstet. Gynecol., 110(5): 1102–1112.
LeMaster J.W., Broadbridge C.L., Lumley M.A. et al. (2018) Acculturation and post-migration psychological symptoms among Iraqi refugees: a path analysis. Am. J. Orthopsychiatr., 88(1): 38–47.
Milgrom J., Holt C. (2014) Early intervention to protect the mother-infant relationship following postnatal depression: study protocol for a randomised controlled trial. Trials, 3(15): 385.
Mindell J.A., Cook R.A., Nikolovski J. (2015) Sleep patterns and sleep disturbances across pregnancy. Sleep Med., 16(4): 483–488.
Morin N., Akhtar A., Barth J., Schnyder U. (2018) Psychiatric disorders in refugees and internally displaced persons after forced displacement: a systematic review. Front. Psychiatr., 21(9): 433.
NICE (2014) Antenatal and postnatal mental health: clinical management and service guidance: Guideline CG192 (http://guidance.nice.org.uk/cg192).
Nodine P.M., Matthews E.E. (2013) Common sleep disorders: management strategies and pregnancy outcomes. J. Midwifery Womens Health, 58(4): 368–377.
Rallis S., Skouteris H., McCabe M., Milgrom J. (2014) A prospective examination of depression, anxiety and stress throughout pregnancy. Women Birth, 27(4): 36–42.
Sharma S.K., Nehra A., Sinha S. et al. (2016) Sleep disorders in pregnancy and their association with pregnancy outcomes: a prospective observational study. Sleep Breath, 20(1): 87–93.
Skouteris H., Wertheim E.H., Germano C. (2009) Assessing sleep during pregnancy: a study across two time points examining the Pittsburgh Sleep Quality Index and associations with depressive symptoms. Women’s Health Iss., 19: 45–51.
Spinelli M.G., Endicott J. (2003) Controlled clinical trial of interpersonal psychotherapy versus parenting education program for depressed pregnant women. Am. J. Psychiatr., 160: 555–562.
Volkovich E., Tikotzky L., Manber R. (2016) Objective and subjective sleep during pregnancy: links with depressive and anxiety symptoms. Arch. Womens Ment. Health, 19(1): 173–181.
Zhu C.S., Tan T.C., Chen H.Y. et al. (2018) Threatened miscarriage and depressive and anxiety symptoms among women and partners in early pregnancy. J. Affect. Disord., 237: 1–9.