Gebelik ve Postpartum Dönemde Sık Görülen Ruhsal Bozukluklar (Common Psychiatric Disorders in Pregnancy and Postpartum Period)

Psikiyatrik hastaliklarin gorulme sikligi, kadinlarin dogurganlik caginda diger yasa donemlerine oranla kismen artmaktadir. Gebelik ve postpartum doneminse, ruhsal hastalik gorulme sikliginda artistan cok, hastaligin alevlenmesi ile iliskili oldugu dusunulmektedir. Buna gore, gebelik ve postpartum donem pek cok kadin icin anksiyete bozuklugu, depresyon, yeme bozuklugu ve psikoz gibi psikiyatrik hastaliklara yatkinligin arttigi bir donem olabilmektedir. Gebelik surecinde bedendeki fizyolojik degisiklikler, cinsel ilgideki degisiklikler ve dogumla ilgili anksiyete, duygudurum degisikligine katki saglayabilir. Bunun yaninda gebelikte gorulen somatik yakinmalar, depresyon ve anksiyete belirtileri hekimlerce genellikle gebelikle ilgili hormonal ve fiziksel degisikliklere baglanmakta ve siklikla daha az teshis edilebilmekte ve buna bagli olarak da tedavileri aksamaktadir. Daha onceden hastalik oykusu bulunan kadinlarin hamilelik ya da postpartum doneminde bu hastaliklarin alevlenme riski bulunmaktadir. Ayrica bu donemlerde bazi psikiyatrik bozukluklarin tedavileri degisebilmekte veya ilac dozlarinda degisiklige gidilmesi gerekliligi ortaya cikabilmektedir. Bu donemdeki psikiyatrik hastaliklarla ilgili calismalarin cogunun son yillarda gerceklesmesinden dolayi klinisyenlerin bu donemdeki bireylere yaklasimina yonelik bilgi oldukca sinirlidir. Tedavisi ihmal edilen bu ruhsal bozukluklarin anne-cocuk iliskisinin ciddi olarak bozulmasi ile sonuclandigi goz onune alindiginda, bu konuya duyarlilik ile yaklasilmasinin gerektigi aciktir. Bu makalede gebelik ve postpartum donemde sik karsilasilan psikiyatrik hastaliklar konusunda makaleler gozden gecirilerek, bu hastaliklarin tanisi, mudahale yontemleri ve tedavi konularinda klinisyenlere onerilerde bulunulmaktadir. Anahtar Kelimeler: gebelik; postpartum; depresyon; anksiyete; yeme bozukluklari; psikoz. Abstract Psychiatric disorders are common at women during particularly their reproductive years, when compared to other life periods. It is believed that, pregnancy and postpartum period is not associated with increased incidence of any mental disorder, but the severity of the disorder. Accordingly, pregnancy and postpartum periods may be a time of increased susceptibility to psychiatric disorders such as anxiety disorder, depression, eating disorder and psychosis. Physiological changes in the body during pregnancy, changes in sexual interest and birth-related anxiety might contribute to mood changes. Besides, somatic complaints, depression and anxiety symptoms seen in pregnancy are frequently linked to pregnancy-related hormonal and physical changes and can be less commonly diagnosed by physicians, consequently therapies are being delayed. During the pregnancy or postpartum periods of women with a prior history of disease, there is an increased risk of exacerbation of these diseases. Additionally during these periods, the treatment of certain psychiatric disorders may change or the necessity of amendment in drug doses may arise. Because studies about the psychiatric disorders in this period have been done in recent years, clinicians have limited data about approaching to the individuals in this period. Given that the neglected therapy of these disorders results in severe impairment of the mother-baby relationship, it is clear that the issue should be approached with sensitivity. In this paper, articles about common psychiatric disorders during pregnancy and postpartum period are reviewed and making suggestions to clinicians about identifying, interventions and treatments of these disorders. Key Words: pregnancy; postpartum; depression; anxiety; eating disorders; psychosis.