Bipolar bozukluk tanılı kadınlarda gebelikte ve postpartum dönemde rekürrens ve ilişkili etkenler
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Dosyalar
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Gebelikte ve postpartum dönemde bipolar bozukluğun (BPB) rekürrensi ile ilgili risk faktörleri yeterince ortaya konulmuş değildir. Bu çalışmada; BPB tanılı kadınların gebelikte ve postpartum dönemdeki duygudurum epizodlarının gelişimi ile ilişkili olabilecek etkenlere ulaşmak amaçlanmıştır. Yöntem: Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi Psikiyatri polikliniğine başvuran, DSM-5 tanı ölçütlerine göre BPB tanısı alan 58 hasta ve bu hastalara ait 102 gebelik olgusu çalışmaya dahil edilmiştir. Araştırmacı tarafından oluşturulan form ile olguların; sosyodemografik ve klinik özellikleri, genel gebelik bilgileri, gebelik öncesi son epizod bilgileri, son gebelikte ve postpartum dönemde hastalık bilgileri toplanmıştır. Veriler, gebelik ve postpartum dönem için, ayrı ayrı, duygudurum epizodu geçiren ve geçirmeyen grupları karşılaştırmak için kullanılmıştır. Bulgular: Tüm olguların (n=102) %26.5'i (n=27) gebelikte, %40.2'si (n=41) postpartum dönemde duygudurum epizodu geçirdi. Gebelikten önceki son epizodda hastane yatışı olması ve postpartum dönemde duygudurum epizodu geçirmiş olmak gebelikteki rekürrens ile anlamlı derecede ilişkili ve bağımsız etkenlerdi. Toplam epizod sayısının daha yüksek olması, en az bir epizodda psikotik özellik olması ve planlı gebelik postpartum rekürrens ile anlamlı derecede ilişkili ve bağımsız etkenlerdi. Ayrıca; baskın polarite, tedavi yanıt hızı, komorbid panik bozukluk, planlı gebelik, gebelik öncesi son epizodun düzensiz tedavi sonucu gelişmesi gebelikteki rekürrens ile; son gebelikteki duygudurum epizodunun düzelme süresinin artması ve gebelikte duygudurum epizodu geçirmiş olmak postpartum rekürrens ile anlamlı derecede ilişkili ancak bağımsız olmayan etkenlerdi. Sonuç: Bulgularımız, gebelik ve postpartum dönemdeki duygudurum epizodları ile bazı klinik özelliklerin ilişkili olduğunu göstermektedir. Konu ile ilgili daha büyük örneklemli ileriye dönük izlem çalışmalarının yapılması gerekmektedir.
The risk factors for the recurrence of bipolar disorder(BPD) during pregnancy and postpartum period have not been adequately demonstrated. In this study; It was aimed to reveal the factors that may be related to the development of mood episodes in women with BPD during pregnancy and postpartum period. Method: 58 patients who applied to Necmettin Erbakan University Meram Medical School Psychiatry outpatient clinic and were diagnosed with BPD according to DSM-5 diagnostic criteria and 102 pregnancy belonging to these patients were included in the study. Sociodemographic and clinical characteristics, general pregnancy information, information regarding last episode before pregnancy, disease information in the last pregnancy and postpartum period were collected with the form created by the researcher. Data were used to compare groups with and without mood episodes for pregnancy and the postpartum period, separately. Results: Among all cases (n:102), 26.5% (n:27) had a mood episode during pregnancy and 40.2% (n:41) had a mood episode in the postpartum period. The hospitalization in the last episode before pregnancy and having a mood episode in the postpartum period were significantly related and independent factors for recurrence in pregnancy. Higher total number of episodes, psychotic features in at least one episode and planned pregnancy were determined as independent factors which were significantly related with postpartum recurrence. Furthermore; predominant polarity, treatment response rate, comorbid panic disorder, planned pregnancy, development of the last episode before pregnancy as a result of treatment non-compliance were dependent factors that were significantly associated with recurrence in pregnancy. Increased duration of mood episode recovery in the last pregnancy and having a mood episode during pregnancy were dependent factors that were significantly associated with postpartum recurrence. Conclusion: Our findings show that mood episodes during pregnancy and postpartum period are associated with several clinical factors. Prospective follow-up studies with larger samples are needed on the subject.
The risk factors for the recurrence of bipolar disorder(BPD) during pregnancy and postpartum period have not been adequately demonstrated. In this study; It was aimed to reveal the factors that may be related to the development of mood episodes in women with BPD during pregnancy and postpartum period. Method: 58 patients who applied to Necmettin Erbakan University Meram Medical School Psychiatry outpatient clinic and were diagnosed with BPD according to DSM-5 diagnostic criteria and 102 pregnancy belonging to these patients were included in the study. Sociodemographic and clinical characteristics, general pregnancy information, information regarding last episode before pregnancy, disease information in the last pregnancy and postpartum period were collected with the form created by the researcher. Data were used to compare groups with and without mood episodes for pregnancy and the postpartum period, separately. Results: Among all cases (n:102), 26.5% (n:27) had a mood episode during pregnancy and 40.2% (n:41) had a mood episode in the postpartum period. The hospitalization in the last episode before pregnancy and having a mood episode in the postpartum period were significantly related and independent factors for recurrence in pregnancy. Higher total number of episodes, psychotic features in at least one episode and planned pregnancy were determined as independent factors which were significantly related with postpartum recurrence. Furthermore; predominant polarity, treatment response rate, comorbid panic disorder, planned pregnancy, development of the last episode before pregnancy as a result of treatment non-compliance were dependent factors that were significantly associated with recurrence in pregnancy. Increased duration of mood episode recovery in the last pregnancy and having a mood episode during pregnancy were dependent factors that were significantly associated with postpartum recurrence. Conclusion: Our findings show that mood episodes during pregnancy and postpartum period are associated with several clinical factors. Prospective follow-up studies with larger samples are needed on the subject.
Açıklama
Anahtar Kelimeler
Bipolar bozukluk, Peripartum dönem, Rekürrens, Bipolar disorder, Peripartum period, Recurrence
Kaynak
WoS Q Değeri
Scopus Q Değeri
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Sayı
Künye
Harmankaya, F. M. (2021). Bipolar bozukluk tanılı kadınlarda gebelikte ve postpartum dönemde rekürrens ve ilişkili etkenler. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Bölümü Ruh Sağlığı ve Hastalıkları Anabilim Dalı, Konya.
