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Z Geburtshilfe Neonatol 2021; 225(04): 300-305
DOI: 10.1055/a-1471-7256
Übersicht

Messinstrumente zur peripartalen Diagnostik von Depression, Angst und Stress (Teil 1 einer Serie zur psychologischen Diagnostik im Peripartalzeitraum)

Questionnaires for the Assessment of Peripartum Depression, Anxiety and Stress (Part 1 of a series on psychological assessment during the peripartum period)
Tobias Weigl 
1   Psychology School, Hochschule Fresenius – University of Applied Sciences, Düsseldorf, Deutschland
,
Susan Garthus-Niegel 
1   Psychology School, Hochschule Fresenius – University of Applied Sciences, Düsseldorf, Deutschland
2   Fakultät Medizin, MSH Medical School Hamburg – University of Applied Sciences and Medical University, Hamburg, Deutschland
3   Institut und Poliklinik für Arbeits- und Sozialmedizin, TU Dresden, Dresden, Deutschland
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Zusammenfassung

Während der Schwangerschaft und nach der Geburt kann es bei Frauen und Männern zu psychischen Beschwerden kommen. Am häufigsten finden sich Ängste in Bezug auf die Schwangerschaft und die Geburt sowie prä- und postpartal erhöhte Depressionswerte. Bei Populationen mit besonderen Belastungen, wie den Eltern von Frühgeborenen, ist darüber hinaus von einer stark erhöhten Stressbelastung auszugehen. Zur standardisierten sowie zeitökonomischen Erfassung der genannten Beschwerden sind geeignete Fragebögen nötig. Allerdings liegen nur wenige für den deutschen Sprachraum validierte Instrumente vor, die in Forschung und Klinik zudem nur wenig bekannt sind. Eine Ausnahme stellt hier die Edinburgh Postnatal Depression Scale dar. Weiterhin werden Männer zumeist nicht explizit in Fragebögen berücksichtigt. Zur Vorbeugung sowie Behandlung psychischer Beschwerden im Peripartalzeitraum stellen geeignete Screening-Instrumente eine wichtige Voraussetzung dar. Auf dieser Grundlage können bei den Betroffenen akute Belastungen abgemildert und chronische Verläufe mit Folgen für das Kind oder die Paarbeziehung verhindert werden. Hierfür scheint zukünftig eine Vereinheitlichung hinsichtlich der verwendeten Instrumente nötig.

Abstract

During pregnancy and after birth, women and men may experience symptoms of psychological distress. The most common symptoms comprise pregnancy-related anxiety and fear of childbirth as well as elevated levels of depression throughout the peripartum period. Particularly burdened populations, such as parents of premature infants, are also likely to experience greatly increased stress levels. Adequate questionnaires are needed to provide a standardized and time-efficient assessment of the aforementioned symptoms. However, only few questionnaires have been validated in the German language, and with the exception of the Edinburgh Postnatal Depression Scale, most of them are not very common in research and clinical practice. Furthermore, men are widely underrepresented in these questionnaires. Nevertheless, suitable screening tools are a prerequisite for the prevention and treatment of mental health problems in the peripartum period. Thus, symptoms of acute distress can be alleviated and the manifestation of chronic mental disorders with adverse consequences for the child or the couple relationship can be prevented. Therefore a standardization of the instruments used might be needed for future research and clinical practice.

Schlüsselwörter

Prävention - Fragebögen - peripartale psychische Gesundheit

Key words

prevention - self-report measures - perinatal mental health


Publikationsverlauf

Eingereicht: 08. Februar 2021

Angenommen nach Revision: 21. März 2021

Artikel online veröffentlicht:
31. Mai 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Lonstein JS. Regulation of anxiety during the postpartum period. Front Neuroendocrinol 2007; 28: 115-141
    CrossrefPubMedGoogle Scholar
  • 2 Yim IS, Tanner Stapleton LR, Guardino CM. et al. Biological and psychosocial predictors of postpartum depression: systematic review and call for integration. Annu Rev Clin Psychol 2015; 11: 99-137
    CrossrefPubMedGoogle Scholar
  • 3 Yin X, Sun N, Jiang N. et al. Prevalence and associated factors of antenatal depression: Systematic reviews and meta-analyses. Clin Psychol Rev 2020; 83: 101932
    CrossrefPubMedGoogle Scholar
  • 4 Szpunar MJ, Parry BL. A systematic review of cortisol, thyroid-stimulating hormone, and prolactin in peripartum women with major depression. Arch Womens Ment Health 2018; 21: 149-161
    PubMedGoogle Scholar
  • 5 Weigl T, Schneider N, Stein A. et al. Postpartal Affective and Endocrine Differences Between Parents of Preterm and Full-Term Infants. Front Psychiatry 2020; 11: 251
    CrossrefPubMedGoogle Scholar
  • 6 Kuhner C. Mental disorders in pregnancy and postpartum: Prevalence, course, and clinical diagnostics. Nervenarzt 2016; 87: 926-936
    CrossrefPubMedGoogle Scholar
  • 7 Dorsch VM, Rohde A. Mood disorders in pregnancy and post partum period. MMW Fortschr Med 2010; 152: 27-30
    PubMedGoogle Scholar
  • 8 Weigl T. Postpartale psychische Störungen und ihre Bedeutung für die Wochenbettbetreuung. Die Hebamme 2019; 32: 32-41
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 9 Bowers ME, Yehuda R. Intergenerational Transmission of Stress in Humans. Neuropsychopharmacology 2016; 41: 232-244
    CrossrefPubMedGoogle Scholar
  • 10 Wittkowski A, Vatter S, Muhinyi A. et al. Measuring bonding or attachment in the parent-infant-relationship: A systematic review of parent-report assessment measures, their psychometric properties and clinical utility. Clin Psychol Rev 2020; 82: 101906
    CrossrefPubMedGoogle Scholar
  • 11 Weidner K, Garthus-Niegel S, Junge-Hoffmeister J. Traumatic Birth: Recognition and Prevention. Z Geburtshilfe Neonatol 2018; 222: 189-196
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 12 Bell AF, Andersson E. The birth experience and womenʼs postnatal depression: A systematic review. Midwifery 2016; 39: 112-123
    CrossrefPubMedGoogle Scholar
  • 13 Garthus-Niegel S, von Soest T, Vollrath ME. et al. The impact of subjective birth experiences on post-traumatic stress symptoms: a longitudinal study. Arch Womens Ment Health 2013; 16: 1-10
    CrossrefPubMedGoogle Scholar
  • 14 Khalifeh H, Hunt IM, Appleby L. et al. Suicide in perinatal and non-perinatal women in contact with psychiatric services: 15 year findings from a UK national inquiry. Lancet. Psychiatry 2016; 3: 233-242
    PubMedGoogle Scholar
  • 15 Oates M. Suicide: the leading cause of maternal death. Br J Psychiatry 2003; 183: 279-281
    CrossrefPubMedGoogle Scholar
  • 16 Shi P, Ren H, Li H. et al. Maternal depression and suicide at immediate prenatal and early postpartum periods and psychosocial risk factors. Psychiatry Res 2018; 261: 298-306
    CrossrefPubMedGoogle Scholar
  • 17 Grigoriadis S, Wilton AS, Kurdyak PA. et al. Perinatal suicide in Ontario, Canada: a 15-year population-based study. CMAJ 2017; 189: E1085-E1092
    CrossrefPubMedGoogle Scholar
  • 18 Brockington I. Suicide and filicide in postpartum psychosis. Arch Womens Ment Health 2017; 20: 63-69
    CrossrefPubMedGoogle Scholar
  • 19 Bauer A, Parsonage M, Knapp M. et al. The costs of perinatal mental health problems. London: Centre for Mental Health and London School of Economics. 2014
    Google Scholar
  • 20 Huizink AC, Delforterie MJ, Scheinin NM. et al. Adaption of pregnancy anxiety questionnaire-revised for all pregnant women regardless of parity: PRAQ-R2. Arch Womens Ment Health 2016; 19: 125-132
    CrossrefPubMedGoogle Scholar
  • 21 Huizink AC, Mulder EJ, Robles de Medina PG. et al. Is pregnancy anxiety a distinctive syndrome?. Early Hum Dev 2004; 79: 81-91
    CrossrefPubMedGoogle Scholar
  • 22 Mudra S, Gobel A, Barthel D. et al. Psychometric properties of the German version of the pregnancy-related anxiety questionnaire-revised 2 (PRAQ-R2) in the third trimester of pregnancy. BMC Pregnancy Childbirth 2019; 19: 242
    CrossrefPubMedGoogle Scholar
  • 23 Nilges P, Essau C. Depression, anxiety and stress scales: DASS – A screening procedure not only for pain patients. Schmerz 2015; 29: 649-657
    CrossrefPubMedGoogle Scholar
  • 24 Martini J, Einbock K, Wintermann G. et al. Die Depression-Angst-Stress-Skala für die Peripartalzeit: Ein Screeninginstrument für die Schwangerschaft und das Wochenbett. Klinische Diagnostik und. Evaluation 2009; 4: 288-309
    PubMedGoogle Scholar
  • 25 Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther 1995; 33: 335-343
    CrossrefPubMedGoogle Scholar
  • 26 Martini J. Wenn das Muttersein nicht glücklich macht. Ärztliche Praxis NeurologiePsychiatrie 2011; 3: 34-37
    PubMedGoogle Scholar
  • 27 Andrews G, Peters L. The psychometric properties of the Composite International Diagnostic Interview. Soc Psychiatry Psychiatr Epidemiol 1998; 33: 80-88
    CrossrefPubMedGoogle Scholar
  • 28 Martini J, Bauer M, Lewitzka U. et al. Predictors and outcomes of suicidal ideation during peripartum period. J Affect Disord 2019; 257: 518-526
    CrossrefPubMedGoogle Scholar
  • 29 Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 1987; 150: 782-786
    CrossrefPubMedGoogle Scholar
  • 30 Bergant AM, Nguyen T, Heim K. et al. German language version and validation of the Edinburgh postnatal depression scale. Deutsche medizinische Wochenschrift 1998; 123: 35-40
    PubMedGoogle Scholar
  • 31 Herz E, Thoma M, Umek W. et al. Nicht-psychotische postpartale Depression. Geburtshilfe und Frauenheilkunde 1997; 57: 282-288
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 32 Garthus-Niegel S, Staudt A, Kinser P. et al. Predictors and Changes in Paternal Perinatal Depression Profiles-Insights From the DREAM Study. Front Psychiatry 2020; 11: 563761
    CrossrefPubMedGoogle Scholar
  • 33 Matthey S. Does an early postpartum Edinburgh Postnatal Depression Scale (EPDS) really detect the majority of women with elevated EPDS scores at 16-weeks postpartum?. Arch Womens Ment Health 2017; 20: 811-812
    CrossrefPubMedGoogle Scholar
  • 34 Matthey S, Agostini F. Using the Edinburgh Postnatal Depression Scale for women and men-some cautionary thoughts. Arch Womens Ment Health 2017; 20: 345-354
    CrossrefPubMedGoogle Scholar
  • 35 Matthey S, Della Vedova AM, Agostini F. The Edinburgh Postnatal Depression Scale in routine screening: errors and cautionary advice. Am J Obstet Gynecol 2017; 216: 424
    CrossrefPubMedGoogle Scholar
  • 36 Kozinszky Z, Dudas RB. Validation studies of the Edinburgh Postnatal Depression Scale for the antenatal period. J Affect Disord 2015; 176: 95-105
    CrossrefPubMedGoogle Scholar
  • 37 Miles MS, Funk SG, Carlson J. Parental Stressor Scale: neonatal intensive care unit. Nurs Res 1993; 42: 148-152
    CrossrefPubMedGoogle Scholar
  • 38 Urlesberger P, Schienle A, Pichler G. et al. A new German Scale for Assessing Parental Stress after Preterm Birth (PSS:NICU_German/2-scales). Z Geburtshilfe Neonatol 2017; 221: 81-87
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 39 Singer D. Long-term survival of preterm neonates. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2012; 55: 568-575
    PubMedGoogle Scholar
  • 40 Kreuzhof J, Maier R, Dobler K. The Stepwise Care of Very Low Birth Weight Infants in Germany and Internationally. Z Geburtshilfe Neonatol 2020; 224: 31-37
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 41 Reulbach U, Bleich S, Knorr J. et al. Pre-, peri- and postpartal depression. Fortschr Neurol Psychiatr 2009; 77: 708-713
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 42 Robertson E, Grace S, Wallington T. et al. Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry 2004; 26: 289-295
    CrossrefPubMedGoogle Scholar
  • 43 Huizink AC, Menting B, De Moor MHM. et al. From prenatal anxiety to parenting stress: a longitudinal study. Arch Womens Ment Health 2017; 20: 663-672
    CrossrefPubMedGoogle Scholar
  • 44 Brunton RJ, Dryer R, Krageloh C. et al. The pregnancy-related anxiety scale: A validity examination using Rasch analysis. J Affect Disord 2018; 236: 127-135
    CrossrefPubMedGoogle Scholar
  • 45 Gawlik S, Waldeier L, Muller M. et al. Subclinical depressive symptoms during pregnancy and birth outcome – a pilot study in a healthy German sample. Arch Womens Ment Health 2013; 16: 93-100
    CrossrefPubMedGoogle Scholar
  • 46 Lai BP, Tang AK, Lee DT. et al. Detecting postnatal depression in Chinese men: a comparison of three instruments. Psychiatry Res 2010; 180: 80-85
    CrossrefPubMedGoogle Scholar
  • 47 Thiel F, Pittelkow MM, Wittchen HU. et al. The Relationship Between Paternal and Maternal Depression During the Perinatal Period: A Systematic Review and Meta-Analysis. Front Psychiatry 2020; 11: 563287
    CrossrefPubMedGoogle Scholar
  • 48 Condon JT, Boyce P, Corkindale CJ. The First-Time Fathers Study: a prospective study of the mental health and wellbeing of men during the transition to parenthood. Aust N Z J Psychiatry 2004; 38: 56-64
    CrossrefPubMedGoogle Scholar
  • 49 Winter L, Colditz PB, Sanders MR. et al. Depression, posttraumatic stress and relationship distress in parents of very preterm infants. Arch Womens Ment Health 2018; 21: 445-451
    CrossrefPubMedGoogle Scholar
  • 50 Garthus-Niegel S, Horsch A, Handtke E. et al. The Impact of Postpartum Posttraumatic Stress and Depression Symptoms on Couplesʼ Relationship Satisfaction: A Population-Based Prospective Study. Front Psychol 2018; 9: 1728
    CrossrefPubMedGoogle Scholar
  • 51 Weigl T. Psychische Auswirkungen der Frühgeburt auf die Eltern. Die Hebamme 2018; 31: 268-273
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 52 Hesse BW. Can psychology walk the walk of open science?. Am Psychol 2018; 73: 126-137
    CrossrefPubMedGoogle Scholar
  • 53 Sangsawang B, Wacharasin C, Sangsawang N. Interventions for the prevention of postpartum depression in adolescent mothers: a systematic review. Arch Womens Ment Health 2019; 22: 215-228
    CrossrefPubMedGoogle Scholar