Clinical Features of Mental Disorders among Pregnant Women

Author Name(s): Victor A. Ruzhenkov, Ruslan T. Kuliev, Sergey P. Pakhomov, Irina N. Verzilina, Victoria V. Ruzhenkova, Inna S. Lukyantseva
Author Email: ruzhenkov@bsu.edu.ru

Abstract

A sample of 450 women with a normal pregnancy was examined using the clinical, psychopathological and psychometrical methods. Clinically outlined mental disorders with a predominance of neurotic, stress-related and somatoform disorders were found in 26.9% of cases. In 8.4% of cases pre-morbid (prenosological) mental disorders were detected. Psychometric examination revealed that 11.7% of pregnant women without clinical signs of psychiatric disorders had mild symptoms of anxiety, depression and asthenia. In most cases (79.3%), mental disorders were formed long before pregnancy, flowed in a mild form, and the majority (94.2%) of women did not seek help from a psychiatrist. The fifth (20.7%) part of diagnosed mental disorders, formed during pregnancy, were perceived by women as a natural “aspect of pregnancy”. Gestational, individual-personal and social-environmental factors played a significant role in the genesis of the pre-morbid mental disorders and conditions with high risk of disadaptation. Conducting sessions of relaxation training aimed at reducing anxiety and normalizing moods had a beneficial effect on the mental status of pregnant women and the course of pregnancy.

Introduction

Pregnancy, taking place without complications, is registered from 22.6% [1] to 36.2% [2] among women in Russia. Body reorganization during pregnancy can lead to both its pathology and cause disorders of the mental sphere [3]. The onset of pregnancy contributes to the aggravation of premorbid characteristics, leads to acute types of adaptation to pregnancy, anxiety and insecurity [4], exacerbating existing emotional disorders [5]. The states of anxiety of various levels are observed in 40% of women with a normal pregnancy [6, 7]. Almost 70% of pregnant women show individual symptoms of depression, and the incidence of perinatal depressions amounts to 10-20% [8, 9, 10].

The risk factors for the occurrence of mental disorders in pregnant women are emotional lability, irritability, spontaneous aggression and pregnancy overvaluation [11]. The pregnant women with mental disorders have a high percentage of cesarean section and high incidences of neonatal pathology are noted [12]. Anxiety disorders significantly affect the course of pregnancy and perinatal outcomes [5, 7].

There is another point of view, suggesting that pregnancy is essentially not associated with an increased risk of mental disorders [13, 14], although it is allowed the risk of depression in young, unmarried women with stressful life events and complicated pregnancy. Thus, there is conflicting information about the prevalence and clinical structure of mental disorders during pregnancy in the literature.

Due to the widespread prevalence, screening of mental disorders in pregnant women and providing them with primary health care is topical [15]. It has been proven that active treatment of pregnant women with mental disorders helps prevent the aggravation or relapse of mental disorders during pregnancy and in the postpartum period [16].

 

Conclusion

The data presented indicate the actualization of conflicting personality traits in pregnant women during pregnancy, which is a risk factor for conflict situations and tensions with the formation of borderline mental disorders. Considering the high specific gravity of mental disorders in pregnant women with physiological pregnancy, their donosological forms, as well as the high risk of maladaptation, there is an urgent need for consulting and diagnostic work with pregnant by the psychotherapist and clinical psychologist. Conducting sessions of relaxation training aimed at reducing anxiety and normalizing moods has a beneficial effect on both the mental status of pregnant women and the course of pregnancy.

References

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[11] Ruzhenkov, V.A., Kolosova, M.A., Ruzhenkova, V.V., 2014. Psychiatric Disorders among Women after Late Term Therapeutic Abortions (Clinical Findings and Risk Factors). Research Journal of Pharmaceutical, Biological and Chemical Sciences, 5: 1083-1086.

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[14] Ruzhenkov, V.A., Kuliev, R.T., Ruzhenkova V.V., Boeva, A.V., 2014. Psychopharmacotherapy of mental disorders in the course of physiological pregnancy. Research Journal of Pharmaceutical, Biological and Chemical Sciences, 5: 1087-1090.

[15] Rondó, P.H.C., Ferreira, R.F., Lemos, J.O., Pereira-Freire, J.A., 2016. Mental disorders in pregnancy and 5-8 years after delivery Glob Ment Health (Camb). 23(3): e31. eCollection 2016.

[16] Suzuk, I.S., 2017. Recent status of pregnant women with mental disorders at a Japanese perinatal center. J Matern Fetal Neonatal Med., 31: 1-19.

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