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      Biopsychosocial models of peripartum depression: a narrative review Translated title: Los modelos biopsicosociales y la depresión perinatal: una revisión descriptiva

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          Abstract

          ABSTRACT Background: Peripartum depression (PPD) is a prevalent, heterogeneous disorder with various underlying mechanisms and unwanted outcomes. Substantial uncertainty surrounding PPD aetiology exists. To comprehensively investigate PPD, research is adopting the biopsychosocial theoretical model highlighting the interplay between biological and psychosocial factors. This paper aims to provide an overview of risk factors and biopsychosocial models of PPD. Method: A literature search was conducted in databases to identify risk factors and biopsychosocial models of PPD. Results: The most robust biological and psychosocial risk factors of PPD and findings from integrative studies are outlined. Several biopsychosocial models are identified, explaining antepartum, postpartum or peripartum depression. Integrative models show promise but differ in conceptualisation and proposed aetiological pathways underlying PPD. Conclusion: Biopsychosocial principles should be applied throughout the perinatal research and healthcare provision as a necessary landmark towards guiding future theory, improving maternal mental health care and ensuring better outcomes for mothers and children.

          Translated abstract

          RESUMEN Antecedentes: La depresión perinatal (DPN) es un trastorno predominante heterogéneo al que subyacen diversos mecanismos y consecuencias indeseadas. Hay una gran incertidumbre sobre la etiología de la DPN. Con el fin de investigar exhaustivamente el trastorno, la investigación asume el modelo teórico biopsicosocial, que destaca la interacción entre los factores biológicos y psicosociales. El estudio pretende presentar un resumen de los factores de riesgo y de los modelos psicosociales de la DPN. Método: Se llevó a cabo una búsqueda de las publicaciones en las bases de datos para localizar los factores de riesgo y los modelos biopsicosociales. Resultados: Se describen los factores biológicos de riesgo psicosocial más consistentes de la DPN y los resultados de los estudios integradores. Se detectaron diversos modelos biopsicosociales que explicaban la depresión preparto, posparto y perinatal. Los modelos integradores son prometedores pero difieren en la conceptualización y las trayectorias propuestas que subyacen a la DPN. Conclusión: Deberían aplicarse los principios biopsicosociales a lo largo de la investigación perinatal y facilitar asistencia sanitaria como hito necesario que sirva de guía a la teoría futura, mejorando la asistencia mental materna y garantizando los mejores resultados para madres e hijos.

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          The need for a new medical model: a challenge for biomedicine

          G. Engel (1977)
          The dominant model of disease today is biomedical, and it leaves no room within tis framework for the social, psychological, and behavioral dimensions of illness. A biopsychosocial model is proposed that provides a blueprint for research, a framework for teaching, and a design for action in the real world of health care.
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            Identifying the women at risk of antenatal anxiety and depression: A systematic review

            Background Pregnancy is a time of increased vulnerability for the development of anxiety and depression. This systematic review aims to identify the main risk factors involved in the onset of antenatal anxiety and depression. Methods A systematic literature analysis was conducted, using PubMed, PsychINFO, and the Cochrane Library. Original papers were included if they were written in English and published between 1st January 2003 and 31st August 2015, while literature reviews and meta-analyses were consulted regardless of publication date. A final number of 97 papers were selected. Results The most relevant factors associated with antenatal depression or anxiety were: lack of partner or of social support; history of abuse or of domestic violence; personal history of mental illness; unplanned or unwanted pregnancy; adverse events in life and high perceived stress; present/past pregnancy complications; and pregnancy loss. Limitations The review does not include a meta-analysis, which may have added additional information about the differential impact of each risk factor. Moreover, it does not specifically examine factors that may influence different types of anxiety disorders, or the recurrence or persistence of depression or anxiety from pregnancy to the postpartum period. Conclusions The results show the complex aetiology of antenatal depression and anxiety. The administration of a screening tool to identify women at risk of anxiety and depression during pregnancy should be universal practice in order to promote the long-term wellbeing of mothers and babies, and the knowledge of specific risk factors may help creating such screening tool targeting women at higher risk.
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              Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes

              Introduction: The postpartum period represents the time of risk for the emergence of maternal postpartum depression. There are no systematic reviews of the overall maternal outcomes of maternal postpartum depression. The aim of this study was to evaluate both the infant and the maternal consequences of untreated maternal postpartum depression. Methods: We searched for studies published between 1 January 2005 and 17 August 2016, using the following databases: MEDLINE via Ovid, PsycINFO, and the Cochrane Pregnancy and Childbirth Group trials registry. Results: A total of 122 studies (out of 3712 references retrieved from bibliographic databases) were included in this systematic review. The results of the studies were synthetized into three categories: (a) the maternal consequences of postpartum depression, including physical health, psychological health, relationship, and risky behaviors; (b) the infant consequences of postpartum depression, including anthropometry, physical health, sleep, and motor, cognitive, language, emotional, social, and behavioral development; and (c) mother–child interactions, including bonding, breastfeeding, and the maternal role. Discussion: The results suggest that postpartum depression creates an environment that is not conducive to the personal development of mothers or the optimal development of a child. It therefore seems important to detect and treat depression during the postnatal period as early as possible to avoid harmful consequences.
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                Author and article information

                Journal
                clinsa
                Clínica y Salud
                Clínica y Salud
                Colegio Oficial de la Psicología de Madrid (Madrid, Madrid, Spain )
                1130-5274
                2174-0550
                2023
                : 34
                : 2
                : 91-99
                Affiliations
                [01] Zagreb orgnameCatholic University of Croatia Croatia
                Article
                S1130-52742023000200007 S1130-5274(23)03400200007
                10.5093/clysa2023a16
                97152189-b6a6-43da-b535-f037a346be16

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 19 June 2023
                : 23 June 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 71, Pages: 9
                Product

                SciELO Spain

                Categories
                Research Article

                Depresión perinatal,Peripartum mental health,Postpartum,Pregnancy,Biopsychosocial model,Risk factors,Peripartum depression,Salud mental perinatal,Puerperio,Embarazo,Modelo biopsicosocial,Factores de riesgo

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