Pushkarova T. Non-psychotic depressive and anxiety disorders in women during pregnancy in postpartum period and infant mental health protection (kliniks, diagnostiks, therapy, prophilactis).

The dissertation presents the research on epidemiology, phenomenological and pshodynamic typology of non-psychotic depressive and anxiety disorders in women during pregnancy and postpartum period. A screening of 1250 pregnant women in the second trimester has shown that 250 of them had non-psychotic depressive and anxiety disorders (DAD) and 18,9% of 153 women in postpartum period were diagnosed as postpartum depression. There has been performed an analysis of predisposing factors: sociodemografic, obstetric complications and diseases, stressful life events. Significant differences have been found between a group of women with DAD and 81 healthy pregnant women. Stressful life events, previous perinatal losses, obstetric diseases and complications, as well as significant psychodynamic conflicts and emotional dysregulation, had been defined as risk factors and predictors for depressive and anxiety disorders in pregnant women and for posnatal depression. Correlations have been found between maternal anxiety and depression during pregnancy and in postpartum period and infant neurotic disorders. It has been recognized that high levels of anxiety, perinatal losses, obstetric complications, stressful life events, conflictual relations between pregnant women and their partners and significant unconscious conflicts inhibit prenatal maternal attachment and disturb early mother-child relations. Correlations between high rates of maternal depression and the newborn weight/Apgar Scale Score were registered. A psychoanalytically oriented investigation of the pregnant women's internal world combined with a brief expressive-supportive intervention has reduced maternal anxiety and depression and has had a protective preventive effect on the infants. The findings of the research suggests integrated specialized mental health programs for pregnant women and mothers with infants in general praxis, obstetrics, gynecology and pediatry.