Peculiarities of perinatal depression: diagnostics, treatment, consequences

Unė Krasauskaitė1,  Mantas Guzevičius1

1Lithuanian University of Health Sciences, Academy of Medicine, Faculty of Medicine, Kaunas, Lithuania



According to the diagnostic and statistical manual of mental disorders: 5th edition (DSM-5) depression that occurred during the pregnancy or up to 4 weeks postpartum is called perinatal depression. This disorder is hard to identify as it is nonhomogenous and manifests differently in every woman. Prevalence of the disease depends on various factors. Experiencing depression before pregnancy is one of the main risk factors for perinatal depression to develop. It is diagnosed in accordance with DSM-5 criteria when two main and two additional symptoms manifest in a period of two weeks. Depression during pregnancy and after giving birth can lead to serious consequences for both mother and child, if not treated promptly. It is important to perform a psychiatric examination and prescribe treatment. Especially when there are moderate to severe symptoms, suicidal thoughts or signs of psychosis. For adequate treatment the safety – risk balance and individual patient’s situation must be accessed. Second generation antidepressants (selective serotonin uptake inhibitors) is a first – choice pharmacotherapy for perinatal depression. Combining psychotherapy with medication is important when treating moderate to severe depression. Women may refuse to use antidepressants during pregnancy or breastfeeding thinking it might affect the fetus or newborn. It is therefore important to let them know about alternative treatments. Psychotherapy is a method of first choice for treatment of mild to moderate depression. Additionally, cognitive behavioral and interpersonal therapy can be effective means of prevention and treatment. Perinatal depression can have adverse effects on the fetus as well as newborn. Consequently, the disorder can lead to harmful maternal behavior that would affect fetus during the prenatal period. Untreated depression during pregnancy persists after childbirth.

Keywords: perinatal depression, pregnancy, postpartum depression, mental disorder.