Ernesto Mangiapane
IPSA, Italy
Title: Multidisciplinary management of Post-Partum Depression (PPD): from screening to the implementation of a specific clinical-care treatment protocol
Biography
Biography: Ernesto Mangiapane
Abstract
Post-Partum Depression (PPD) is defined as depression with the onset of symptoms during pregnancy or within 6 weeks of delivery. The PPD occurs in 10- 15% of the new mothers and if not diagnosed it is present in 50% at 6 months, and in 25% at a year (Trop et al., 2018) . The implementation of a protocol is essential to examine the current diagnostic criteria, the probability of performing differential diagnosis or to find predictors of risk factors for PPD. Screening tools must be able to establish the right timing of action and women acceptability. The support path arises from the collaboration between those who provide primary care to women - Midwives and Ob/Gyn and mental health professionals - Psychologists and Psychiatrists (Missonnier S., 2003). The selected professional figures are called on a longitudinal management of the cases, in order to ensure a holistic treatment and a close follow-up. The multidisciplinary aspect of treatment for PDD reflects the need for health of every woman and her child and has positive implications for the family and the whole society. If no action is taken, the PPD is a significant risk factor for the development of the child as well as for the style of insecure attachment to the caregiver (Coyle et al., 2000). It has been documented how the risk of depression affects maternal behavior, limiting emotional expression and the quality of relational exchanges, within the process of mutual emotional regulation (Ammaniti et al., 2006). PPD can lead to an affective dysregulation and a deficit in psycho-biological synchronization which represents a psychopathological vulnerability for the child. Psychoneuroimmunology studies on PPD show how the main risk factor is related to the inflammatory process increased by stress (it increases the level of cortisol - a hormone often elevated in depressed people) . Normally inflammation increases during the last trimester of pregnancy - a period when there is also a high risk of depression (Kendall-Tackett KA. A, 2007). The use of the multidisciplinary protocol would lead to the prevention of psychopathological disorders in the child.