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Trastorno de angustia durante el embarazo y el periodo postparto

Published online by Cambridge University Press:  12 May 2020

Borwin Bandelow ,
Felicita Sojka ,
Andreas Broocks ,
Göran Hajak ,
Stefan Bleich  and
Eckart Rüther
Borwin Bandelow
Affiliation:
von-Siebold-Str. 5, Departamento de Psiquiatría y Psicoterapia, Universidad de Gotinga, Alemania
Felicita Sojka
Affiliation:
von-Siebold-Str. 5, Departamento de Psiquiatría y Psicoterapia, Universidad de Gotinga, Alemania
Andreas Broocks
Affiliation:
Departamento de Psiquiatría y Psicoterapia, Universidad de Lübeck, Alemania
Göran Hajak
Affiliation:
Departamento de Psiquiatría y Psicoterapia, Universidad de Regensburg, Alemania
Stefan Bleich
Affiliation:
Departamento de Psiquiatría y Psicoterapia, Universidad de Erlangen-Nuremberg, Alemania
Eckart Rüther
Affiliation:
von-Siebold-Str. 5, Departamento de Psiquiatría y Psicoterapia, Universidad de Gotinga, Alemania
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Resumen

Antecedentes.

– Los estudios anteriores sobre la influencia del embarazo y el periodo postparto en el curso del trastorno de angustia (panic disorder) no han sido coherentes. El presente estudio pretende cuantificar las manifestaciones de angustia en estos periodos en una muestra grande de mujeres.

Método.

– Se evaluó retrospectivamente las manifestaciones de angustia, incluidas las exacerbaciones y las nuevas manifestaciones del trastorno de angustia, en una muestra de 128 mujeres con trastorno de angustia con o sin agorafobia, 93 de las cuales habían tenido 195 embarazos.

Resultados.

– Las manifestaciones de angustia fueron menores en número durante el embarazo y más frecuentes en el periodo postparto cuando se comparaba con el periodo de control. Las mujeres que nunca habían estado embarazadas tenían significativamente más manifestaciones de angustia que las mujeres con embarazos anteriores. La lactancia materna y los abortos espontáneos no tuvieron un efecto significativo. Las mujeres con angustia postparto comunicaron más acontecimientos de estrés psicosocial durante este periodo.

Conclusiones.

– Se analizan las posibles razones para la angustia postparto y los efectos protectores del embarazo, incluidos los factores psicosociales u hormonales y otros cambios neurobiológicos. La angustia postparto coincide con una caída repentina de las hormonas después del parto.

Keywords

Trastorno de angustiaEmbarazoPostpartoEstrógenosProgesterona
Type
Artículo original
Information
European Psychiatry (Ed. Española) , Volume 14 , Issue 1 , February 2007 , pp. 44 - 50
Copyright
Copyright © European Psychiatric Association 2007

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References

Bibliografía

[1]Andrade, L, Eaton, WW, Chilcoat, HD. Lifetime co-morbidity of panic at tacks and major depression in a population-based study: age of onset. Psychol Med 1996;26(5):991-6.CrossRefGoogle Scholar
[2]APA. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington DC: American Psychiatric Press; 1994.Google Scholar
[3]Bandelow, B, Sengos, G, Wedekind, D, Mucther, G, Pilz, J, Broocks, A, et, al. Urinary excretion of cortisol, norepinephrine, testosterona, and melatonin in panic disorder. Pharmacopsychiatry 1997;30(4): 113-7 [published erratum appears in Pharmacopsychiatry 1997 Nov;30(6):278],CrossRefGoogle ScholarPubMed
[4]Bandelow, B, Wedekind, D, Pauls, J, Broocks, A, Hajak, G, Ruther, E. Salivary cortisol in panic attacks. Am J Psychiatry 2000;157(3):454-6.CrossRefGoogle ScholarPubMed
[5]Bandelow, B, Wedekind, D, Sandvoss, V, Broocks, A, Majak, G, Pouls, J, et, al. Diurnal variation of cortisol in panic disorder. Psychiatry Res 2000;95(3):245-50.CrossRefGoogle ScholarPubMed
[6]Bloch, M, Schmidt, PJ, Danaceau, M, Murphy, J, Nieman, L, Rubinow, DR. Effects of gonadal steroids in women with a history of postpartum depression. Am J Psychiatry 2000;157(6):924-30.CrossRefGoogle ScholarPubMed
[7]Brunner, E, Domhof, S, Langer, ENonparametric Analysis of Longitudinal Data in Factorial Experiments. New York: Wiley; 2002.Google Scholar
[8]Brunner, E, Langer, F. Nichtparametrische Analyse Longitudinaler Daten. Oldenbourg: Munchen Wien; 1999.Google Scholar
[9]Buckwalter, JG, Stanczyk, FZ, McCleary, CA, Bluestein, BW, Buckwalter, DK, Rankin, KP, et, al. Pregnancy, the postpartum, and steroid hormones: effects on cognition and mood. Psychoneuroendocrinology 1999;24(1):69-84.CrossRefGoogle Scholar
[10]Chakravorty, SG, Halbreich, U. The influence of estrogen on monoamine oxidase activity. Psychopharmacol Bull 1997;33(2):229-33.Google ScholarPubMed
[11]Cohen, LS, Sichel, DA, Dimmock, JA, Rosenbaum, JF. Impact of pregnancy on panic disorder: a case series. J Clin Psychiatry 1994;55(7):284-8.Google ScholarPubMed
[12]Cohen, LS, Sichel, DA, Dimmock, JA, Rosenbaum, JF. Postpartum course in women with preexisting panic disorder. J Clin Psychiatry 1994;55(7):289-92.Google ScholarPubMed
[13]Cohen, LS, Sichel, DA, Faraone, SV, Robertson, LM, Dimmock, JA, Rosenbaum, JF. Course of panic disorder during pregnancy and the puerperium: a preliminary study. Biol Psychiatry 1996;39(11):950-4.CrossRefGoogle ScholarPubMed
[14]Cowley, DS, Roy-Byme, PP. Panic disorder during pregnancy. J Psychosom Obstet Gynaecol 1989;10:193-210.CrossRefGoogle Scholar
[15]Cox, JL, Murray, D, Chapman, G. A controlled study of the onset, duration and prevalence of postnatal depression. Br J Psychiatry 1993;163:27-31.CrossRefGoogle ScholarPubMed
[16]Etgen, AM, Karkanias, GB. Estrogen regulation of noradrenergic signaling in the hypothalamus. Psychoneuroendocrinology 1994; 19(5-7):603-10.CrossRefGoogle ScholarPubMed
[17]Fisch, RZ. Postpartum anxiety disorder. J Clin Psychiatry 1989;50(7):286.Google Scholar
[18]George, DT, Ladenheim, JA, Nutt, DJ. Effect of pregnancy on panic at tacks. Am J Psychiatry 1987;144(8):1078-9.Google Scholar
[19]Gorman, JM, Copian, JD. Comorbidity of depression and panic disorder. J Clin Psychiatry 1996;57(Suppl 10):34-41 [discussion 42-3].Google ScholarPubMed
[20]Gregoire, AJ, Kumar, R, Everitt, B, Henderson, AF, Studd, JW. Transdermal oestrogen for treatment of severe postnatal depression. Lancet 1996;347(9006):930-3.CrossRefGoogle ScholarPubMed
[21]Griez, EJ, Hauzer, R, Meijer, J. Pregnancy and estrogen-induced panic. Am J Psychiatry 1995; 152(11): 1688.Google ScholarPubMed
[22]Halbreich, U. Hormonal interventions with psychopharmacological potential: an overview. Psychopharmacol Bull 1997;33(2):281-6.Google ScholarPubMed
[23]Harris, B, Lovett, L, Newcombe, RG, Read, GF, Walker, R, Riad-Fahmy, D. Maternity blues and major endocrine changes: Cardiff puerperal mood and hormone study II. BMJ 1994;308(6934):949-53.Google ScholarPubMed
[24]Harris, B, Lovett, L, Smith, J, Read, G, Walker, R, Newcombe, R. Cardiff puerperal mood and hormone study. III. Postnatal depression at 5 to 6 weeks postpartum, and its hormonal correlates across the peripartum period. Br J Psychiatry 1996;168(6):739-44.CrossRefGoogle ScholarPubMed
[25]Hendrick, V, Stowe, ZN, Altshuler, LL, Hostetter, A, Fukuchi, A. Paroxetine use during breast-feeding. J Clin Psychopharmacol 2000;20(5):587-9.CrossRefGoogle ScholarPubMed
[26]Hendrick, VC, Altshuler, LL. Management of breakthrough panic disorder symptoms during pregnancy. J Clin Psychopharmacol 1997;17(3):228-9.CrossRefGoogle ScholarPubMed
[27]Hertzberg, T, Wahlbeck, K. The impact of pregnancy and puerperium on panic disorder: a review. J Psychosom Obstet Gynaecol 1999;20(2):59-64.CrossRefGoogle ScholarPubMed
[28]Iqbal, MM, Sobhan, T, Ryals, T. Effects of commonly used benzodiazepines on the fetus, the neonate, and the nursing infant. Psychiatr Serv 2002;53(1):39-49CrossRefGoogle ScholarPubMed
[29]Klein, DF. False suffocation alarms, spontaneous panics, and related conditions. An integrative hypothesis. Arch Gen Psychiatry 1993;50(4):306-17.CrossRefGoogle ScholarPubMed
[30]Klein, DF. Pregnancy and panic disorder. J Clin Psychiatry 1994;55(7):293-4.Google ScholarPubMed
[31]Klein, DF, Skrobala, AM, Garfinkel, RS. Preliminary look at the effects of pregnancy on the course of panic disorder. Anxiety 1994; 1(5):227-32.Google Scholar
[32]Kraus, RP. Postpartum anxiety disorder. J Clin Psychiatry 1989;50(7): 268-9 [letter; comment].Google Scholar
[33]Martin, MC, Hoffman, PG. The endocrinology of pregnancy. In: Greenspan, FS, Forsham, PH, editors. Basic and Clinical Endocrinology, 2nd ed. Los Altos, CA: Lange; 1986. p. 476-500.Google Scholar
[34]Metz, A, Sichel, DA, Goff, DC. Postpartum panic disorder. J Clin Psychiatry 1988;49(7):278-9.Google ScholarPubMed
[35]Misri, S, Kostaras, D, Kostaras, X. The use of selective serotonin reuptake inhibitors during pregnancy and lactation: Current knowledge. Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie 2000;45(3):285-7.CrossRefGoogle ScholarPubMed
[36]Northcott, CJ, Stein, MB. Panic disorder in pregnancy. J Clin Psychiatry 1994;55(12):539-42Google ScholarPubMed
[37]O’ Hara, MW, Zekoski, EM, Philipps, LH, Wright, EJ. Controlled prospective study of postpartum mood disorders: comparison of childbearing and nonchildbearing women. J Abnorm Psychol 1990;99(1):3-15.Google Scholar
[38]Paul, SM, Purdy, RH. Neuroactive steroids. FASEB J 1992;6(6):2311-22.CrossRefGoogle ScholarPubMed
[39]Pigott, TA. Gender differences in the epidemiology and treatment of anxiety disorders. J Clin Psychiatry 1999;60(Suppl 18):4-15.Google ScholarPubMed
[40]Schmidt, ME, Matochik, JA, Goldstein, DS, Schouten, JL, Zametkin, AJ, Potter, WZ. Gender differences in brain metabolic and plasma catecholamine responses to alpha 2-adrenoceptor blockade. Neuropsychopharmacology 1997; 16(4):298-310.Google ScholarPubMed
[41]Seeman, MV. Psychopathology in women and men: focus on female hormones. Am J Psychiatry 1997;154(12): 1641-7.CrossRefGoogle ScholarPubMed
[42]Sholomskas, DE, Wickamaratne, PJ, Dogolo, L, O'Brien, DW, Leaf, PJ, Woods, SW. Postpartum onset of panic disorder: a coincidental event? J Clin Psychiatry 1993;54(12):476-80.Google ScholarPubMed
[43]Sichel, DA, Cohen, LS, Robertson, LM, Ruttenberg, A, Rosenbaum, JF. Prophylactic estrogen in recurrent postpartum affective disorder. Biol Psychiatry 1995;38(12):814-8.CrossRefGoogle ScholarPubMed
[44]Simpson, K, Noble, S. Fluoxetine a review of its use in women's health. CNS Drugs 2000;14(4):301-28.CrossRefGoogle Scholar
[45]Spigset, O, Hagg, S. Excretion of psychotropic drugs into breast milk—pharmacokinetic overview and therapeutic implications. CNS Drugs 1998;9(2): 111-34.CrossRefGoogle Scholar
[46]Stowe, ZN, Cohen, LS, Hostetter, A, Ritchie, JC, Owens, MJ, Nemeroff, CB. Paroxetine in human breast milk and nursing infants. Am J Psychiatry 2000; 157(2): 185-9.CrossRefGoogle ScholarPubMed
[47]Yerborg, C, Griez, E, Meijer, J. Increase of panic during the second half of pregnancy. Eur Psychiatry 1994;9:260-1.Google Scholar
[48]Villeponteaux, VA, Lydiard, RB, Laraia, MT, Stuart, GW, Ballenger, JC. The effects of pregnancy on preexisting panic disorder. J Clin Psychiatry 1992;53(6):201-3.Google ScholarPubMed
[49]WHO. World Health Organisation. Tenth Revision of the International Classification of Diseases, Chapter V (F): Mental and Behavioural Disorders (including disorders of psychological development). Clinical Descriptions and Diagnostic Guidelines. Geneva: World Health Organisation; 1991.Google Scholar
[50]Wieck, A. Endocrine aspects of postnatal mental disorders. Baillieres Clin Obstet Gynaecol 1989;3(4):857-77.CrossRefGoogle ScholarPubMed
[51]Wisner, KL, Peindl, KS, Hanusa, BH. Effects of childbearing on the natural history of panic disorder with comorbid mood disorder. J Affect Disord 1996;41(3): 173-80.CrossRefGoogle ScholarPubMed
[52]Wittchen, H-U, Wunderlich, U, Gruschwitz, S, Zandig, M. Strukturiertes Klinischos Interview fur DSM-IV. Gottingen: Hogrefe; 1997.Google Scholar
[53]Yonkers, KA, Zlotnick, C, Allsworth, J, Warshaw, M, Shea, T, Keller, MB. Is the course of panic disorder the same in women and men? Am J Psychiatry 1998;155(5): 596-602.CrossRefGoogle ScholarPubMed