Anxiety, prenatal distress, and resilience during the first trimester of gestation.

OBJECTIVE: To describe and analyze the relationship between pregnancy-related anxiety, prenatal distress, and individual resilience in pregnant women during the first trimester of pregnancy and compare it with the obstetric variable of parity. METHOD: Quantitative, descriptive, cross-sectional study using non-probabilistic circumstantial sampling. A total of 144 women participated. The Prenatal Distress Questionnaire, the Resilience Scale, and the Pregnancy-Related Anxiety Questionnaire were used. A descriptive analysis with measures of central tendency was performed, and the reliability of the instruments was assessed. RESULTS: The average age was 33.57 years. 58.3% were multiparous and 41.7% primiparous. Anxiety was found in 21.5% and very high levels of resilience in 54.9%. Primiparous women showed higher levels of worry about the future and fear of childbirth than multiparous women. Pregnant women with high resilience showed lower levels of anxiety and stress. CONCLUSION: Pregnant women with higher levels of resilience show less anxiety and stress during the first trimester of pregnancy. Primiparous women show more anxiety and stress than multiparous women.

Prevalence of psychiatric disorders in the first trimester of pregnancy and factors associated with current suicide risk.

This study aimed to describe the prevalence of psychiatric disorders and to identify the factors associated with Current Suicide Risk (CSR) in the first trimester of pregnancy. The Mini-International Neuropsychiatric Interview (M.I.N.I.) was employed to diagnose mental disorders in 239 women enrolled in a prospective cohort in Rio de Janeiro, Brazil. Serum lipids, leptin and socio-economic status were the independent variables. CSR, the dependent variable, was entered as binary (yes/no) variable into crude and adjusted Poisson regression models with robust variances. CSR was found to be the main psychiatric syndrome (18.4%), followed by agoraphobia (17.2%), major depressive disorder (15.1%) and generalized anxiety disorder (10.5%). Women with CSR showed higher mean levels of cholesterol (169.2 vs. 159.2; p=0.017), high density lipoprotein (50.4 vs. 47.7; p=0.031) and low density lipoprotein (102.8 vs. 95.6; p=0.022) when compared to women without CSR. The adjusted regression model showed a higher prevalence ratio (PR) of CSR among pregnant women with generalized anxiety disorder (PR=2.70, 95% CI: 1.36-5.37), with ≥ two parturitions (PR=2.46, 95% CI: 1.22-4.93), and with major depressive disorder (PR=2.11, 95% CI: 1.08-4.12). We have shown that generalized anxiety disorder, major depressive disorder and higher parity are associated with CSR in the first trimester of pregnancy.

Aspectos psicológicos de la hiperemesis gravídica / Hyperemesis gravidarum. Psychological aspects

La hiperemesis gravídica, es uno de los puntos obscuros entre la gineco-obstetricia y el área de la salud mental, ya que dentro de la definición que hace Fairweather, se refiere que para ser considerada como tal, se deben excluir una serie de padecimientos que por si solos pueden ser los causantes de la emesis, sin embargo a lo largo de varias investigaciones se ha observado que el fondo de esta puede ser de tipo emocional, si bien puede estar relacionado de acuerdo a algunos teóricos, desde rechazo inconsciente del embarazo, hasta problemas de relacion con la madre o identificación con el papel femenino. Desde nuestro punto de vista, una de las posibles explicaciones al padecimiento se puede dar a través de las conductas neuróticas del tipo de la histeria conversiva. El propósito del presente es difundir algunos de los conceptos en torno al padecimiento, y de esta forma considerar la alternativa de la intervención psicoterapéutica en la atención integral de la paciente que sufre el padecimiento