Trastorno mental común y síntoma depresivo perinatal: revisión integrativa

Silva, Bruno Pereira da; Neves, Paulo A R; Mazzaia, Maria Cristina; Gabrielloni, Maria Cristina

doi:10.1590/0034-7167-2019-0823

Brasil

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REVIEW • Rev. Bras. Enferm. 73 (Suppl 1) • 2020 • https://doi.org/10.1590/0034-7167-2019-0823 linkcopiar

Trastorno mental común y síntoma depresivo perinatal: revisión integrativa

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo: investigar la aparición y los factores de riesgo de trastorno mental común y síntoma depresivo perinatal.

Métodos: revisión integral de la literatura, utilizando las bases de datos CINAHL, Embase, PubMed, PsycINFO y LILACS, buscando estudios realizados entre 2014 y 2019. La recopilación de datos se produjo entre junio y julio de 2019. Descriptores en Ciencia de Health (DeCS) y Medical Subject Heading (MeSH) en las estrategias de búsqueda utilizadas en cada base de datos.

Resultados: se incluyeron 13 artículos. La mayoría de los estudios se realizaron en Brasil y con un diseño transversal. Las prevalencias más altas de trastorno mental común (63%) y síntomas depresivos (30%) se encontraron en estudios brasileños.

Conclusión: se encontraron altas frecuencias para el trastorno mental perinatal, con énfasis en estudios realizados en Brasil. El bajo nivel socioeconómico, ser madre soltera, antecedentes previos de trastorno mental, embarazo no planificado y multiparidad fueron factores de riesgo para los trastornos investigados.

Descriptores: Depressión; Transtornos Mentales; Salud de la Mujer; Escalas de Valoración Psiquiátrica; Revisión

Database	Search strategy
CINAHL	(((MH "Pregnancy") OR TI Pregnancy OR AB Pregnancy) OR ((MH "Depression, Postpartum") OR TI ("postpartum depression" or "postnatal depression" or ppd) OR AB ("postpartum depression" or "postnatal depression" or ppd)) AND ("common mental disorder" OR "common mental disorders"))
Embase	("common mental disorder"/exp OR "common mental disorder" OR "common mental disorders") AND ("postnatal depression"/exp OR "pregnancy"/exp) AND [Embase]/lim
LILACS	tw: (("transtorno mental comum" OR "transtornos mentais comuns" OR "common mental disorder" OR "common mental disorders")) AND (instance: "regional") AND (mh: ("Gravidez" OR "Depressão Pós - Parto") AND db: ("LILACS" OR "BDENF" OR "INDEXPSI" OR "SMS-SP"))
PubMed/MEDLINE	(("common mental disorder" OR "common mental disorders")) AND ((("Pregnancy" [Mesh] OR "Pregnancy" [tiab])) OR ("Depression, Postpartum" [Mesh] OR "Depression, Postpartum" [tiab]))
PsycINFO	"COMMON MENTAL DISORDER" OR Any Field: "COMMON MENTAL DISORDERS" AND (Any Field: PREGNANCY OR Any Field: "POSTPARTUM DEPRESSION")

Author, year, country	Design	Sample	Perinatal period	Occurrence	Instruments and scores	Level of Evidence
Alvarenga, Frizzo, 2017, Brazil⁽¹⁶⁾	Cohort	79	3^rd gestational trimester	63% CMD☐	SRQ-20 ≥8	III
Alvarenga, Frizzo, 2017, Brazil⁽¹⁶⁾	Cohort	79	30 days after birth	30.4% MIDS 16.5% MDS 3.8% SDS	BDI-I 12-18 MIDS 20-35 MDS ≥36 SDS	III
Aryal, et al, 2018, Nepal⁽¹⁷⁾	Cross-sectional	164☐	Gestation☐	21% (95% CI 15,7-28.3) AS 24% (95% CI17.8-31.0) DS 14.6% (95% CI: 10.0-21.0) CMD	HSCL 25 ≥17.5 AS ≥24.5 DS	V
Aryal, et al, 2018, Nepal⁽¹⁷⁾	Cross-sectional	567	After birth (up to 12 months)	19% (95% CI15.7-2.1) AS 15% (95% CI 12.4-18.4) DS 11.5% (95% CI: 9.1-14.4) CMD	HSCL 25 ≥17.5 AS ≥24.5 DS	V
Bekele, et al, 2017, Ethiopia⁽¹⁸⁾	Cross-sectional	753	3^rd gestational trimester	26.2% (95% CI 23.04-29.36) CMD	SRQ-20 ≥6	V
Clarke, et al, 2014, Nepal⁽¹⁹⁾	Cross-sectional	9.078	41 days after birth	9.8% CMD	GHQ-12 ≥6	V
Estrin, et al, 2019, England⁽²⁰⁾	Cross-sectional	488 < 25 years old☐	1^st gestational trimester	45.1% (95% CI 23.5-68,7) CMD <25 years old	SCID-I-Research Version^* * Diagnostic instrument, without scoring;	V
Estrin, et al, 2019, England⁽²⁰⁾	Cross-sectional	57 ≥25 years old	1^st gestational trimester	15.5% (95% CI 12.0-19.8) CMD ≥25 years old		V
Filha, et al, 2016, Brazil⁽¹⁰⁾	Cross-sectional	23.894	12 months after birth	26.3% DS☐	EPDS ≥13	V
Hain, et al, 2016, Germany⁽²¹⁾	Cohort	297	3^rd gestational trimester	10% DS☐	BDI-V EPDS^ Score not described in the study.	III
		278	6 weeks after birth	10% DS☐
		266	20 weeks after birth	6% DS☐
Lucchese, et al, 2017, Brazil⁽²²⁾	Cross-sectional	229	2^nd gestational trimester	51.7% (95% CI 51.7-62.6) CMD	SRQ-20 ≥7	V
MacLean, et al, 2015, Brazil⁽²³⁾	Cohort	831	Between 20-30 gestational weeks	36.2% CMD☐	SRQ-20 ≥8	III
MacLean, et al, 2015, Brazil⁽²³⁾	Cohort	219	11 months after birth	NPR	SRQ-20 ≥8	III
Reichenheim, et al, 2014, Brazil⁽²⁴⁾	Cross-sectional	810	5 months after birth	25.4% (95% CI 22.4-28.4) CMD	SRQ-20 ≥7	V
Tran, 2014, et al, Vietnan⁽²⁵⁾	Cohort	378	12-20 gestational weeks	38.9% CMD☐	EPDS-V ≥4	III
			≥ 32 gestational weeks	28% CMD☐
			8 weeks after birth	10.8% CMD☐
			6 months after birth	12.4% CMD☐
Usuda, et al, 2016, Japan⁽²⁶⁾	Cross-sectional	177	12-24 gestational weeks	1.1% (95% CI 0.00-0.04) DS	EPDS ≥9	V
Usuda, et al, 2016, Japan⁽²⁶⁾	Cross-sectional	177	12-24 gestational weeks	6.2% (95% CI 0.03-0.11) CMD	MINI^* * Diagnostic instrument, without scoring;	V
Wikman, et al, 2019, Sweden⁽²⁷⁾	Cohort	1.491	Between 17-32 gestational weeks	8.5% DS☐	EPDS ≥13 gestation ≥12 after birth	III
			6 weeks after birth	10.9% DS☐
			6 months after birth	5.4% DS☐
			All trajectories☐	14.6% PDS☐

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Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
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[TFN1] Note: SRQ-20 - Self-Reporting Questionnaire; BDI-I - Beck Depression Inventory I; HSCL 25 - Hopkins Symptom Checklist 25; GHQ-12 - 12-item General Health Questionnaire; SCID-I-Research Version - Structured Clinical Interview for DSM-IV-TR Axis I Disorders; EPDS - Edinburgh Postnatal Depression Scale; BDI-V - Beck Depression Inventory; GHQ-28 - 28-item version of the General Health Questionnaire; MINI - The Mini-International Neuropsychiatric Interview; AS - Anxious Symptom; DS - Depressive Symptom; MIDS - Mild Depressive Symptom; MDS - Moderate Depressive Symptom; SDS - Severe Depressive Symptom; PDS - Persistent Depressive Symptom; CMD - Common Mental Disorder; NPR - No prevalence for the period and the persistence of CMD for both periods; ☐ Total study participants: 731⁽¹⁷⁾ and 545⁽²⁰⁾; ☐ Did not describe the gestational trimester; ☐ Investigated the trajectory of perinatal depressive symptoms, from 17-32 weeks of gestation to 6 months after birth⁽²⁷⁾; ☐Confidence interval not available.

[TFN2] ^*
Diagnostic instrument, without scoring;

[TFN3] ^**
Score not described in the study.