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EV0590

When happiness after childbirth turns to sadness: an outpatient therapy program for the treatment of peripartum and postpartum mental disorders

WHEN HAPPINESS AFTER CHILDBIRTH TURNS INTO SADNESS..." OUTPATIENT THERAPEUTIC PROGRAM FOR THE TREATMENT OF PERIPARTUM AND POSTPARTUM MENTAL DISORDERS

A multidisciplinary outpatient therapy program for mental health problems during the peripartum and postpartum periods is presented, with high symptom levels observed among the women enrolled.

The aim is to introduce an outpatient therapy program developed for women experiencing psychological distress or mental disorders related to pregnancy and childbirth. The program is delivered by a multidisciplinary team at a specialist mental health clinic in Lower Saxony, Germany, and covers the period from pregnancy and childbirth until the child is one year old; data were collected on age, diagnosis, and symptom levels, with symptoms assessed using the perinatal version of the Depression Anxiety Stress Scales (DASS-P) and the Edinburgh Postnatal Depression Scale (EPDS). The sample consists of 13 women, with a mean age of 34 years (range 25–38); diagnoses comprise major depressive disorder in 6 women, generalized anxiety disorder in 4, and posttraumatic stress disorder in 3. Mean DASS-P subscale scores (standard deviations) were 6 (4.68) for depression, 7 (3.19) for anxiety, and 7 (3.03) for stress, with a total score of 20 (8.15); the mean EPDS total score was 16 (5.01), with scores above 13 indicating a high likelihood of depression according to the scale's thresholds. The program addresses pregnancy and childbirth difficulties; depressive, anxious, and obsessive thoughts; feelings of inadequacy, shame, and guilt; regret about motherhood; mother–infant interaction and attachment; couple and family conflicts; stigma; and the treatment of these issues as taboo. It also provides referrals to support services for breastfeeding, crying, sleep routines, and feeding, as well as parent groups, and facilitates networking with relevant associations, specialist physicians, and psychotherapists. According to the authors, the persistent taboo surrounding these issues in clinical practice, together with feelings of shame, guilt, and inadequacy and fear of stigmatization, can lead to underdiagnosis and chronic symptoms, impairing mother–child interaction and the child's emotional and behavioral development. Current care provision remains persistently inadequate, particularly in terms of the availability of necessary inpatient treatment; adequate early care, encouragement of help-seeking, and stronger networks between services are needed.

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