169,989 research outputs found
Women mental health
No full textWomen mental health is a major public health challenge.
Over the past three decades, there has been growing interest in the understanding of the strong influence of sex hormones on women’s mental and physical health. In particular, the literature clearly documents that fluctuating levels of reproductive hormones can manifest as premenstrual, perinatal, and perimenopausal psychiatric disorders in women who are vulnerable to these fluctuations. Perinatal depression is a global epidemic with adverse life-long consequences for the mother, the partner and the offspring. For many women perinatal period is a challenging time, with an increased rate of mental illness, aggravated by widespread stigma. Therefore, suicide is a major cause of maternal deaths.
Despite the high prevalence of perinatal depression most cases remain undetected leading to an increased burden of the disease.
The need and the modality to perform screening programs in order to prevent and reduce the negative impact of perinatal depression are still a matter of controversy.
International guidelines highlight the failure of the screening plans when they are not linked to treatment options.
SOS MAMMA counselling service is a program that was born in 2012 at Fondazione Policlinico Tor Vergata, providing support for women with perinatal depression. This service supplies a free multidisciplinary counselling, performed by at least a psychiatrist, psychologist, maternal/child health nurses, obstetrician and gynaecologist. After the first referral, the health professionals offer an integrated therapeutic program individualized for each woman, with psychological sessions, pharmacological options, light therapy, and trauma focused therapy depending on the case.
Finally, the author on behalf of an Inter-University Roman Group, present the protocol of a multicenter prospective clinical trial designed to perform a screening for perinatal depression in pregnant women
Psychological issues in improving adherence and alliance
No full textFrom an intersubjective point of view, adherence to therapy can be defined as a multi-dimensional phenomenon which occurs through the dynamic interaction of different variables which pertain both to the doctor and to the patient. In psychiatry, the relationship between doctor and patient is the core of the therapeutic program because it ensures the therapeutic continuity. The context where the prescription happens is within the “therapeutic field”: a dynamic doctor-patient relationship that goes beyond the symptoms, gathering multiple factors in an intersubjective balance. In this model of complex prescription, focused on relationship, the attachment styles emerge as central points: as the therapist (and the drug) represent attachment figures and the patient is a caregiving “object,” each of them enters the relationship with their Internal Working Models (IWM) and behavioral patterns, which must be taken into account in the construction of a prescription to optimize adherence. Even in patients suffering from psychosis, the quality of the therapeutic relationship is a key determinant of outcome and attachment styles influence the quality of therapeutic relationships. A good doctor-patient relationship is important in the construction of adherence, and must include alliance with caregivers and family members, as well as with paramedical staff. Subjective well-being and quality of life are core issues as well in pursuing adherence to long term pharmacological, psychological and rehabilitative treatment programs
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