CC BY
33
y^K 618.6-06:616.895.4-055.2
N. Abdieva1, L. Kosherbaeva2, Z. Sagyndykova2
Asfendiyarov Kazakh National medical university 1doctoral student
2department of Integrated Systems of Economics and Health Management POSTPARTUM DEPRESSION IN KAZAKHSTAN AMID GLOBAL DATA
This article presents the results of a literature review to determine the prevalence of postpartum depression in the world. Risk factors for a depressive state were also identified to assess the possible prevalence of this ailment in the Republic of Kazakhstan. A literature review of more than a hundred sources showed that on average the prevalence of postpartum depression worldwide is 15-20%. Although reliable sources claim that postpartum depression is a maternal mental health problem that affects many women in all regions of the world, there are no such data in our country and need to be studied.
Keywords: depression, prenatal depression, postpartum depression, puerperal depression, mental health.
Introduction: WHO reflected in its report that all women should have the highest attainable standard of health through the best possible care before and during pregnancy, childbirth, and the postpartum period [1]. However, in modern conditions, at the international level, the assessment of individual components of the quality of life of pregnant women has not yet been carried out, which makes it difficult to find additional opportunities for improving the health status of women during pregnancy and the postpartum period [2]. The birth of a child, in addition to positive emotions, can also lead to feelings of anxiety, fatigue, and despondency [3].
One in six mothers may experience depression after giving birth [4]. Depression is a disease characterized by a constant state of despondency and a loss of interest in activities that usually bring satisfaction, as well as an inability to do everyday activities for at least two weeks [5]. Postpartum Depression (PPD) is a maternal mental health problem that affects many women in all regions of the world [6]. PDD is considered as a factor affecting the development of the child in the early period of his life and partially determines his future [7]. Psychosocial well-being is one of the main components of quality of life. However, in many cases it is left without due attention and requires deep study.
Table 1 - The prevalence of postpartum depression by region
The aim of our research work was to study the prevalence of depression in the postpartum period over the world and assess the likely picture of PPD in Kazakhstan.
Methods: We searched the PubMed, Google Scholar databases of articles published over the past twenty years that focus on the prevalence of postpartum depression in mothers over 18 years of age. Search keywords were "postpartum depression", "prenatal depression", "prevalence of depression", "puerperal depression", "mental health of women". Studying was search in three languages: English, Russian and Kazakh. Preference was for systematic reviews, a meta-analysis, and randomized clinical trials.
Results: We analyzed more than a hundred works from various data sources. A literature review of the frequency of PDD indicates that in developing countries, it ranges from 1.7% to 82.1%, with the lowest values in Pakistan and the highest in Turkey. For developed countries, the prevalence rate varies from 5.2% to 74.0%, with the lowest values in Germany and the highest percentage in the USA. When Edinburgh Postnatal Depression Scale is used for the diagnosis of ADD, the incidence of ADD in developed countries is from 5.5% to 34%, and for developing countries, the incidence of ADD is higher [8].
№ Region/ Country Instruments Sample size Prevalence (%) Authors
1. America US ICD-9-CM (English) 161,454 16.2 Levine et al.[9]
EPDS > 12 (English) 2972 5.1 Abbasi et al. [10]
EPDS > 10 (English) 299 17.5 Dolbier et al. [11]
2. Canada EPDS > 10 (English) 226 16.4 Verreault et al. [12]
3. England EPDS > 12 (English) 410,367 13.2 Leahy-Warren et al. [13]
4. France EPDS > 12 (Translated, validated) 264 16.7 Gaillard et al. [14]
5. Germany EPDS > 9 mild EPDS > 12 medium to severe (Translated, validated) 19 10.1, 1.9 Goecke et al. [15]
6. Italy EPDS > 13 (Not mentioned) 85 16.7 Elisei et al. [16]
7. Spain EPDS > 11 (Translated, validated) 420 9.3, 4.4 Escriba-Aguir and Artazcoz[17]
8. Sweden EPDS > 10 (Translated, validated) 1,707 12.0 Agnafors et al. [18]
9. Australia EPDS > 13 (English) 1,507 16.1 Woolhouse et al.[19]
10. Armenia EPDS > 12 (Translated, validated by the researcher) 437 14.4 Petrosyan et al. [20]
11. Bahrain EPDS > 12 (Translated, validated by the researcher) 237 37.1 Al-Dallal et al. [21]
12. China EPDS > 10 (Translated, validated) 1,823 27.4 Deng et al. [22]'
13. Hong Kong EPDS > 10 EPDS > 15 (Translated, validated) 610 31.6 Lau et al. [23]
14. India EPDS > 13 (Translated, validated by the researcher) 123 46.9 Johnson et al. [24]
15. Iran EPDS > 13 (Translated, 1,910 19 Abdollahi et al. [25]
BecmHUK Ka3HMd № I - 2020
validated)
16. Israel EPDS > 10 (Translated, validated) 564 31 Alfayumi et al. [26]
17. Japan EPDS > 9 (Translated, validated) 65 16.9, 7.7 Shimizu et al. [27]
18. Jordan EPDS > 13 (Translated, validated by the researcher) 33 22.1 21.2 Mohammad et al. [28]
19. Korea EPDS > 10 (Translated, validated) 153 42.5 Park et al. [29]
20. Mongolia WHO Self Reporting Questionnaire 1,044 9.1 Pollock et al. [30]
21. Nepal EPDS > 10 (Translated, validated) 346 30 Giri et al. [31]
22. Oman EPDS > 13 (Translated, validated) 282 10.6 Al Hinai and Al Hinai [32]
23. Pakistan EPDS > 12 (Translated, validated) 763 38.3 Husain et al. [33]
24. Qatar EPDS > 12 (Translated, validated) 1,379 17.6 Bener et al. [34]
25. Saudi Arabia EPDS > 10 (Translated, validated) 450 17.8 Alasoom and Koura [35]
26. Turkey EPDS > 12 (Translated, validated) 87 48.3 Bolak Boratav et al. [36]
27. UAE EPDS > 10, MINI 137 5.9, 10.1 Hamdan and Tamim [37]
28. Vietnam EPDS > 13 (Translated, validated) 431 18.1 Murray et al. [38]
Discussion: The estimated probable number of postpartum depression is 15% in different regions of the world, and the diagnostic criteria DSM-IV (Diagnostic and Statistical Manuel of Mental Disorders (4rd edn)) of postpartum depression are representative for comparison [39]. With these assumptions, an average of about 60,000 out of 400,000 Kazakhstan women in labor, on average, over the past five years, may suffer postpartum depression.
If we look at the relevance of the study of PPD from the point of view of etiology, although there is no single conclusion about this, then we will encounter the following factors: Haros B. claims that the highest rise in depressive mood occurs approximately on the 5th day after childbirth, which is combined with strong hormonal fluctuations [40]. And our birth rate over the past five years has increased by 1% [41]. Although the figure is not impressive, we can say that we are steadily moving in this matter and not regressing.
Basraon S., Constantine M.M. consider metabolic disorders in the thyroid gland affect cognition and emotions [42]. As a result of medical and demographic studies conducted by the Kazakh Academy of Nutrition in collaboration with international organizations, an average low urine iodine concentration (<100 |J/l) was found in 54% of women of reproductive age throughout the republic [43].
One of the major risk factors in the opinion of Cox J.L. - poor marital relations [44]. In our country over the past five years, the number of divorces has increased by 6% [41]. Uncontrolled pregnancy (multiple births) according to Kumar R. studies also occurs among risk factors [45]. The statistics of the last five years of our country show that the number of women giving birth a third time increased by 46.7%, the number of women giving birth a fourth time by 65% and the number of women giving birth a fifth or more times by 54% in 2013-2017 [41].
Some authors claim that young mothers are predisposed to depressive symptoms. Other publications claim that older women who give birth for the first time are at greater risk [46]. In this case, we see a tendency to decrease in childbirth at an early age (up to 20 years), although it remains approximately 2% of the total number of births. And the number of births after thirty-year-old has been steadily growing by 1-2% every year over the past five years [41].
And at the end, "Kazakhstan has a growing statistic on murders of newborns by mothers," there is an article of the nationwide movement "Kazakhstan 2050" released in 2016, according to the
General Prosecutor's Office of the Republic of Kazakhstan it is said that for 2013 12, 2014 14, 2015 11 and 6 cases only for the quarter 2016 were recorded under the article "The murder of a newborn baby by a mother." [47] Although the article did not mention the mental state of mothers at the time of the murder, the main reason was pointed out by factors of a medical-social nature that are a risk factor for postpartum depression, too. Budget cuts and the limited number of trained professionals are likely to contribute to this global disparity in mental health [48]. Thus, the need for widely available, inexpensive and innovative psychological resources that are specifically focused on perinatal mood and affective symptoms is necessary for women from all over the world.
Preventive interventions are effective in reducing the incidence of depression [49] and are effective in reducing the risk of PPD among pregnant and postpartum women without depression [50].
Unfortunately, the problem of postpartum depression was not properly reflected either in the order of the Ministry of Health of the Russian Federation or in the created and created modern structures of these centers. [51]. In the Kyrgyz Republic, to date, special targeted studies of the state of mental health of puerperas have not been conducted, and even more so, no special training for pregnant women has been conducted to reduce the number of postpartum depression [52]. According to the results of a literature review in the Post-Soviet countries, the mental state of women in the postpartum period has not been studied in sufficient quantities.
Despite the intensive work carried out over the past decades, the problem of depressive disorders so far cannot yet be considered sufficiently studied [53].
WHO recommends that public health develop practical training programs that cover the main mental health problems women face in a specific country or region of residence. An affordable, comprehensive program for educating women during pregnancy can be effective in preventing postpartum depression. Conclusions:
Postpartum depression is the most common disorder of childbearing, which basically remains unrecognized and very rarely undergoes adequate therapy. In addition to being susceptible to depressive disorder, many psychosocial stressors can have an effect on PPD. The indicated risk factors of the literature review give us the right to assert that Kazakhstan has high chances of developing a depressive state, including in the postpartum period.
VeStnik KQzfimU № I - 2020
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Н.К. Эбдиева, Л.К. Кошербаева, З.Р. Сагиндыкова ДУНИЕЖУЗ1Л1К ДЕРЕКТЕРДЩ НЕГ1З1НДЕП KA3AKCTAHAAFbI БОСАЖАННАН КЕЙ1Н БОЛАТЫН ДЕПРЕССИЯЛЬЩ ЖАFДАЙ
TYЙiн: Бул ма;алада элемдегi босанганнан кейiнгi депрессияныц таралуын аныцтауга арналган эдеби шолу нэтижелерi келтiрiлген. Казахстан Республикасында осы аурудыц ыцтимал таралуын багалау ушш депрессиялы; жагдайдыц ;ауш факторлары аны;талды. Жузден астам дереккездерге шолу дуние ЖYзi бойынша босанганнан кейiнгi депрессияныц таралуы орташа есеппен 15-20%
курайтынын к0рсеттi. Сенiмдi а;парат к0здерi босанганнан кейiнгi депрессия элемнiц барлы; аймацтарындагы кептеген эйелдерге эсер ететiн ана психикасыныц проблемасы деп мэлiмдейдi, бiрак; бiздiц елiмiзде мундай деректер жо; жэне оны зерттеудi ;ажет етедь TYЙiндi свздер: депрессия, босанганга дешнп депрессия, эйелдердiц психикалы; денсаулыгы.
Н.К. Абдиева, Л.К. Кошербаева, З.Р. Сагиндыкова ПОСЛЕРОДОВОЕ ДЕПРЕССИВНОЕ СОСТОЯНИЕ В КАЗАХСТАНЕ НА ФОНЕ МИРОВЫХ ДАННЫХ
Резюме: В данной статье даны результаты литературного обзора, с целью определения распространенности послеродовой депрессии в мире. Так же были выявлены факторы риска депрессивного состояния, для оценки возможной распространённости этого недуга в Республике Казахстан. Литературный обзор более ста источников показал, что в среднем распространенность послеродовой
депрессии по всему миру составляет 15-20%. Хотя достоверные источники утверждают, послеродовая депрессия-проблема психического здоровья матери, которое затрагивает многих женщин всех регионов мира, в нашей стране таких данных нет и требует изучения. Ключевые слова: депрессия, пренатальная депрессия, послеродовая депрессия, психическое здоровье женщин.
УДК 364.42/44
Н.Т. Джайнакбаев, С.З. Ешимбетова, ^.М. Тоцсанбай, Э.Ю. Шатагулова, С.А. Вазарцев, Д.Я. Юсупов, Е.А. Исаев
НУО Казахстанско-Российский медицинский университет Кафедра психиатрии, наркологии и неврологии
ОПЫТ РАБОТЫ CALL-CENTER ПО ОКАЗАНИЮ ПСИХОЛОГИЧЕСКОЙ ПОМОЩИ СЕМЬЯМ ДЕТЕЙ ИНВАЛИДОВ И АНАЛИЗ ДЕЯТЕЛЬНОСТИ ЗА 2019 ГОД ПО РЕСПУБЛИКЕ КАЗАХСТАН
В данной работе проведен анализ заявок (обращений) поступивших от родственников детей-инвалидов в Call-center, осуществляющего свою деятельность с 2015 года на базе Казахстанско-Российского Медицинского Университета. Это уникальный новый метод в работе врача-психиатра (психолога): онлайн консультирование родственников детей-инвалидов по целому ряду жизненно важных вопросов (клинических, социальных, медико-психологичеких, лечебно-диагностических, этических, профилактических, тактических, педагогических). В результате исследования выявлены -регионы Республики Казахстан, наиболее чаще обращающихся за онлайн-консультацией, уточнен контингент, обратившихся за помощью.Также сделан анализ с точки зрения этиопатогенеза, нозологии. Полученные результаты служат улучшению качества жизни детей-инвалидов, помогут их родственникам и заинтересованным лицам успешно осуществлять социально-реабилитационную и психокоррекционную программу.
Ключевые слова: онлайн-консультирование, call-center, дети-инвалиды, родственники, заявки, социально-психологическая и медико-коррекционная помощь
Актуальность. Проблема детской инвалидности в нашей стране является одной из самых актульных вопросов. Согласно данным министерства труда и социальной защиты РК от 15 апреля 2019 года, в 2018 году отмечается рост
инвалидности как среди взрослых, таки среди детского населения страны. В частности, 680 тысяч людей с инвалидностью в целом, из них 87 тысяч детей в возрасте до 18 лет, что составляет 1,5% от общей численности детского
