depression postpartum
TRANSCRIPT
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KATHERINE L. WISNER, M.D., BARBARA L. PARRY, M.D., AND CATHERINEM. PIONTEK, M.D.
POSTPARTUM DEPRESSION
Journal Readin
Ole! " Erna Wa#iPe$%i$%in " Dr. To$$& Her$an'&a!, S(.K)
RS. S&a$'udin, SH Ko#a Su*a%u$i
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Masalah Klinis
De(re'i (o'#(ar#u$ +- ani#a (o'# (ar#u$a#au + " / ani#a (o'# (ar#u$
A$eri*a 'eri*a#
Kela!iran 0 )u#a1#a!un
+12)u#a1#a!un $enala$i anuan ini.
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Defnisi
De(re'i (o'#(ar#u$ adala! #erda(a#n&a li$a darie)ala &an #er3an#u$ dala$ Ta%el +, dan 'ala!'a#un&a !aru' %eru(a $ood de(re'i a#au (er!a#ian$enurun a#au *e'enanan dala$ a*#i4i#a'
$enurun.
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Ta%el +. 5e)ala De(re'i Ma&or denan on'e# (a'3a $ela!ir*anDe(re'i $a&or dide6ni'i*an denan #erda(a#n&a li$a dari e)ala
%eri*u#, 'ala! 'a#un&a !aru' $ood de(re'i a#au (er!a#ian
$enurun a#au *e'enanan 7" Me$%uru*n&a 'ua'ana !a#i, 'erin di'er#ai a#au di%a&ani
ole! *e3e$a'an &an %era#
Ber*urann&a $ina# a#au *e'enanan dala$ *eia#an
5anuan na8'u $a*an *e!ilanan na8'u $a*an %ia'an&a
di'er#ai denan (enurunan %era# %adan
5anuan #idur (alin 'erin in'o$nia dan #idur
#er8ra$en#a'i, %a!*an *e#i*a %a&i #idur
9i'i* ai#a'i :(alin 'erin; a#au (erla$%a#an ('i*o$o#or
Kelela!an, (enurunan eneri Pera'aan #ida* %er!ara a#au %er'ala! &an %erle%i!an a#au
#ida* #e(a#
Penurunan *on'en#ra'i a#au *e$a$(uan un#u* $e$%ua#
*e(u#u'an
Berulann&a (i*iran #en#an *e$a#ian a#au *eininan %unu!diri
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Penyebab
Penurunan 3e(a# !or$on re(rodu*'i 'e#ela!$ela!ir*an
9a*#or (redi'(o'i'i lain "
Peri'#ia '#re' dala$ *e!idu(an
E(i'ode de(re'i (ada $a'a lalu :#ida* 'elalu%er!u%unan denan $ela!ir*an;
Ria&a# anuan $ood (ada *eluara
Tida* %er!u%unan
Tin*a# (endidi*an ani#aJeni' *ela$in %a&i
Men&u'ui a#au #ida* $en&u'ui
Jeni' (er'alinan
A(a*a! *e!a$ilan diren3ana*an a#au #ida*.
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Screening
S*ala De(re'i Po'#na#al Edin%ur!
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EvaluasiMe$erlu*an ru)u*an (eraa#an &an 3e(a#
Ren3ana $ela*u*an #inda*an %unu! diri
Pi*iran un#u* $elu*ai %a&i
Me$(un&ai anuan 8un'ional $a&or :'e(er#i$en!indari *eluara dan #e$an, *e#ida* $a$(u $en)aa
*e%er'i!an, a#au *e#ida*$a$(uan un#u* $eraa# %a&idenan %ai*;
Pen&ala!unaan
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Dierensial Diagnosis
+. Ba%& Blue'
2. P'i*o'i' Po'#(ar#u$
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Pengobaan Ani!e"resanTabel #$ %ar&a'oera"i unu' De"resi Pos"aru&
Oba Do'i'
Re*o$enda'
i :$1!ari;@
E8e* 'a$(in I$(li*a'i (enunaan o%a#
'ela$a $en&u'ui
Selecive seroonin(reu"a'e inhibiorSerraline =?2 Mual, $en3re#, #re$or,
in'o$nia, di'8un'i 'e*'ual ,
in#era*'i o%a# &an $un*in 7
O%a# dan $e#a%oli# a*#i8 le$a!
u$u$n&a #ida* #erde#e*'i (ada
%a&i #ida* ada la(oran e8e*
'a$(inParo)eine 2? Mual, $enan#u*, *elela!an,
(u'in,di'8un'i 'e*'ual ,in#era*'i o%a# &an $un*in 7
Me#a%oli# #ida* a*#i8 #in*a# #ida*
#erde#e*'i (ada %a&i, #ida* adala(oran *e)adian %uru*
%luo)a&in =?2 Mual, $enan#u*, anore*'ia,
*e3e$a'an, di'8un'i 'e*'ual,
in#era*'i o%a# &an $un*in 7
Me#a%oli# #ida* a*#i8 #in*a# #ida*
#erde#e*'i (ada %a&i, #ida* ada
la(oran *e)adian %uru**ialo"ra& 2?0 Mual, in'o$nia, (u'in,
$enan#u*
%a&i lainn&a #ida* $e$ili*i
$a'ala! dan *adar 'eru$ &an
#ida* #erde#e*'i a#au !an&a dia#a' %a#a' de#e*'i
%luo)eine 2? Mual, $enan#u*, anore*'ia,
*e3e$a'an, di'8un'i 'e*'ual,
in#era*'i o%a# &an $un*in 7
O%a# dan $e#a%oli# a*#i8 #ela!
rela#i8 (an)an a*#u (aru!n&a
'eru$ 'eru(a denan &an
dila(or*an (ada oran dea'a
#in*a# e)ala (ada %e%era(a %a&i
#in*a# (a(aran (rala!ir$ena$%a! *adar 'eru$ (ada
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Tricyclic ani!e"ressansNorri"yline =?+= Seda'i, %era# %adan, $ulu#
*erin, *on'#i(a'i, !i(o#en'i
or#o'#a#i*, $un*in in#era*'i
o%a# 7 da'ar?line EK5
dire*o$enda'i*an
O%a# dan $e#a%oli# u$u$n&a di
%aa! a#au 'edi*i# di a#a' %a#a'
#erde#e*'i #ida* ada la(oran e8e*
'a$(in (ada %a&i
Desi"ra&ine +? Seda'i, %era# %adan, $ulu#
*erin, *on'#i(a'i, !i(o#en'i
or#o'#a#i*, $un*in in#era*'i
o%a# 7 da'ar?line EK5
dire*o$enda'i*an
O%a# dan $e#a%oli# di %aa!
#in*a# *uan#i#a#i8 #ida* ada e8e*
'a$(in
Sero#onin?nore(ine8rin reu(#a*e
in!i%i#orSeroonin(nore"ine"hrine reu"a'e inhibior+enlaa)ine =? Mual, %er*erina#, $ulu# *erin,
(u'in, in'o$nia, $enan#u*,
di'8un'i 'e*'ual
Tida* #erde#e*'i a#au renda! *adar
'eru$ o%a# $e#a%oli# %ia'an&a
diu*ur dan $iri( denan &an
dia$a#i (ada oran dea'a di
%e%era(a %a&i #in*a# o%a# &an
le%i! %e'ar dala$ ASI dari(ada di
#in*a# 'eru$ i%u,ainnya-u"ro"ion ?0= Pu'in, 'a*i# *e(ala, $ulu#
*erin, %er*erina#, #re$or,
ai#a'i, *e)an )aran #er)adi,
$un*in in#era*'i o%a# 7
Tida* di*e#a!ui
Nea.o!one ? $enan#u*, $ual, (u'in,
*e$un*inan in#era*'i o%a# 7
Tida* ada da#a &an di#er%i#*an
(ada #in*a# 'eru$ (ada %a&i'eda'i dan $a*an &an %uru*
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ASI
'er#raline 9IRSTLINE dala$ (eno%a#an un#u*i%u $en&u'ui 'edi*i# ri'i*o.
9luoFe#ineKoli*, %era# %adan 'e#ela! la!ir*uran,
Ci#alo(ra$ #idur %a&i eli'a!
An#ide(re'an #ri'i*li*do*'e(inde(re'i(erna(a'an dan 'eda'i
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Psi'oera"i
('i*o#era(i in#er(er'onal, +2?'e'i &an %er8o*u'(ada (eru%a!an dan !u%unan (en#in , 'ana#e8e*#i8 un#u* $en!ilan*an e)ala de(re'i dan(er%ai*an dala$ 8un'i ('i*o'o'ial
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Tera"i /or&onal
E'#radiol (eno%a#an un#u* de(re'i (o'#(ar#u$:2 $1!ari ;
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Kesi&"ulan !an Re'o&en!asi