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Relationship between ACR and other determinants of microalbuminuria in T2DM patients

Uticaj porođajne mase i aktuelne težine deteta na nastanak prevremenog puberteta

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Postpartal depression and thyroid disorders

Marijana Jandrić-Kočić
Marijana Jandrić-Kočić
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Published: 01.12.2019.

Volume 49, Issue 1 (2020)

pp. 53-57;

https://doi.org/10.5937/pramed2002053j

Abstract

Introduction: Postpartum depression negatively affects a woman's quality of life and the development of a relationship with her child, which can have far-reaching consequences on the cognitive, behavioral and emotional development of the child. Etiology includes genetic predisposition, sudden hormonal changes, and sociodemographic factors. Case report: A 28-year-old patient, married, mother of a one-month-old boy. She graduated from the High school of economics, unemployed. She appears in the family medicine clinic due to chronic fatigue and bad mood, at the insistence of her husband, who thinks that she needs professional help. She grew up in a harmonious family. He gets along well with his wife, there are no existential problems. It denies previous illnesses. Neat appearance, inconspicuous posture and behavior, psychomotor diskette slowed down, more sparse spontaneous verbalization, slightly compromised volitional instinctual dynamisms, lowered basic mood. In the laboratory findings, hypothyroidism with elevated thyroid peroxidase antibody and antithyreoglobulin antibodies is detected. The thyroid ultrasound verifies the right lobe of 46x14x15mm, the left lobe of 48x13x12mm, inhomogeneous and easily hypoechoic structure. The Edinburgh Postnatal Depression Scale indicates the presence of depression (total score 18). The patient is referred for a consultative examination by a psychiatrist and a nuclear medicine specialist. Psychiatrist indicates the introduction of Sertralin 50 mg tablets (1x1/2 for the first seven days, then 1x1) and Bromasepam tablets 1,5 mg (2x1/2), nuclear specialist Levotiroskin sodium tablets 50 mcg (1x1/2 for 5 days and 1x1 for 2 days). After six months, withdrawal of the symptoms of the disease and exclusion of therapy by a psychiatrist. Conclusion: Autoimmune thyroid disease is a significant and often unrecognized cause of postpartum depression. Early detection and timely therapeutic intervention of these have a significant role in the prevention and successful treatment of postpartum depression.

References

1.
Jovicic S, Pavicevic D. Four cases of successfully treated women suffering from postpartum psychosis. Vol. 38, Engrami. 2016. p. 71–80.
2.
Gašparović M. Kombinirani kognitivno-bihevioralni i farmakološki tretman poslijeporođajne depresije – prikaz slučaja. Vol. 4, Journal of Applied Health Sciences. 2018. p. 73–9.
3.
Association AP. Diagnostic and statistical manual of mental disorders. 2013.
4.
Cox JL, Holden JM, Sagovsky R. Detection of Postnatal Depression. Vol. 150, British Journal of Psychiatry. 1987. p. 782–6.
5.
Khanlari S, Barnett AM B, Ogbo FA, Eastwood J. Re-examination of perinatal mental health policy frameworks for women signalling distress on the Edinburgh Postnatal Depression Scale (EPDS) completed during their antenatal booking-in consultation: a call for population health intervention. Vol. 19, BMC Pregnancy and Childbirth. 2019.
6.
Shrestha SD, Pradhan R, Tran TD, Gualano RC, Fisher JRW. Reliability and validity of the Edinburgh Postnatal Depression Scale (EPDS) for detecting perinatal common mental disorders (PCMDs) among women in low-and lower-middle-income countries: a systematic review. Vol. 16, BMC Pregnancy and Childbirth. 2016.
7.
Araya AV, Massardo T, Fiedler J, Risco L, JC. Q, Liberman C. Depressive Disorders and Thyroid Function. 2012.
8.
Li D, Li Y, Chen Y, Li H, She Y, Zhang X, et al. Neuroprotection of reduced thyroid hormone with increased estrogen and progestogen in postpartum depression. Vol. 39. 2019. p. 20182382.
9.
Minaldi E, D’Andrea S, C C. Thyroid autoimmunity and risk of post-partum depression: a systematic review and meta-analysis of longitudinal studies. Vol. 43. 2020. p. 271–7.
10.
Zhou Y, Wang X, Zhao Y, Liu A, Zhao T, Zhang Y, et al. Elevated thyroid peroxidase antibody increases risk of postpartum depression by decreasing prefrontal cortex BDNF and 5-HT levels in mice. Vol. 9. p. 10–307.
11.
Keshavarzi F, Yazdchi K, Rahimi M, Rezaei M, Farnia V, Davarinejad O, et al. Post partum depression and thyroid function. Vol. 6. 2011. p. 117–20.
12.
Lazarus JH, Hall R, Othman S, Parkes AB, Richards CJ, McCulloch B, et al. The clinical spectrum of postpartum thyroid disease. Vol. 89, QJM. 1996. p. 429–36.
13.
Abalovich M, Mitelberg L, Allami C, Gutierrez S, Alcaraz G, Otero P, et al. Subclinical hypothyroidism and thyroid autoimmunity in women with infertility. Vol. 23, Gynecological Endocrinology. 2007. p. 279–83.
14.
Harris B, Oretti R, Lazarus J, Parkes A, John R, Richards C, et al. Randomised trial of thyroxine to prevent postnatal depression in thyroid-antibody-positive women. Vol. 180, British Journal of Psychiatry. 2002. p. 327–30.
15.
McCoy SJ, Beal JM, Payton ME, Stewart AL, DeMers AM, Watson GH. Postpartum thyroid measures and depressive symptomology: a pilot study. Vol. 108. 2008. p. 503–7.
16.
Groer MW, Vaughan JH. Positive Thyroid Peroxidase Antibody Titer Is Associated with Dysphoric Moods during Pregnancy and Postpartum. Vol. 42, Journal of Obstetric, Gynecologic & Neonatal Nursing. 2013. p. E26–32.
17.
Bergink V, Pop VJM, Nielsen PR, Agerbo E, Munk-Olsen T, Liu X. Comorbidity of autoimmune thyroid disorders and psychiatric disorders during the postpartum period: a Danish nationwide register-based cohort study. Vol. 48, Psychological Medicine. 2018. p. 1291–8.
18.
Farooq RK, Asghar K, Kanwal S, Zulqernain A. Role of inflammatory cytokines in depression: Focus on interleukin-1β. Vol. 6, Biomedical Reports. 2017. p. 15–20.
19.
Jucevičiūtė N, Žilaitienė B, Aniulienė R. The link between thyroid autoimmunity, depression and bipolar disorder. Vol. 14. 2019. p. 52–8.
20.
Eller T, Metsküla K, Talja I, Maron E, Uibo R, Vasar V. Thyroid autoimmunity and treatment response to escitalopram in major depression. Vol. 64, Nordic Journal of Psychiatry. 2010. p. 253–7.
21.
Lin CY, Li CK, Liu JM, Hsu RJ, Chuang HC, Chang FW. Postpartum Depression and Subsequent Autoimmune Diseases in Taiwan. Vol. 15, International Journal of Environmental Research and Public Health. p. 1783.

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