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Pawils S, Kochen E, Weinbrenner N, Loew V, Döring K, Daehn D, Martens C, Kaczmarek P, Renneberg B. [Postpartum depression-who cares? Approaches to care via midwifery, gynaecology, paediatrics and general practice]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2022; 65:658-667. [PMID: 35554610 PMCID: PMC9132831 DOI: 10.1007/s00103-022-03545-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/03/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Postpartum depression (PPD) is one of the most common mental illnesses in the postpartum period. If left untreated, it can have serious consequences for the mother-child relationship and the development of the child. In order to prevent possible negative effects, early diagnosis of affected mothers and professional care are essential. AIM OF THE STUDY This article explores the sense of responsibility of the four primary care providers in the postpartum period-midwives, gynaecologists, general practitioners and paediatricians-and examines how they deal with the disease as well as the barriers and possibilities for optimisation in care. MATERIALS AND METHODS The primary care providers of postpartum women in Germany were interviewed in four independent studies. Quantitative questionnaires were used to interview midwives, gynaecologists and general practitioners, and a qualitative telephone survey was conducted with representatives of the German Association of Paediatricians and Adolescents (BVKJ). A systematic comparative analysis was carried out. RESULTS AND DISCUSSION Midwives and gynaecologists showed a significantly higher sense of responsibility for the recognition and treatment of PPD than general practitioners and paediatricians. Closer interdisciplinary cooperation and thus a wider range of referral and therapy options were named by all four professional groups as a central prerequisite for improving the care situation in Germany. A uniform regulation of financial remuneration is also an important aspect for all providers.
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Affiliation(s)
- Silke Pawils
- Zentrum für Medizinische Psychologie, Institut und Poliklinik für Medizinische Psychologie, Universitätsklinik Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.
| | - Eileen Kochen
- Zentrum für Medizinische Psychologie, Institut und Poliklinik für Medizinische Psychologie, Universitätsklinik Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Nora Weinbrenner
- Zentrum für Medizinische Psychologie, Institut und Poliklinik für Medizinische Psychologie, Universitätsklinik Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Viola Loew
- Zentrum für Medizinische Psychologie, Institut und Poliklinik für Medizinische Psychologie, Universitätsklinik Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Kornelia Döring
- Zentrum für Medizinische Psychologie, Institut und Poliklinik für Medizinische Psychologie, Universitätsklinik Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Daria Daehn
- Fachbereich Erziehungswissenschaften und Psychologie, Klinische Psychologie und Psychotherapie, Freie Universität Berlin, Berlin, Deutschland
| | - Claudia Martens
- Zentrum für Medizinische Psychologie, Institut und Poliklinik für Medizinische Psychologie, Universitätsklinik Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Philip Kaczmarek
- Zentrum für Medizinische Psychologie, Institut und Poliklinik für Medizinische Psychologie, Universitätsklinik Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Babette Renneberg
- Fachbereich Erziehungswissenschaften und Psychologie, Klinische Psychologie und Psychotherapie, Freie Universität Berlin, Berlin, Deutschland
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Georg AK, Bark C, Wiehmann J, Taubner S. Frühkindliche Regulationsstörungen: Störungsbilder und Behandlungskonzepte. PSYCHOTHERAPEUT 2022. [DOI: 10.1007/s00278-022-00594-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sprengeler MK, Mattheß J, Eckert M, Richter K, Koch G, Reinhold T, Vienhues P, Berghöfer A, Fricke J, Roll S, Keil T, Ludwig-Körner C, Kuchinke L, von Klitzing K, Schlensog-Schuster F. Efficacy of parent-infant psychotherapy compared to care as usual in children with regulatory disorders in clinical and outpatient settings: study protocol of a randomised controlled trial as part of the SKKIPPI project. BMC Psychiatry 2021; 21:118. [PMID: 33639894 PMCID: PMC7913440 DOI: 10.1186/s12888-021-03112-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 02/09/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The first years of life are a significant period for child development, when children are particularly sensitive and prone to crises. This early phase lays the foundation for healthy growth. Clinical assessment of psychological symptoms in early infancy and adequate treatment are both important in improving the diagnostic outcome and preventing later long-term developmental consequences. The most common psychological problems in the first 3 years of life are regulatory disorders. The aim of this trial is to investigate the efficacy of Parent-Infant Psychotherapy (PIP) for infants and young children (aged 0-36 months, diagnosed with at least one regulatory disorder) and their mothers, compared to care as usual (CAU). METHODS In this open multicentre randomised controlled trial, 160 mother-infant dyads are randomised to receive PIP or CAU for 6 weeks of intervention in clinical or outpatient (including home treatment) settings. The primary outcome is the maternal sensitivity (sensitivity scale of the Emotional Availability Scales (EAS)) after 6 weeks. Secondary outcomes include assessment of interaction, mental health problems, attachment, development, psychological factors, treatment adherence, health care system utilisation, and costs, after 6 weeks and 12 months. DISCUSSION This study will evaluate whether a manualised focus-based short-term psychodynamic psychotherapeutic intervention in mother-child dyads improves the care situation for families of children diagnosed with regulatory disorders, and helps prevent long-term psychopathologies. Assessment of the intervention in different settings will support the development of more tailored interventions for affected infants and their mothers. TRIAL REGISTRATION German Clinical Trial Register, ID: DRKS00017008 . Registered 03/20/2019.
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Affiliation(s)
- Mona Katharina Sprengeler
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, Liebigstrasse 20a, 04103, Leipzig, Germany.
| | - Janna Mattheß
- International Psychoanalytic University Berlin, Berlin, Germany
| | - Melanie Eckert
- International Psychoanalytic University Berlin, Berlin, Germany
| | - Katharina Richter
- International Psychoanalytic University Berlin, Berlin, Germany
- Institute of Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Gabriele Koch
- International Psychoanalytic University Berlin, Berlin, Germany
| | - Thomas Reinhold
- Institute of Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Petra Vienhues
- Fachklinik für Psychiatrie, Psychosomatik und Psychotherapie, DIAKO Nordfriesland, Flensburg, Germany
| | - Anne Berghöfer
- Institute of Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Julia Fricke
- Institute of Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Stephanie Roll
- Institute of Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- State Institute of Health, Bavarian Health and Food Safety Authority, Bad Kissingen, Germany
| | | | - Lars Kuchinke
- Psychological Methods and Evaluation, International Psychoanalytic University Berlin, Berlin, Germany
| | - Kai von Klitzing
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, Liebigstrasse 20a, 04103, Leipzig, Germany
| | - Franziska Schlensog-Schuster
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, Liebigstrasse 20a, 04103, Leipzig, Germany
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