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Abstract(s)
A perturbação bipolar, uma das doenças psiquiátricas mais comuns na sociedade ocidental, é um distúrbio psiquiátrico caracterizado por variações excessivas do estado de humor, energia e actividade, que se podem perpetuar no tempo com consequências nefastas para o funcionamento do indivíduo, uma vez que está associada a uma disfunção psicossocial marcada.
No entanto, tendo em conta que este distúrbio (enquanto entidade nosológica) é bastante heterogéneo, apresenta-se com diferenças marcadas ao nível da evolução, gravidade e combinação de formas de apresentação, tornando o seu diagnóstico e tratamento por vezes muito difícil. Pelo que não é de admirar que um dos temas que se tem debatido nos últimos anos é o diagnóstico, tratamento e controlo desta doença em mulheres grávidas, puérperas ou mesmo em idade fértil que planeiam engravidar. Questões como quando se iniciar, duração e tipo de tratamento têm sido debatidas ao longo dos anos com pouco consenso.
Assim sendo, esta dissertação tem o objectivo de esclarecer algumas das questões sobre esse tema, assim como o de procurar clarificar de que maneira o desequilíbrio hormonal associado à gravidez e parto pode influenciar o aparecimento/agravamento da perturbação bipolar.
Para tal, optou-se por uma metodologia de revisão sistemática de literatura, abordando-se o conceito de perturbação bipolar e tratamento na população geral, seguindo-se uma referência aos principais efeitos adversos da medicação utilizada neste distúrbio durante a gravidez e pós-parto. Analisamos ainda os riscos que a reunião da bipolaridade e da gravidez/pós-parto comportam não só para a mãe e o feto/recém-nascido, mas também para o curso da doença de forma aguda e crónica.
Bipolar disorder, one of the most common psychiatric disorders in Western society, is a psychiatric syndrome characterized by excessive changes in mood, energy and activity, which can perpetuate in time with disastrous consequences for the individual’s functioning, since it is associated with marked psychosocial impairment. However, given that this disorder (as a nosological entity) is very uneven and it presents with marked differences in evolution, severity and forms of presentation’s combinations, its diagnosis and treatment can be very difficult sometimes. So, it is no surprise that some of the issues that have been debated in recent years are the diagnosis, treatment and control of this disease in pregnant women, recent mothers and even in women of childbearing age who plan to become pregnant. Questions such as when to start, duration and type of treatment have been debated over the years with little agreement. Therefore, this dissertation aims to clarify some of the questions on this subject, as well as to seek to elucidate how the hormone imbalance associated with pregnancy and delivery may influence the onset/worsening of bipolar disorder. To this end, we opted for a systematic review of literature addressing the concept and treatment of bipolar disorder in the general population, followed by reference to the main adverse effects of the medication used in this disorder during pregnancy and postpartum. We also analyzed the risks that the meeting of bipolarity and pregnancy/postpartum bear not only for the mother and the fetus/newborn, but also to the disease acute and chronic course.
Bipolar disorder, one of the most common psychiatric disorders in Western society, is a psychiatric syndrome characterized by excessive changes in mood, energy and activity, which can perpetuate in time with disastrous consequences for the individual’s functioning, since it is associated with marked psychosocial impairment. However, given that this disorder (as a nosological entity) is very uneven and it presents with marked differences in evolution, severity and forms of presentation’s combinations, its diagnosis and treatment can be very difficult sometimes. So, it is no surprise that some of the issues that have been debated in recent years are the diagnosis, treatment and control of this disease in pregnant women, recent mothers and even in women of childbearing age who plan to become pregnant. Questions such as when to start, duration and type of treatment have been debated over the years with little agreement. Therefore, this dissertation aims to clarify some of the questions on this subject, as well as to seek to elucidate how the hormone imbalance associated with pregnancy and delivery may influence the onset/worsening of bipolar disorder. To this end, we opted for a systematic review of literature addressing the concept and treatment of bipolar disorder in the general population, followed by reference to the main adverse effects of the medication used in this disorder during pregnancy and postpartum. We also analyzed the risks that the meeting of bipolarity and pregnancy/postpartum bear not only for the mother and the fetus/newborn, but also to the disease acute and chronic course.
Description
Keywords
Depressão Major Diagnóstico de Conversão Gravidez Perturbação Bipolar Tratamento