In the National Institute for Health and Care Excellence (NICE) guidelines, selective serotonin reuptake inhibitors (SSRIs) and Cognitive Behavioral Therapy (CBT), which have established effectiveness, are recommended as primary options for the treatment of PD. Hence, it is importance to improve of symptoms by evidenced-based interventions.
Untreated anxiety can have negative long-term consequences for both mother and child. PD is often (but not always) diagnosed alongside agoraphobia. PD is characterized by both recurrent and unexpected panic attacks, with at least one of the attacks having been followed by 1 month (or more) of one (or more) of the following: (a) persistent concern about having additional attacks (b) worry about the implications of the attack or its consequences (e.g., losing control, having a heart attack, “going crazy”) (c) a significant change in behavior related to the attacks. Thus, PD is more common in postpartum women than in the general population. Also, the prevalence rates of PD in the general population range from 1.5 to 3.5% meanwhile, although using a small sample, a previous study showed that 11% of postpartum women have PD. Specifically, the prevalence of clinically significant anxiety and depression, which is the most common mental condition during the postpartum period, has been observed at a rate of 10–20% in developed countries and approximately 30% in developing countries.
A recent literature review reported that generalized anxiety disorder, PD, obsessive compulsive disorder (OCD), and post-traumatic stress disorder are frequently diagnosed in postpartum women. In the field of women’s health, anxiety and depression symptoms are common in the postpartum period. It is important that therapists prescribe tasks that patients can perform collaboratively with their children. ConclusionsĬBT provides a therapeutic effect and is a feasible method for treating postpartum PD.
After treatment, all participants’ panic symptoms were found to have decreased according to the PDSS, and two no longer met clinical criteria: Chihiro’s score changed from 13 to 3, Beth’s PDSS score at baseline from 22 to 6, and Tammy’s score changed from 7 to 1. All patients were exceedingly preoccupied with the perception that a “mother must protect her child,” which reinforced the fear that “the continuation of their perinatal symptoms would prevent them from rearing their children”. All patients received a total of 16 weekly 50-min sessions of CBT, and all completed the treatment. The Panic Disorder Severity Scale (PDSS) was used to evaluate patients’ panic symptoms and their severity. Case presentationĪll patients in this study were married, in their thirties, and diagnosed using the Mini-International Neuropsychiatric Interview as having PD with agoraphobia. In this manuscript, we report on our administration of CBT to three postpartum patients with PD, detailing the improvement in their symptoms. Although cognitive behavioral therapy (CBT) has been determined to be an effective treatment for PD, few studies have been conducted on CBT effectiveness in treating postpartum PD and, to the best of the knowledge of the present authors, no research has been conducted on postpartum PD among Japanese women. Ten to 30 % of perinatal women are diagnosed with panic disorder (PD)-far more than the 1.5–3% rate among the general population. Clinical anxiety is common during the perinatal period, and anxiety symptoms often persist after childbirth.
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