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Edited by
Ornella Corazza, University of Hertfordshire and University of Trento, Italy,Artemisa Rocha Dores, Polytechnic Institute of Porto and University of Porto, Portugal
Dysfunctional exercise is one of the most challenging behaviours in individuals with eating disorders, among whom it makes a significant contribution to morbidity and impaired quality of life. This chapter examines the prevalence of dysfunctional exercise symptoms in the context of an eating disorder, the neurobiological basis of dysfunctional exercise symptoms, and the various predisposing and maintaining factors that are involved. It then highlights the need for management and treatment of excessive exercise to address the neurobiological and psychological factors involved, and describes the evidence base for such treatments, especially physiotherapy-based psychological interventions. A multidisciplinary approach to management is recommended, so that treatment can be formulated within the wider context of the individual’s psychosocial difficulties, enabling them to challenge their exercise-related beliefs and behaviour. Finally, two semi-fictional case studies are presented that illustrate common presentations of dysfunctional exercise in eating disorder clinics.
Postpartum depression is a common psychiatric complication after pregnancy, so it is necessary to know the depressive symptoms to be able to carry out early prevention and treatment interventions. It is a health problem with a prevalence that ranges between 10–15% according to the world literature. Behavioral and psychosocial factors favoring postpartum depression are recognized.
Objectives
-To emphasize multidisciplinary treatment in the combined attention to the mother-baby. -To demostrate decreased risk for baby if early use of antidepressants. -To evaluate of the impact of desvenlafaxine during breastfeeding.
Methods
Descriptive-study. Clinical Case. Evolution of postpartum depression. Follow-up of a patient based on coordination with the midwife attending a successful breastfeeding while treatment with desvenlafaxine. Use of Edinburgh Postnatal Depression Scale.
Results
-Use of Desvenlafaxine 50-100mg being compatible with breastfeeding, in adittion to depressive illness improvement *Obstetrics and psychiatry guidelines and safety considerations for lactation and antidepressants).
Conclusions
-Postpartum-depression could be the first episode of depression in a healthy woman. Sometimes there are unnoticed symptoms during pregnancy. -Health-care for puerperal women should be focused on both, biomedical and psychosocial issues, with a coordinated multidisciplinar team. -Due to important early treatment during the puerperium, it is recommended a close medical control of the mother´s psychological state after the birth. -If depression appears, a psychiatric follow-up is kept even after the episode remission. Besides, the role of the midwife is essential during lactation. -Some antidepressants like desvenlafaxine have demonstrated benefits over the risk of the baby´s complications without treatment.
Disclosure
No significant relationships.
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