Sabine Aust

Zusammenfassung: Postpartale Depressionen sind häufig und folgenschwer: Betroffene Mütter verspüren trotz ständiger Nähe zum Kind eine innere Distanz, genährt von Selbstzweifeln und Versagensängsten. Dieses paradoxe Erleben beeinträchtigt nicht selten die Bindungsqualität und folglich auch die Entwicklung des Kindes. Somit sind Aufklärung, Früherkennung sowie der Abbau von Behandlungsbarrieren entscheidende Faktoren für die nachhaltige Förderung von psychischer Gesundheit und Kindesentwicklung. Mit einer Prävalenz von 7–10 % können auch Väter an einer postpartalen Depression erkranken. Im vorliegenden Artikel werden jedoch die spezifischen Herausforderungen am Beispiel psychisch erkrankter Mütter beleuchtet.

Purpose: Postpartum depression (PPD) affects about 17% of parents after childbirth and can have adverse effects on individuals, families and offspring. Parents with PPD frequently encounter significant barriers to tailored health care that make timely access to treatment difficult.Methods: Twenty‐nine help‐seeking German parents of at least one child (< 1 year old) and with symptoms of depression participated in a synchronous 1‐day online cognitive behavioural therapy (CBT) group intervention. Following a mixed‐methods approach, intervention acceptance and preferences were evaluated using semi‐structured interviews conducted 2 weeks post‐intervention. Analyses were performed via qualitative content analysis. Severity of depressive symptoms were assessed via the Edinburgh Postnatal Depression Scale (EPDS) 1 week before and 4 weeks after the intervention.Results: Twenty‐one interviews were conducted. Most participants rated the workshop as overall helpful (n = 164, 72.57%), with workshop characteristics, such as the online format (n = 112; 68.29%) and structure (n = 15; 20.55%) being most helpful. Expectations were mostly content‐related (n = 25; 52.08%), and 80% (n = 20) of expectations were met (e.g. regarding self‐help strategies being taught or deepening of existing knowledge). Two weeks after participation, the majority of parents were still applying intervention techniques in their daily lives (n = 42; 77.78%). Depressive symptoms were also significantly reduced at post‐measurement (t = 3159; p = 0.004; d = 0.608).Conclusions: The 1‐day online CBT group intervention is easily accessible and could support parents after birth by teaching cognitive behavioural strategies to cope with symptoms of PPD.

Transcranial direct current stimulation (tDCS) is a neuromodulation technique, which noninvasively alters cortical excitability via weak polarizing currents between two electrodes placed on the scalp. Since it is comparably easy to handle, cheap to use and relatively well tolerated, tDCS has gained increasing interest in recent years. Based on well-known behavioral effects, a number of clinical studies have been performed in populations including patients with major depressive disorder followed by schizophrenia and substance use disorders, in sum with heterogeneous results with respect to efficacy. Nevertheless, the potential of tDCS must not be underestimated since it could be further improved by systematically investigating the various stimulation parameters to eventually increase clinical efficacy. The present article briefly explains the underlying physiology of tDCS, summarizes typical stimulation protocols and then reviews clinical efficacy for various psychiatric disorders as well as prevalent adverse effects. Future developments include combined and more complex interactions of tDCS with pharmacological or psychotherapeutic interventions. In particular, using computational models to individualize stimulation protocols, considering state dependency and applying closed-loop technologies will pave the way for tDCS-based personalized interventions as well as the development of home treatment settings promoting the role of tDCS as an effective treatment option for patients with mental health problems.