{"id":575,"date":"2021-02-11T14:23:51","date_gmt":"2021-02-11T14:23:51","guid":{"rendered":"http:\/\/134.122.102.56\/SAND\/uk\/?post_type=professionals&#038;p=575"},"modified":"2022-01-28T13:36:25","modified_gmt":"2022-01-28T13:36:25","slug":"perinatal-anxiety","status":"publish","type":"professionals","link":"https:\/\/path-perinatal.eu\/uk\/professionals\/perinatal-anxiety\/","title":{"rendered":"Perinatal anxiety"},"content":{"rendered":"\n<section id=\"gm53c63cc\" class=\"wp-block-gutentor-m3 section-gm53c63cc gutentor-module gutentor-container-cover has-color-bg has-custom-bg\"><div class=\"grid-container\">\n<div id=\"section-g0ff736\" class=\"wp-block-gutentor-e1 section-g0ff736 gutentor-element gutentor-element-advanced-text centre\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\">There are a number of anxiety disorders that women may experience in the perinatal period including generalised anxiety disorder (GAD), <a href=\"https:\/\/path-perinatal.eu\/uk\/professionals\/perinatal-obsessive-compulsive-disorder\/\" data-type=\"professionals\" data-id=\"9628\"><span class=\"has-inline-color has-vivid-cyan-blue-color\">obsessive compulsive disorder<\/span><\/a>, panic disorder, phobias (including needle phobia and <a href=\"https:\/\/path-perinatal.eu\/uk\/professionals\/post-traumatic-stress-disorder-ptsd-birth-trauma-and-tokophobia\/\" data-type=\"professionals\" data-id=\"576\"><span class=\"has-inline-color has-vivid-cyan-blue-color\">tokophobia), post-traumatic stress disorder<\/span><\/a> (PTSD) and social anxiety disorder. These can occur on their own or co-exist with depression. Anxiety and related disorders are known to affect 15%-20% of women in the perinatal period<sup>1,2<\/sup>.<\/p><\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator\" \/>\n\n\n\n<div id=\"section-gc866d2\" class=\"wp-block-gutentor-e1 section-gc866d2 gutentor-element gutentor-element-advanced-text centre\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\">The common signs and symptoms of perinatal anxiety include fatigue, irritability, tension, concentration difficulties, and insomnia. They can be associated with fears of foetal or baby\u2019s wellbeing, maternal wellness, illness in the partner and parental mortality. Anxiety can be disabling if these fears are recurrent, time-consuming, intrusive, and acquire a quality of irrationality.<\/p><\/div><\/div>\n\n\n\n<section id=\"gmc998d0c\" class=\"wp-block-gutentor-m3 section-gmc998d0c gutentor-module gutentor-container-cover has-color-bg has-custom-bg\"><div class=\"grid-container\">\n<div id=\"section-g06d1ad\" class=\"wp-block-gutentor-e1 section-g06d1ad gutentor-element gutentor-element-advanced-text\"><div class=\"gutentor-text-wrap\"><h3 class=\"gutentor-text\"><strong>NICE guidance recommends use of the 2 item Generalized Anxiety Disorder scale (GAD 2) for screening<sup>3<\/sup>:<\/strong><\/h3><\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator\" \/>\n\n\n\n<div id=\"section-ga52260\" class=\"wp-block-gutentor-e7 section-ga52260 gutentor-element gutentor-element-list\"><ul class=\"grid-row gutentor-grid-item-wrap list-indicator-icon\"><li class=\"gutentor-list-item grid-lg-12 grid-md-12 grid-12\"><span class=\"gutentor-single-item gutentor-single-item-0\"><span class=\"gutentor-list-item-wrap g-s-list-wrap\"><span class=\"gutentor-single-list-item-icon\"><i class=\"list-item-icon fas fa-arrow-right\"><\/i><\/span><span class=\"gutentor-list-item\"><p class=\"gutentor-single-item-title\">Over the last 2 weeks, how often have you been bothered by feeling nervous, anxious or on edge?<\/p><\/span><\/span><\/span><\/li><li class=\"gutentor-list-item grid-lg-12 grid-md-12 grid-12\"><span class=\"gutentor-single-item gutentor-single-item-1\"><span class=\"gutentor-list-item-wrap g-s-list-wrap\"><span class=\"gutentor-single-list-item-icon\"><i class=\"list-item-icon fas fa-arrow-right\"><\/i><\/span><span class=\"gutentor-list-item\"><p class=\"gutentor-single-item-title\">Over the last 2 weeks, how often have you been bothered by not being able to stop or control worrying?<\/p><\/span><\/span><\/span><\/li><\/ul><\/div>\n\n\n\n<div id=\"section-g3ea0b6\" class=\"wp-block-gutentor-e1 section-g3ea0b6 gutentor-element gutentor-element-advanced-text\"><div class=\"gutentor-text-wrap\"><h3 class=\"gutentor-text\"><strong>An answer of &#8216;not at all&#8217; scores 0; &#8216;several days&#8217; scores 1; &#8216;more than half the days&#8217; scores 2; &#8216;nearly every day&#8217; scores 3. If a woman scores 3 or more on the GAD 2 scale, consider:<\/strong><\/h3><\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator\" \/>\n\n\n\n<div id=\"section-g75c906\" class=\"wp-block-gutentor-e7 section-g75c906 gutentor-element gutentor-element-list\"><ul class=\"grid-row gutentor-grid-item-wrap list-indicator-icon\"><li class=\"gutentor-list-item grid-lg-12 grid-md-12 grid-12\"><span class=\"gutentor-single-item gutentor-single-item-0\"><span class=\"gutentor-list-item-wrap g-s-list-wrap\"><span class=\"gutentor-single-list-item-icon\"><i class=\"list-item-icon fas fa-arrow-right\"><\/i><\/span><span class=\"gutentor-list-item\"><p class=\"gutentor-single-item-title\">Using the <a href=\"https:\/\/patient.info\/doctor\/generalised-anxiety-disorder-assessment-gad-7\" data-type=\"URL\" data-id=\"https:\/\/patient.info\/doctor\/generalised-anxiety-disorder-assessment-gad-7\" target=\"_blank\" rel=\"noreferrer noopener\">GAD 7<\/a> scale for further assessment or<\/p><\/span><\/span><\/span><\/li><li class=\"gutentor-list-item grid-lg-12 grid-md-12 grid-12\"><span class=\"gutentor-single-item gutentor-single-item-1\"><span class=\"gutentor-list-item-wrap g-s-list-wrap\"><span class=\"gutentor-single-list-item-icon\"><i class=\"list-item-icon fas fa-arrow-right\"><\/i><\/span><span class=\"gutentor-list-item\"><p class=\"gutentor-single-item-title\">Referring the woman to her GP or, if a severe mental health problem is suspected, to a mental health professional<\/p><\/span><\/span><\/span><\/li><\/ul><\/div>\n<\/div><\/section>\n\n\n\n<div id=\"section-g0558d8\" class=\"wp-block-gutentor-e1 section-g0558d8 gutentor-element gutentor-element-advanced-text centre\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\">For a woman with persistent subthreshold symptoms of anxiety in pregnancy or the postnatal period, consider facilitated self\u2011help. For a woman with anxiety disorder of mild to moderate severity in pregnancy or the postnatal period, offer a low\u2011intensity psychological intervention (for example, facilitated self\u2011help) or a high\u2011intensity psychological intervention (for example, CBT) as initial treatment.<\/p><\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator is-style-default\" \/>\n\n\n\n<div id=\"section-g05b28a\" class=\"wp-block-gutentor-e1 section-g05b28a gutentor-element gutentor-element-advanced-text centre\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\">Local mental health services or third sector organisations may be able to offer specific counselling or group programmes for anxiety. In addition, you can recommend online CBT, self-help books, physical activities, relaxation techniques, support from health visitors and peer support groups.<\/p><\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator is-style-default\" \/>\n\n\n\n<div id=\"section-ga1211f\" class=\"wp-block-gutentor-e1 section-ga1211f gutentor-element gutentor-element-advanced-text centre\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\">If the disorder is causing severe distress and\/or impairment then medication may be required, often in combination with psychological therapy. SSRIs (selective serotonin re-uptake inhibitors) are the most commonly used class of antidepressant medication in the perinatal period<sup>4<\/sup>. For further advice on medications in the perinatal period, please refer to <a href=\"https:\/\/path-perinatal.eu\/uk\/professionals\/top-tips-for-gps-in-prescribing-in-perinatal-period\/\" data-type=\"professionals\" data-id=\"611\"><span class=\"has-inline-color has-vivid-cyan-blue-color\">\u2018Top Tips for GPs on prescribing in the perinatal period\u2019.<\/span><\/a><\/p><\/div><\/div>\n<\/div><\/section>\n\n\n\n<section id=\"gm0240503\" class=\"wp-block-gutentor-m3 section-gm0240503 gutentor-module gutentor-container-cover has-color-bg has-custom-bg\"><div class=\"grid-container\">\n<div id=\"section-g8da16c\" class=\"wp-block-gutentor-e6 section-g8da16c gutentor-element gutentor-element-image text-align-center-desktop text-align-center-tablet text-align-center-mobile crop crop-top\"><div class=\"gutentor-element-image-box\"><div class=\"gutentor-bg-image\"><\/div><\/div><\/div>\n\n\n\n<div id=\"section-ga05164\" class=\"wp-block-gutentor-e1 section-ga05164 gutentor-element gutentor-element-advanced-text centre\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\">If both medication and CBT have not been successful, the woman\u2019s daily activities are being severely affected by her anxiety or there are associated risks (such as suicidal ideation\/intent or thoughts to harm others), referral to the local specialist perinatal mental health service or community mental health team should be considered.<\/p><\/div><\/div>\n<\/div><\/section>\n\n\n\n<section id=\"gm43c604e\" class=\"wp-block-gutentor-m3 section-gm43c604e gutentor-module gutentor-container-cover has-color-bg has-custom-bg\"><div class=\"grid-container\">\n<div id=\"section-g09fc5f\" class=\"wp-block-gutentor-e1 section-g09fc5f gutentor-element gutentor-element-advanced-text\"><div class=\"gutentor-text-wrap\"><h2 class=\"gutentor-text\"><strong>Resources<\/strong><\/h2><\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator has-text-color has-background has-white-background-color has-white-color is-style-default\" \/>\n\n\n\n<div id=\"section-g947658\" class=\"wp-block-gutentor-e1 section-g947658 gutentor-element gutentor-element-advanced-text white_link\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\">Anxiety UK<a href=\"https:\/\/www.anxietyuk.org.uk\/\"><span class=\"has-inline-color has-vivid-cyan-blue-color\"> <\/span><\/a><br><a href=\"https:\/\/www.anxietyuk.org.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">anxietyuk.org.uk<\/a><\/p><\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator has-text-color has-background has-white-background-color has-white-color is-style-default\" \/>\n\n\n\n<div id=\"section-g9b6d34\" class=\"wp-block-gutentor-e1 section-g9b6d34 gutentor-element gutentor-element-advanced-text white_link\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\">No Panic <br><a href=\"https:\/\/nopanic.org.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">nopanic.org.uk<\/a><\/p><\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator has-text-color has-background has-white-background-color has-white-color\" \/>\n<\/div><\/section>\n\n\n\n<section id=\"gme892b15\" class=\"wp-block-gutentor-m3 section-gme892b15 gutentor-module gutentor-container-cover has-color-bg has-custom-bg\"><div class=\"grid-container\">\n<section id=\"gmd3a3f42\" class=\"wp-block-gutentor-m4 section-gmd3a3f42 gutentor-module gutentor-advanced-columns gutentor-equal-column-height\"><div class=\"grid-container gutentor-rm-ct-space-d gutentor-rm-ct-space-t gutentor-rm-ct-space\"><div class=\"grid-row\">\n<div id=\"col-gm30b72b\" class=\"wp-block-gutentor-m4-col col-gm30b72b gutentor-single-column  grid-lg-2 grid-md-12 grid-12 centre\"><div id=\"section-gm30b72b\" class=\"section-gm30b72b gutentor-col-wrap\">\n<div id=\"section-g0b3af5\" class=\"wp-block-gutentor-e1 section-g0b3af5 gutentor-element gutentor-element-advanced-text\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\"><strong><span class=\"has-inline-color has-white-color\">Training for healthcare professionals: <\/span><\/strong><br><br><span class=\"has-inline-color has-white-color\">Watch our video where Dr Bosky Nair, Consultant Perinatal Psychiatrist, talks about perinatal anxiety disorders<\/span><\/p><\/div><\/div>\n<\/div><\/div>\n\n\n\n<div id=\"col-gm9a85a4\" class=\"wp-block-gutentor-m4-col col-gm9a85a4 gutentor-single-column  grid-lg-10 grid-md-12 grid-12 centre\"><div id=\"section-gm9a85a4\" class=\"section-gm9a85a4 gutentor-col-wrap\">\n<section id=\"gm6d9f677\" class=\"wp-block-gutentor-m3 section-gm6d9f677 gutentor-module gutentor-container-cover centre\"><div class=\"grid-container gutentor-rm-ct-space-d gutentor-rm-ct-space-t gutentor-rm-ct-space\">\n<section id=\"gm6dd470c\" class=\"wp-block-gutentor-m4 section-gm6dd470c gutentor-module gutentor-advanced-columns\"><div class=\"grid-container gutentor-rm-ct-space-d gutentor-rm-ct-space-t gutentor-rm-ct-space\"><div class=\"grid-row gutentor-rm-row-space-d gutentor-rm-row-space-t gutentor-rm-row-space\">\n<div id=\"col-gm6eb0da\" class=\"wp-block-gutentor-m4-col col-gm6eb0da gutentor-single-column  grid-lg-1 grid-md-1 grid-1 gutentor-rm-col-space-d gutentor-rm-col-space-t gutentor-rm-col-space\"><div id=\"section-gm6eb0da\" class=\"section-gm6eb0da gutentor-col-wrap\"><\/div><\/div>\n\n\n\n<div id=\"col-gm8195e7\" class=\"wp-block-gutentor-m4-col col-gm8195e7 gutentor-single-column  grid-lg-10 grid-md-10 grid-10 gutentor-rm-col-space-d gutentor-rm-col-space-t gutentor-rm-col-space\"><div id=\"section-gm8195e7\" class=\"section-gm8195e7 gutentor-col-wrap\">\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Perinatal Anxiety Disorder\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/a0lOzMia-hg?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n<\/div><\/div>\n\n\n\n<div id=\"col-gmcf2e40\" class=\"wp-block-gutentor-m4-col col-gmcf2e40 gutentor-single-column  grid-lg-1 grid-md-1 grid-1 gutentor-rm-col-space-d gutentor-rm-col-space-t gutentor-rm-col-space\"><div id=\"section-gmcf2e40\" class=\"section-gmcf2e40 gutentor-col-wrap\"><\/div><\/div>\n<\/div><\/div><\/section>\n<\/div><\/section>\n<\/div><\/div>\n<\/div><\/div><\/section>\n<\/div><\/section>\n\n\n\n\n\n<section id=\"gmba4a364\" class=\"wp-block-gutentor-m3 section-gmba4a364 gutentor-module gutentor-container-cover has-color-bg has-custom-bg\"><div class=\"grid-container\">\n<div id=\"section-g7dbb8d\" class=\"wp-block-gutentor-e1 section-g7dbb8d gutentor-element gutentor-element-advanced-text\"><div class=\"gutentor-text-wrap\"><h3 class=\"gutentor-text\"><strong><strong>References<\/strong><\/strong><\/h3><\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator is-style-default\" \/>\n\n\n\n<div id=\"section-gdda15d\" class=\"wp-block-gutentor-e1 section-gdda15d gutentor-element gutentor-element-advanced-text centre\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\">1. Fawcett EJ, Fairbrother N, Cox ML, White IR, Fawcett JM. The Prevalence of Anxiety Disorders During Pregnancy and the Postpartum Period: A Multivariate Bayesian Meta-Analysis. J Clin Psychiatry. 2019.<\/p><\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator is-style-default\" \/>\n\n\n\n<div id=\"section-ge332d7\" class=\"wp-block-gutentor-e1 section-ge332d7 gutentor-element gutentor-element-advanced-text centre\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\">2. Fairbrother N, Janssen P, Antony MM, Tucker E, Young AH. Perinatal anxiety disorder prevalence and incidence. J Affect Disord. 2016<\/p><\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator is-style-default\" \/>\n\n\n\n<div id=\"section-g854022\" class=\"wp-block-gutentor-e1 section-g854022 gutentor-element gutentor-element-advanced-text centre\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\">3. UK National Institute for Health and Care Excellence (NICE). Antenatal and postnatal mental health: clinical management and service guidance (clinical guideline CG192). 2018. <a href=\"https:\/\/www.nice.org.uk\/guidance\/CG192\" target=\"_blank\" rel=\"noreferrer noopener\"><span class=\"has-inline-color has-vivid-cyan-blue-color\">nice.org.uk\/guidance\/CG192<\/span><\/a><\/p><\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator is-style-default\" \/>\n\n\n\n<div id=\"section-g0d7082\" class=\"wp-block-gutentor-e1 section-g0d7082 gutentor-element gutentor-element-advanced-text centre\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\">4. Hamish McAllister-Williams, R et al British Association for Psychopharmacology consensus guidance on the use of psychotropic medication preconception, in pregnancy and postpartum 2017<\/p><\/div><\/div>\n<\/div><\/section>\n","protected":false},"excerpt":{"rendered":"","protected":false},"featured_media":0,"parent":0,"template":"","class_list":["post-575","professionals","type-professionals","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/path-perinatal.eu\/uk\/wp-json\/wp\/v2\/professionals\/575","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/path-perinatal.eu\/uk\/wp-json\/wp\/v2\/professionals"}],"about":[{"href":"https:\/\/path-perinatal.eu\/uk\/wp-json\/wp\/v2\/types\/professionals"}],"wp:attachment":[{"href":"https:\/\/path-perinatal.eu\/uk\/wp-json\/wp\/v2\/media?parent=575"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}