PSYCHOPATHOLOGIE
INHOUD
1. Psychopathologie in het algemeen ....................................................................................................4
1.1 Belang van psychopathologie in opleiding vroedkunde ..................................................................4
1.1.1 Reeds bestaande psychiatrische problematiek voor zwangerschap .........................................4
1.1.2 Invloed psychiatrische stoornis op zwangerschap ..................................................................4
1.1.3 Peripartale psychische problematiek .....................................................................................4
1.2 Kenmerken van psychische stoornis ............................................................................................4
1.2.1 Verschijnsel of gedrag is abnormaal.......................................................................................4
1.2.2 Abnormale verschijnsel of gedrag veroorzaakt ongemak, hinder of lijden .................................5
1.2.3 Negatieve weerslag op functioneren ......................................................................................5
1.2.4 Toestand heeft bepaalde minimum duur ................................................................................5
1.3 Oorzaken van psychische stoornis ...............................................................................................5
1.3.1 Psychologische oorzaken ......................................................................................................5
1.3.2 Biologische oorzaken ............................................................................................................5
1.3.3 Sociale oorzaken ..................................................................................................................5
1.3.4 Bio-psycho-sociaal model.....................................................................................................6
1.3.5 Chronische stress ................................................................................................................6
1.4 Diagnose van psychische stoornis ...............................................................................................7
1.5 Behandeling van psychische stoornis ...........................................................................................7
2. Psychiatrische stoornissen verbonden aan peripartum ......................................................................8
2.1 Angststoornissen ........................................................................................................................8
2.1.1 Inleiding ...............................................................................................................................8
2.1.2 Paniekstoornis .....................................................................................................................8
2.1.3 Gegeneraliseerde angststoornis ............................................................................................9
2.1.4 Fobie ...................................................................................................................................9
2.1.5 Peripartum ......................................................................................................................... 10
2.1.6 Behandeling van angststoornissen ...................................................................................... 11
2.2 PTSS ........................................................................................................................................ 11
2.2.1 Inleiding ............................................................................................................................. 11
2.2.2 Kenmerken PTSS ................................................................................................................ 12
2.2.3 Peripartum ......................................................................................................................... 12
2.2.4 Behandeling PTSS ............................................................................................................... 13
2.3 Obsessief-compulsieve stoornis ................................................................................................ 13
2.3.1 Kenmerken OCD ................................................................................................................. 13
2.3.2 Behandeling OCD ............................................................................................................... 13
2.4 Depressieve stoornis ................................................................................................................. 14
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,PSYCHOPATHOLOGIE
2.4.1 Inleiding ............................................................................................................................. 14
2.4.2 Kenmerken depressie ......................................................................................................... 14
2.4.3 Verloop & prognose depressie ............................................................................................. 15
2.4.4 Oorzaken depressie ............................................................................................................ 15
2.4.5 Behandeling depressie ........................................................................................................ 15
2.4.6 Depressie in peripartum ...................................................................................................... 16
2.5 Verslaving ................................................................................................................................. 17
2.5.1 Algemeen ........................................................................................................................... 17
2.5.2 Wat betekent verslaving ...................................................................................................... 17
2.5.3 Soorten middelen ............................................................................................................... 17
2.5.4 Benzodiazepines ................................................................................................................ 18
2.5.5 Alcohol .............................................................................................................................. 18
2.5.6 XTC .................................................................................................................................... 18
2.5.7 Cannabis ........................................................................................................................... 19
2.5.8 Preventie ............................................................................................................................ 19
2.5.9 Behandeling ....................................................................................................................... 19
2.6 Psychose & bipolaire stoornis .................................................................................................... 19
2.6.1 Kenmerkn psychose ........................................................................................................... 19
2.6.2 Oorzaken psychose ............................................................................................................ 20
2.6.3 Behandeling psychose ........................................................................................................ 20
2.6.4 Psychosespectrum stoornissen & link met peripartum ......................................................... 21
2.6.5 Manie & bipolaire stoornis ................................................................................................... 21
2.6.6 Postpartum psychose ......................................................................................................... 23
2.7 Eetstoornissen.......................................................................................................................... 25
2.7.1 Anorexia nervosa ................................................................................................................ 25
2.7.2 Boulimia nervosa ................................................................................................................ 25
2.7.3 Binge eating disorder .......................................................................................................... 25
2.7.4 PICA .................................................................................................................................. 26
2.8 Borderline persoonlijkheidsstoornis ........................................................................................... 26
2.8.1 Persoonlijkheidsstoornissen in het algemeen ....................................................................... 26
2.8.2 Borderline persoonlijkheidsstoornis .................................................................................... 26
3. Invloed van psychiatrische problematiek op prille moeder-kind relatie .............................................. 28
3.1 Normale moeder-kind relatie ..................................................................................................... 28
3.1.1 Hechting ............................................................................................................................ 28
3.1.2 Veilige hechting .................................................................................................................. 28
3.2 Verstoorde vroege moeder-kind relatie ....................................................................................... 28
3.2.1 Onveilige hechting .............................................................................................................. 28
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, PSYCHOPATHOLOGIE
3.2.2 Gevolgen onveilige hechting ................................................................................................ 29
3.3 Behandeling verstoorde vroege moeder-kind relatie .................................................................... 29
4. Therapie ........................................................................................................................................ 30
4.1 Therapie algemeen.................................................................................................................... 30
4.2 Therapeutische stromingen ....................................................................................................... 30
4.2.1 Psychodynamische stroming............................................................................................... 30
4.2.2 Cognitieve gedragstherapie ................................................................................................. 30
3
INHOUD
1. Psychopathologie in het algemeen ....................................................................................................4
1.1 Belang van psychopathologie in opleiding vroedkunde ..................................................................4
1.1.1 Reeds bestaande psychiatrische problematiek voor zwangerschap .........................................4
1.1.2 Invloed psychiatrische stoornis op zwangerschap ..................................................................4
1.1.3 Peripartale psychische problematiek .....................................................................................4
1.2 Kenmerken van psychische stoornis ............................................................................................4
1.2.1 Verschijnsel of gedrag is abnormaal.......................................................................................4
1.2.2 Abnormale verschijnsel of gedrag veroorzaakt ongemak, hinder of lijden .................................5
1.2.3 Negatieve weerslag op functioneren ......................................................................................5
1.2.4 Toestand heeft bepaalde minimum duur ................................................................................5
1.3 Oorzaken van psychische stoornis ...............................................................................................5
1.3.1 Psychologische oorzaken ......................................................................................................5
1.3.2 Biologische oorzaken ............................................................................................................5
1.3.3 Sociale oorzaken ..................................................................................................................5
1.3.4 Bio-psycho-sociaal model.....................................................................................................6
1.3.5 Chronische stress ................................................................................................................6
1.4 Diagnose van psychische stoornis ...............................................................................................7
1.5 Behandeling van psychische stoornis ...........................................................................................7
2. Psychiatrische stoornissen verbonden aan peripartum ......................................................................8
2.1 Angststoornissen ........................................................................................................................8
2.1.1 Inleiding ...............................................................................................................................8
2.1.2 Paniekstoornis .....................................................................................................................8
2.1.3 Gegeneraliseerde angststoornis ............................................................................................9
2.1.4 Fobie ...................................................................................................................................9
2.1.5 Peripartum ......................................................................................................................... 10
2.1.6 Behandeling van angststoornissen ...................................................................................... 11
2.2 PTSS ........................................................................................................................................ 11
2.2.1 Inleiding ............................................................................................................................. 11
2.2.2 Kenmerken PTSS ................................................................................................................ 12
2.2.3 Peripartum ......................................................................................................................... 12
2.2.4 Behandeling PTSS ............................................................................................................... 13
2.3 Obsessief-compulsieve stoornis ................................................................................................ 13
2.3.1 Kenmerken OCD ................................................................................................................. 13
2.3.2 Behandeling OCD ............................................................................................................... 13
2.4 Depressieve stoornis ................................................................................................................. 14
1
,PSYCHOPATHOLOGIE
2.4.1 Inleiding ............................................................................................................................. 14
2.4.2 Kenmerken depressie ......................................................................................................... 14
2.4.3 Verloop & prognose depressie ............................................................................................. 15
2.4.4 Oorzaken depressie ............................................................................................................ 15
2.4.5 Behandeling depressie ........................................................................................................ 15
2.4.6 Depressie in peripartum ...................................................................................................... 16
2.5 Verslaving ................................................................................................................................. 17
2.5.1 Algemeen ........................................................................................................................... 17
2.5.2 Wat betekent verslaving ...................................................................................................... 17
2.5.3 Soorten middelen ............................................................................................................... 17
2.5.4 Benzodiazepines ................................................................................................................ 18
2.5.5 Alcohol .............................................................................................................................. 18
2.5.6 XTC .................................................................................................................................... 18
2.5.7 Cannabis ........................................................................................................................... 19
2.5.8 Preventie ............................................................................................................................ 19
2.5.9 Behandeling ....................................................................................................................... 19
2.6 Psychose & bipolaire stoornis .................................................................................................... 19
2.6.1 Kenmerkn psychose ........................................................................................................... 19
2.6.2 Oorzaken psychose ............................................................................................................ 20
2.6.3 Behandeling psychose ........................................................................................................ 20
2.6.4 Psychosespectrum stoornissen & link met peripartum ......................................................... 21
2.6.5 Manie & bipolaire stoornis ................................................................................................... 21
2.6.6 Postpartum psychose ......................................................................................................... 23
2.7 Eetstoornissen.......................................................................................................................... 25
2.7.1 Anorexia nervosa ................................................................................................................ 25
2.7.2 Boulimia nervosa ................................................................................................................ 25
2.7.3 Binge eating disorder .......................................................................................................... 25
2.7.4 PICA .................................................................................................................................. 26
2.8 Borderline persoonlijkheidsstoornis ........................................................................................... 26
2.8.1 Persoonlijkheidsstoornissen in het algemeen ....................................................................... 26
2.8.2 Borderline persoonlijkheidsstoornis .................................................................................... 26
3. Invloed van psychiatrische problematiek op prille moeder-kind relatie .............................................. 28
3.1 Normale moeder-kind relatie ..................................................................................................... 28
3.1.1 Hechting ............................................................................................................................ 28
3.1.2 Veilige hechting .................................................................................................................. 28
3.2 Verstoorde vroege moeder-kind relatie ....................................................................................... 28
3.2.1 Onveilige hechting .............................................................................................................. 28
2
, PSYCHOPATHOLOGIE
3.2.2 Gevolgen onveilige hechting ................................................................................................ 29
3.3 Behandeling verstoorde vroege moeder-kind relatie .................................................................... 29
4. Therapie ........................................................................................................................................ 30
4.1 Therapie algemeen.................................................................................................................... 30
4.2 Therapeutische stromingen ....................................................................................................... 30
4.2.1 Psychodynamische stroming............................................................................................... 30
4.2.2 Cognitieve gedragstherapie ................................................................................................. 30
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