Consenso da Associação Brasileira de Psiquiatria para o manejo das emergências psiquiátricas na gestação e puerpério

Autores

  • Leonardo Rodrigo Baldaçara Diretor Regional Centro-Oeste e Coordenador da Comissão de Emergências Psiquiátricas da Associação Brasileira de Psiquiatria, Rio de Janeiro, RJ, Brasil. Universidade Federal do Tocantins, UFT, Palmas, TO, Brasil https://orcid.org/0000-0002-5201-8515
  • Gislene Alves Rocha Hospital Universitário Clemente de Faria, Montes Claros, MG, Brasil https://orcid.org/0000-0003-2844-7915
  • Flávia Ismael Pinto Faculdade de Medicina do ABC, Santo André, SP, Brasil https://orcid.org/0000-0002-4837-9318
  • Igor Emanuel Vasconcelos e Martins Gomes Psiquiatra, Maternidade Escola Assis Chateaubriand, Universidade Federal do Ceará, UFC, Fortaleza, CE, Brazil https://orcid.org/0000-0002-0879-6774
  • Christiane Carvalho Ribeiro Women's Mental Health Studies and Research Commission, Associação Brasileira de Psiquiatria, ABP, Rio de Janeiro, RJ, Brasil https://orcid.org/0000-0001-9248-6703
  • Elie Leal de Barros Calfat Centro de Atenção Integrada à Saúde Mental de Franco da Rocha, Centro de Estudos João Amorim, Franco da Rocha, SP, Brasil https://orcid.org/0000-0001-6223-1056
  • Carlos Eduardo Rosa Pesquisador Colaborador da Divisão de Imagens Médicas do Departamento de Imagens Médicas, Hematologia e Oncologia Clínica, Faculdade de Medicina, Universidade de São Paulo, USP, Ribeirão Preto, SP, Brasil https://orcid.org/0000-0002-9625-4026
  • Verônica da Silveira Leite Mestranda em Ciências da Saúde, Universidade Federal do Tocantins, UFT, Palmas, TO, Brasil https://orcid.org/0000-0002-2919-3219
  • Maria Elisa Lima Barros Centro Universitário de Guanambi FG, Guanambi, BA, Brasil https://orcid.org/0000-0001-9124-4446
  • Luis Souza Motta Serviço de Psiquiatria do Hospital São Lucas da PUCRS, Unidade de Internação Psiquiátrica, Porto Alegre, RS, Brasil https://orcid.org/0000-0002-0206-1590
  • Neusa Aita Agne Serviço de Psiquiatria, Hospital Materno Infantil Presidente Vargas, Unidade de internação psiquiátrica e Ambulatório de Psiquiatria Infantil, Porto Alegre, RS, Brasil
  • Priscila Gabrielli Ribeiro Crisálida Saúde Personalizada, Porto Seguro, BA, Brasil https://orcid.org/0000-0001-8472-5882
  • Ana Luiza Silva Teles Faculdade de Medicina, Centro Universitário de Brasília, DF, Brasil https://orcid.org/0000-0002-0438-3577
  • Leila Rute Oliveira Gurgel do Amaral Universidade Federal do Tocantins, UFT, Palmas, TO, Brasil https://orcid.org/0000-0002-0863-4580
  • Jerônimo de Almeida Mendes Ribeiro Professor Titular do Programa de Formação em Psiquiatria da Associação de Psiquiatria Cyro Martins, CCYM, Porto Alegre, RS, Brasil https://orcid.org/0000-0002-4856-9058
  • Maila de Castro Lourenço das Neves Professora Adjunta de Psiquiatria, Faculdade de Medicina, Universidade Federal de Minas Gerais, UFMG, Belo Horizonte, MG, Brasil https://orcid.org/0000-0003-4125-3736
  • Hewdy Lobo Ribeiro Women's Mental Health Studies and Research Commission, Associação Brasileira de Psiquiatria, ABP, Rio de Janeiro, RJ, Brasil https://orcid.org/0000-0001-9117-1937
  • Ivaldo Silva Departmento de Ginecologia, Universidade Federal de São Paulo, UNIFESP, São Paulo, SP, Brasil https://orcid.org/0000-0002-2370-943X
  • Vanessa J. Lentz Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
  • Benicio N. Frey Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada https://orcid.org/0000-0001-8267-943X
  • Renan Boeira Rocha Women's Mental Health Studies and Research Commission, Associação Brasileira de Psiquiatria, ABP, Rio de Janeiro, RJ, Brasil
  • Amaury Cantilino Women's Mental Health Studies and Research Commission, Associação Brasileira de Psiquiatria, ABP, Rio de Janeiro, RJ, Brasil
  • Joel Rennó Júnior Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, USP, São Paulo, SP, Brazil. https://orcid.org/0000-0003-1954-5898
  • Antônio Geraldo Silva Presidente da Associação Brasileira de Psiquiatria, Rio de Janeiro, RJ, Brasil. Faculdade de Medicina, Universidade do Porto, Porto, Portugal. Pós-doutorando em Medicina Molecular, Faculdade de Medicina, Universidade Federal de Minas Gerais, UFMG, Belo Horizonte, MG, Brasil https://orcid.org/0000-0003-3423-7076

DOI:

https://doi.org/10.25118/2763-9037.2022.v12.389

Palavras-chave:

gravidez, pós parto, emergência psiquiátrica, desordem mental

Resumo

Introdução: Emergências na gravidez e no puerpério são menos frequentes do que em outros grupos, mas não incomuns. No entanto, a literatura sobre o assunto é escassa e controversa. Objetivo: O objetivo deste artigo é apresentar algumas recomendações para o manejo das emergências psiquiátricas mais comuns que podem ocorrer na gravidez ou no puerpério. Método: Esses procedimentos foram focados na discussão e integração dos achados de pesquisas publicadas e revisadas por pares sobre o tema. Pesquisamos bancos de dados eletrônicos usando PubMed. Resumos relevantes foram identificados usando os seguintes termos de busca: Psychotropics medications at pregnancy and breastfeeding: (((psychotropic medications) AND (pregnancy)) OR (psychotropic medications)) AND (breastfeeding) - Psychiatric emergencies: (((((((psychiatric emergencies) AND (pregnancy)) OR (psychiatric emergencies)) AND (postpartum)) OR (psychiatric emergencies)) AND (peripartum)) OR (psychiatric emergencies)) AND (breastfeeding). Os critérios de inclusão incluíram artigos publicados (ou no prelo) sobre gravidez ou amamentação ou pós-parto de dezembro de 2000 a janeiro de 2021 que enfocassem agitação em emergências psiquiátricas. Principais resultados: Apresentamos recomendação para tratamento farmacológico, agitação psicomotora, comportamento suicida, transtornos psicóticos e mania, depressão grave e transtornos por uso de substâncias. Conclusão: Embora muitas das recomendações sejam empíricas, já é possível contar com informações que proporcionam melhores resultados e segurança para a paciente e seu bebê.

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Biografia do Autor

Leonardo Rodrigo Baldaçara, Diretor Regional Centro-Oeste e Coordenador da Comissão de Emergências Psiquiátricas da Associação Brasileira de Psiquiatria, Rio de Janeiro, RJ, Brasil. Universidade Federal do Tocantins, UFT, Palmas, TO, Brasil

Gislene Alves Rocha, Hospital Universitário Clemente de Faria, Montes Claros, MG, Brasil

Flávia Ismael Pinto, Faculdade de Medicina do ABC, Santo André, SP, Brasil

Igor Emanuel Vasconcelos e Martins Gomes, Psiquiatra, Maternidade Escola Assis Chateaubriand, Universidade Federal do Ceará, UFC, Fortaleza, CE, Brazil

Christiane Carvalho Ribeiro, Women's Mental Health Studies and Research Commission, Associação Brasileira de Psiquiatria, ABP, Rio de Janeiro, RJ, Brasil

Elie Leal de Barros Calfat, Centro de Atenção Integrada à Saúde Mental de Franco da Rocha, Centro de Estudos João Amorim, Franco da Rocha, SP, Brasil

Carlos Eduardo Rosa, Pesquisador Colaborador da Divisão de Imagens Médicas do Departamento de Imagens Médicas, Hematologia e Oncologia Clínica, Faculdade de Medicina, Universidade de São Paulo, USP, Ribeirão Preto, SP, Brasil

Verônica da Silveira Leite, Mestranda em Ciências da Saúde, Universidade Federal do Tocantins, UFT, Palmas, TO, Brasil

Maria Elisa Lima Barros, Centro Universitário de Guanambi FG, Guanambi, BA, Brasil

Luis Souza Motta, Serviço de Psiquiatria do Hospital São Lucas da PUCRS, Unidade de Internação Psiquiátrica, Porto Alegre, RS, Brasil

Neusa Aita Agne, Serviço de Psiquiatria, Hospital Materno Infantil Presidente Vargas, Unidade de internação psiquiátrica e Ambulatório de Psiquiatria Infantil, Porto Alegre, RS, Brasil

Priscila Gabrielli Ribeiro, Crisálida Saúde Personalizada, Porto Seguro, BA, Brasil

Ana Luiza Silva Teles, Faculdade de Medicina, Centro Universitário de Brasília, DF, Brasil

Leila Rute Oliveira Gurgel do Amaral, Universidade Federal do Tocantins, UFT, Palmas, TO, Brasil

Jerônimo de Almeida Mendes Ribeiro, Professor Titular do Programa de Formação em Psiquiatria da Associação de Psiquiatria Cyro Martins, CCYM, Porto Alegre, RS, Brasil

Maila de Castro Lourenço das Neves, Professora Adjunta de Psiquiatria, Faculdade de Medicina, Universidade Federal de Minas Gerais, UFMG, Belo Horizonte, MG, Brasil

Hewdy Lobo Ribeiro, Women's Mental Health Studies and Research Commission, Associação Brasileira de Psiquiatria, ABP, Rio de Janeiro, RJ, Brasil

Ivaldo Silva, Departmento de Ginecologia, Universidade Federal de São Paulo, UNIFESP, São Paulo, SP, Brasil

Vanessa J. Lentz, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada

Benicio N. Frey, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada

Renan Boeira Rocha, Women's Mental Health Studies and Research Commission, Associação Brasileira de Psiquiatria, ABP, Rio de Janeiro, RJ, Brasil

Amaury Cantilino, Women's Mental Health Studies and Research Commission, Associação Brasileira de Psiquiatria, ABP, Rio de Janeiro, RJ, Brasil

Joel Rennó Júnior, Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, USP, São Paulo, SP, Brazil.

Antônio Geraldo Silva, Presidente da Associação Brasileira de Psiquiatria, Rio de Janeiro, RJ, Brasil. Faculdade de Medicina, Universidade do Porto, Porto, Portugal. Pós-doutorando em Medicina Molecular, Faculdade de Medicina, Universidade Federal de Minas Gerais, UFMG, Belo Horizonte, MG, Brasil

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2022-08-03

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Baldaçara LR, Rocha GA, Pinto FI, Gomes IEV e M, Ribeiro CC, Calfat EL de B, Rosa CE, Leite V da S, Barros MEL, Motta LS, Agne NA, Ribeiro PG, Teles ALS, Amaral LROG do, Ribeiro J de AM, Neves M de CL das, Ribeiro HL, Silva I, Lentz VJ, Frey BN, Rocha RB, Cantilino A, Rennó Júnior J, Silva AG. Consenso da Associação Brasileira de Psiquiatria para o manejo das emergências psiquiátricas na gestação e puerpério. Debates em Psiquiatria [Internet]. 3º de agosto de 2022 [citado 28º de março de 2024];12:1-44. Disponível em: https://revistardp.org.br/revista/article/view/389

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