Fallgatter A J, Schnizlein M, Pfuhlmann B, Heidrich A
Klinik für Psychiatrie und Psychotherapie, Universität Würzburg, Füchsleinstrasse 15, 97080 Würzburg.
Nervenarzt. 2002 Jul;73(7):680-5. doi: 10.1007/s00115-002-1323-2.
Psychic disturbances in the post-partum period are divided into the postpartum blues, postpartum depression, and postpartum psychoses. The latter are severe endogenous psychoses which mostly fulfill the diagnostic criteria for cycloid psychoses according to Leonhard. Based on three case reports, characteristic symptoms, the phasic clinical course with remissions, and distinct etiological, therapeutic, and forensic aspects of cycloid psychoses in the post-partum period are discussed. The high relapse rate of approximately 50% in patients at risk requires intensive psychiatric care in the peripartal period. In particular, the possibility of a prophylactic treatment of patients at risk with lithium immediately after delivery is emphasized. However, this sophisticated therapeutic strategy requires close cooperation between gynecologists and psychiatrists.
产后精神障碍分为产后情绪低落、产后抑郁症和产后精神病。后者是严重的内源性精神病,大多符合莱昂哈德提出的循环性精神病的诊断标准。基于三例病例报告,讨论了产后循环性精神病的特征性症状、有缓解期的阶段性临床病程以及独特的病因、治疗和法医方面的问题。高危患者约50%的高复发率要求在围产期进行强化精神科护理。特别强调了在分娩后立即用锂对高危患者进行预防性治疗的可能性。然而,这种复杂的治疗策略需要妇科医生和精神科医生密切合作。