Austin Marie-Paule
Royal Hospital for Women, Sydney.
Aust Fam Physician. 2003 Mar;32(3):119-26.
Psychological morbidity, and especially depression and anxiety arising antenatally, are as common as that seen postnatally. Approximately one-third of women will remain depressed postpartum, sometimes for prolonged periods--with the attendant morbidity for mother and infant that this brings. Morbidity is greatest where there is associated drug and alcohol use, domestic violence and personality disorder.
This article aims to provide an overview of psychosocial assessment and the detection and management of depression and anxiety disorders in pregnancy.
Psychosocial assessment of all pregnant women is an integral part of good antenatal care. The Edinburgh Postnatal Depression Scale is a useful adjunct in the detection and monitoring of anxiety and depression antenatally. Many women will decline medication and thus psychological interventions will often be first line treatments. Where medication is required, prospective controlled studies suggest antidepressants are not associated with increased rates of teratogenicity and are thus relatively 'safe'. Management of more severe and/or complex cases needs to be in association with a psychiatrist and a mental health or drug and alcohol team and may require antenatal notification of an 'at risk' offspring.
心理疾病，尤其是产前出现的抑郁和焦虑，与产后出现的情况一样常见。约三分之一的女性产后仍会抑郁，有时持续时间较长，这会给母婴带来相应的健康问题。在伴有药物和酒精使用、家庭暴力及人格障碍的情况下，发病率最高。
本文旨在概述孕期心理社会评估以及抑郁和焦虑症的检测与管理。
对所有孕妇进行心理社会评估是优质产前护理的重要组成部分。爱丁堡产后抑郁量表在产前焦虑和抑郁的检测与监测中是一种有用的辅助工具。许多女性会拒绝药物治疗，因此心理干预往往是一线治疗方法。在需要药物治疗的情况下，前瞻性对照研究表明抗抑郁药与致畸率增加无关，因此相对“安全”。对更严重和/或复杂病例的管理需要与精神科医生以及心理健康或药物和酒精治疗团队联合进行，可能需要对“有风险”的后代进行产前通报。
