Berle Jan Øystein, Spigset Olav
Regionsenter for barne- og ungdomspsykiatri, Helseregion Vest, Postboks 7800, 5020 Bergen.
Tidsskr Nor Laegeforen. 2003 Aug 14;123(15):2037-40.
Psychiatric disorders occur both during pregnancy and postpartum. The consequences of inadequate treatment in these periods can be dramatic, not only for the mother but also for the infant. The reference books and textbooks used in Norway provide very scanty information on the treatment of psychiatric disorders during pregnancy and postpartum. The use of drugs is a particularly difficult issue, as detrimental effects may arise in the fetus and in the suckling infant.
This article is based upon a review of relevant literature supplemented by our own experience in the field.
In general, the effect is better documented for drug treatment than for other therapeutic modalities. Some drugs can be used without particular problems during pregnancy and lactation while others have potentially detrimental effects. Often the risk of not giving the mother adequate treatment must be weighed against the potential risks of drug exposure to the infant. Pregnancy-related psychiatric illness would, when recognized, in most cases have a favourable prognosis provided that adequate treatment is given.
精神疾病在孕期和产后均有发生。在这些时期治疗不当的后果可能很严重,不仅对母亲,对婴儿也是如此。挪威使用的参考书和教科书提供的关于孕期和产后精神疾病治疗的信息非常匮乏。药物的使用是一个特别棘手的问题,因为可能会对胎儿和哺乳婴儿产生有害影响。
本文基于对相关文献的综述,并辅以我们在该领域的自身经验。
总体而言,药物治疗的效果比其他治疗方式有更充分的文献记载。一些药物在孕期和哺乳期使用时没有特别问题,而其他药物则有潜在的有害影响。通常,必须权衡不给母亲充分治疗的风险与药物暴露于婴儿的潜在风险。如果得到充分治疗,大多数情况下,孕期相关的精神疾病在被识别后预后良好。