Durand Bernard
Service de psychopathologie de l'enfant et de l'adolescent, Centre hospitalier intercommunal de Créteil, 94010 Créteil.
Rev Prat. 2003 Nov 15;53(17):1913-9.
If the high level of mental vulnerability marks the postpartum period, there are fewer mental diseases during pregnancy. Nevertheless, this period is marked by the importance of psychological change and the easier accessibility at psychotherapeutic interventions: then, unconscious conflicts can be approached as well as traumatic events. A lot of emotional and behavioral disorders remain within the norm. When the disorders are serious, they must be subjected to both therapeutic and preventive interventions to make sure the pregnancy goes as well as possible until birth and to help establish the mother-baby relationship. At the same time, these interventions are also a means of preventing postpartum disorders, in particularly postpartum depression. Specific disorders' such as denial of pregnancy (approximately 3 for 1,000) must be known, because there is a risk of infanticide. As for mental disorders already known, they involve cooperation between the maternity ward, physicians and the psychiatric department for the follow-up.
如果精神高度脆弱是产后时期的特征,那么孕期的精神疾病就会较少。然而,这一时期的特点是心理变化的重要性以及心理治疗干预更容易实施:此时,无意识冲突以及创伤性事件都可以得到处理。许多情绪和行为障碍仍在正常范围内。当障碍严重时,必须进行治疗和预防干预,以确保孕期尽可能顺利直至分娩,并帮助建立母婴关系。同时,这些干预措施也是预防产后疾病,尤其是产后抑郁症的一种手段。必须了解诸如否认怀孕(约千分之三)等特定疾病,因为存在杀婴风险。至于已知的精神障碍,则需要产科病房、医生和精神科合作进行随访。