Miller L J
Department of Psychiatry, University of Chicago, Illinois 60637.
Hosp Community Psychiatry. 1990 Nov;41(11):1233-7. doi: 10.1176/ps.41.11.1233.
Psychotic denial of pregnancy in chronic mentally ill women may place the women and their fetuses at high risk of postpartum emotional disturbance, precipitous or unassisted delivery, fetal abuse, and neonaticide. Psychotic denial of pregnancy is illustrated with case reports from an inpatient program for pregnant mentally ill women. Women who denied their pregnancies tended to have a diagnosis of chronic schizophrenia, to have previously lost custody of children, and to anticipate separation from the baby they were carrying. The author suggests that treatment for such patients should take place in a setting that integrates comprehensive psychiatric and obstetrical care and may include pharmacotherapy, supportive psychotherapy, and evaluation of the patient's parenting skills and support network to assess whether she is able to keep her baby.
患有慢性精神疾病的女性出现精神病性妊娠否认，可能会使这些女性及其胎儿面临产后情绪障碍、急产或无辅助分娩、虐待胎儿和杀婴等高风险。本文通过一个针对患有精神疾病的孕妇的住院项目中的病例报告，阐述了精神病性妊娠否认的情况。否认自己怀孕的女性往往被诊断为患有慢性精神分裂症，之前曾失去对孩子的监护权，并且预计会与自己腹中胎儿分离。作者建议，对此类患者的治疗应在一个整合了全面精神科和产科护理的环境中进行，可能包括药物治疗、支持性心理治疗，以及对患者育儿技能和支持网络的评估，以判断她是否有能力抚养自己的孩子。
