Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN.
Department of Research, Olmsted Medical Center, Rochester, MN.
Mayo Clin Proc. 2014 Jun;89(6):835-44. doi: 10.1016/j.mayocp.2014.01.027.
Postpartum depression (PPD) is a common, potentially disabling, and, in some cases, life-threatening condition. Fortunately, PPD is also readily detectable in routine practice and is amenable to treatment by a wide variety of modalities that are effective for treating nonpuerperal major depression. Postpartum depression screening can improve case identification (an Edinburgh Postnatal Depression Scale score of ≥ 13 indicates a high risk of PPD) and, when associated with a diagnostic and follow-up program, leads to improved clinical outcomes. Symptom severity, patient preference, past response to treatment, availability of local mental health care resources, and patient decisions about breast-feeding will drive management decisions. In general, cognitive-behavioral therapy and interpersonal therapy are preferred psychotherapies for women with mild to moderate PPD, whereas antidepressants are appropriate in more severe cases. Many patients will require other types of assistance, such as parenting support, case management, or care coordination because many barriers to receiving adequate PPD treatment must still be overcome.
产后抑郁症(PPD)是一种常见的、可能致残的疾病,在某些情况下还可能危及生命。幸运的是,PPD 在常规实践中也很容易被发现,并且可以通过各种有效的治疗方法来治疗,这些方法对非产褥期的重度抑郁症也有效。产后抑郁症的筛查可以提高病例的识别率(爱丁堡产后抑郁量表评分≥13 表明 PPD 风险较高),并且当与诊断和随访计划相结合时,可以改善临床结局。症状严重程度、患者偏好、过去的治疗反应、当地心理健康保健资源的可及性以及患者对母乳喂养的决定将决定管理决策。一般来说,对于轻度至中度 PPD 的女性,认知行为疗法和人际治疗是首选的心理疗法,而抗抑郁药在更严重的情况下更为合适。许多患者将需要其他类型的帮助,如育儿支持、病例管理或护理协调,因为仍然需要克服许多获得足够 PPD 治疗的障碍。