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[否认怀孕]。

[Denial of pregnancy].

作者信息

Rott Peter

出版信息

Dtsch Med Wochenschr. 2016 Dec;141(25):1854-1857. doi: 10.1055/s-0042-120519. Epub 2016 Dec 14.

DOI:10.1055/s-0042-120519
PMID:27975360
Abstract

With an incidence of 1:500, denial of pregnancy is a rather frequent incident in obstetrics. Strikingly, in our society, this issue is placed under a taboo. Reasons might be our moral values and socialization. Since pregnancy and motherhood have to be associated with joy, other sensations are often perceived as socially not accepted and thus denied. A similar phenomenon exists e. g. with postnatal depression.In all existing studies on denial of pregnancy, it was proven that there are no significant at-risk groups. Instead, it occurs in all social and educated classes and no association with parity was shown.Psychologically, the denial can be understood as an adaptive or anxiety disorder. Unconsciously, it serves as a defense mechanism against intrapsychic conflicts. Reinterpretation of physical changes allow sustained unconscious and thus conflict even in the presence of fetal movements and while body weight and abdominal girth are increasing.Lacking and insufficient preventive examinations increase risks for mother and child. Especially, when delivery takes place without professional help.The earlier the pregnant woman realizes her condition, if necessary with help from a reference person or medical personnel, the lower the risks. This implies to train detection and overcome fear of addressing the woman. After the pregnancy is revealed, the woman needs to be integrated into a social network, which conveys that denial of pregnancy is not a psychotic symptom and occurs more often than assumed. If this succeeds, the perspective for mother and child is favorable.

摘要

妊娠否认症的发病率为1:500,在产科中是相当常见的情况。令人惊讶的是,在我们的社会中,这个问题被视为禁忌。原因可能是我们的道德价值观和社会化过程。由于怀孕和为人母必须与喜悦联系在一起,其他感觉往往被认为在社会上是不被接受的,因此被否认。类似的现象也存在,例如产后抑郁症。在所有关于妊娠否认症的现有研究中,都证明不存在明显的高危人群。相反,它发生在所有社会阶层和受过教育的人群中,且与产次无关。从心理学角度来看,这种否认可以被理解为一种适应性或焦虑性障碍。在无意识状态下,它作为一种针对内心冲突的防御机制。对身体变化的重新解释使得即使在有胎动以及体重和腹围增加的情况下,仍能持续处于无意识状态,从而产生冲突。缺乏和不充分的产前检查会增加母婴风险。特别是在没有专业帮助的情况下分娩时。孕妇越早意识到自己的状况,如有必要在他人或医护人员的帮助下,风险就越低。这意味着要培训如何识别并克服与孕妇沟通的恐惧。在妊娠被发现后,需要让孕妇融入一个社会网络,该网络要传达出妊娠否认症不是一种精神病症状,而且比人们想象的更常见。如果做到这一点,母婴的前景就会乐观。

相似文献

1
[Denial of pregnancy].[否认怀孕]。
Dtsch Med Wochenschr. 2016 Dec;141(25):1854-1857. doi: 10.1055/s-0042-120519. Epub 2016 Dec 14.
2
Psychotic denial of pregnancy: phenomenology and clinical management.妊娠妄想性否认:现象学与临床处理
Hosp Community Psychiatry. 1990 Nov;41(11):1233-7. doi: 10.1176/ps.41.11.1233.
3
Can denial of pregnancy be a denial of fertility? A case discussion.否认妊娠能否等同于否认生育能力?一个病例讨论。
Psychiatr Danub. 2013 Sep;25 Suppl 2:S113-7.
4
Psychosomatic disorders of gravida status: false and denied pregnancies.妊娠状态的心身障碍:假孕和否认妊娠
Psychosomatics. 2015 Mar-Apr;56(2):119-28. doi: 10.1016/j.psym.2014.09.004. Epub 2014 Sep 6.
5
Pregnancy denial or concealement: A case report highlighting risks and forensic aspects.妊娠否认或隐瞒:一例突出风险及法医相关问题的病例报告
Aust N Z J Psychiatry. 2016 Sep;50(9):924-5. doi: 10.1177/0004867416636242. Epub 2016 Mar 8.
6
[Denial of pregnancy and neonaticide: psychopathological and clinical features].[否认怀孕与杀婴:精神病理学及临床特征]
Rev Med Interne. 2012 Nov;33(11):635-9. doi: 10.1016/j.revmed.2012.07.013. Epub 2012 Aug 29.
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Denial of pregnancy--characteristics of women at risk.否认怀孕——高危女性的特征
Acta Obstet Gynecol Scand. 2007;86(5):542-6. doi: 10.1080/00016340601159199.
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Analysis of the relationship between neonaticide and denial of pregnancy using data from judicial files.利用司法档案数据分析杀婴与否认妊娠的关系。
Child Abuse Negl. 2012 Jul-Aug;36(7-8):553-63. doi: 10.1016/j.chiabu.2012.05.003. Epub 2012 Jul 31.
9
Psychotic denial of pregnancy: legal and treatment considerations for clinicians.妊娠精神病性否认:临床医生的法律和治疗考虑因素。
J Am Acad Psychiatry Law. 2011;39(1):31-9.
10
Denial of pregnancy.否认怀孕。
Mil Med. 2000 Dec;165(12):iii-iv.

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