Brok Elke C, Lok Patricia, Oosterbaan Desiree B, Schene Aart H, Tendolkar Indira, van Eijndhoven Philip F
GGNet, PO Box 2003, 7230 GC Warnsveld, The Netherlands.
GGNet, Warnsveld, The Netherlands.
J Clin Psychiatry. 2017 Sep/Oct;78(8):e913-e923. doi: 10.4088/JCP.16r11083.
Besides the expected warm and joyful thoughts, a new mother can be disturbed by sudden frightening thoughts or images of harm done to her baby: harming intrusions, an obsessive phenomenon. Its high prevalence and possible consequences in functioning and in mother-child bonding makes it desirable that clinicians are well informed regarding the current state of knowledge about harming intrusions.
To provide a comprehensive review of all studies that have investigated harming intrusions in postpartum women.
A systematic search was performed for primary (MEDLINE, PsycINFO) and secondary (Cochrane Library, National Guideline Clearinghouse, American Psychiatric Association) literature, with data range from inception to April 2015. To provide a complete overview, the approach of the topic by Medical Subject Headings (MeSH) terms and keywords was broad.
Studies in Dutch or English with a clear description of method, covering 1 of our main domains of interest-prevalence, assessment, differential diagnosis, etiology, consequences, and treatment-were selected.
Two authors extracted quantitative and qualitative data fitting in the domains of interest.
Fifty articles were included. The prevalence of harming intrusions is up to 100% in both women with and without psychiatric disorders. Stress and cognitive misinterpretation are important keys in its appearance and severity. Literature consistently states that isolated harming intrusions contain no increased risk of violence; instead, compulsive behavior is very common. Psychoeducation is found to release a lot of distress; so might cognitive-behavioral therapy and psychotropic medications.
除了预期中的温暖愉悦的想法外，初为人母者可能会被突然出现的可怕想法或伤害自己宝宝的画面所困扰：伤害性侵入，这是一种强迫现象。其高发生率以及对功能和母婴关系可能产生的后果，使得临床医生充分了解有关伤害性侵入的当前知识状态变得很有必要。
对所有调查产后女性伤害性侵入的研究进行全面综述。
对主要文献（医学索引数据库、心理学文摘数据库）和次要文献（考克兰图书馆、国家指南库、美国精神病学协会）进行系统检索，数据范围从起始到2015年4月。为提供完整概述，采用医学主题词和关键词对该主题进行宽泛检索。
选取以荷兰语或英语撰写、方法描述清晰、涵盖我们主要关注领域之一（发生率、评估、鉴别诊断、病因、后果和治疗）的研究。
两名作者提取符合感兴趣领域的定量和定性数据。
纳入50篇文章。有精神障碍和无精神障碍的女性中，伤害性侵入的发生率高达100%。压力和认知错误解读是其出现及严重程度的重要因素。文献一致表明，孤立的伤害性侵入不会增加暴力风险；相反，强迫行为非常常见。心理教育被发现可减轻很多痛苦；认知行为疗法和精神药物可能也有此作用。
