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是时候在妇产科常规筛查围产期情绪和焦虑障碍了。

It Is Time for Routine Screening for Perinatal Mood and Anxiety Disorders in Obstetrics and Gynecology Settings.

机构信息

Assistant Professor.

Fellow, Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA.

出版信息

Obstet Gynecol Surv. 2017 Sep;72(9):553-568. doi: 10.1097/OGX.0000000000000477.

Abstract

IMPORTANCE

Women are 2 to 3 times more likely than men to experience depression in their lifetime, and the greatest risk occurs during the reproductive years. As an obstetrics and gynecology physician or provider, you will likely encounter women who are at risk of development or relapse of a mental disorder during this vulnerable time.

OBJECTIVE

The aim of this review is to examine theory and research on mood and anxiety disorders during the perinatal period with an emphasis on screening recommendations.

EVIDENCE ACQUISITION

A PubMed and PsycINFO search for English-language publications about perinatal mood and anxiety disorders and screening was performed and included studies on subtopics.

RESULTS

The literature reviewed suggests that perinatal mood and anxiety symptoms are prevalent and have significant consequences, and best practices for early detection are through routine depression and anxiety screening in the obstetrics setting. This includes overcoming barriers to care and use of liaison services to potentially reduce risk.

CONCLUSIONS AND RELEVANCE

High-quality prenatal care systems should develop the capacity for depression and anxiety risk assessment and treatment. Providers should routinely screen using validated screening tools, provide maternal mental health education, and be aware of the various medical, psychological, and complementary approaches for treating mood and anxiety disorders, to best guide and refer patients. The use of this practice will increase the quality of life in pregnant women with depression and anxiety and may help to reduce the likelihood of adverse birth outcomes, postpartum mental health problems, and adverse effects on offspring.

摘要

重要性

女性一生中患抑郁症的可能性是男性的 2 到 3 倍,风险最大的时期发生在生育期。作为一名妇产科医生或提供者,您可能会在这段脆弱时期遇到有患精神障碍或疾病复发风险的女性。

目的

本综述旨在检查围产期情绪和焦虑障碍的理论和研究,重点是筛查建议。

证据获取

对关于围产期情绪和焦虑障碍以及筛查的英文文献进行了 PubMed 和 PsycINFO 搜索,并纳入了子主题研究。

结果

综述文献表明,围产期情绪和焦虑症状普遍存在,并具有重大影响,早期发现的最佳实践是通过妇产科常规进行抑郁和焦虑筛查。这包括克服护理障碍和使用联络服务,以潜在降低风险。

结论和相关性

高质量的产前保健系统应具备抑郁和焦虑风险评估和治疗能力。提供者应使用经过验证的筛查工具进行常规筛查,提供产妇心理健康教育,并了解治疗情绪和焦虑障碍的各种医学、心理和补充方法,以便为患者提供最佳指导和转介。这种做法的应用将提高患有抑郁症和焦虑症的孕妇的生活质量,并有助于降低不良分娩结局、产后心理健康问题和对后代的不利影响的可能性。

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