University of Pittsburgh Medical Center Western Psychiatric Hospital, Pittsburgh, PA, 15213, USA.
University of Pittsburgh Medical Center Lititz, Lancaster, PA, USA.
Curr Psychiatry Rep. 2022 Dec;24(12):889-896. doi: 10.1007/s11920-022-01392-7. Epub 2022 Nov 23.
As maternal mortality climbs in the USA with mental health conditions driving these preventable deaths, the field of reproductive psychiatry must shift towards identification of women and other birthing individuals at risk and facilitating access. This review brings together recent studies regarding risk of perinatal depression and highlights important comorbidities that place individuals at higher vulnerability to poor perinatal outcomes.
Recent research suggests that identifying risk for perinatal depression including historical diagnoses of depression, anxiety, trauma, and comorbid substance use and intimate partner violence may move the field to focus on preventive care in peripartum populations. Emerging data shows stark health inequities in racial and ethnic minority populations historically marginalized by the health system and in other vulnerable groups such as LGBTQ+ individuals and those with severe mental illness. Innovative models of care using systems-level approaches can provide opportunities for identification and risk analyses of vulnerable peripartum patients and facilitate access to therapeutic or preventive interventions. Utilizing intergenerational approaches and leveraging multidisciplinary teams that thoughtfully target high-risk women and other birthing individuals could promote significant changes to population-level care in maternal health.
随着美国的孕产妇死亡率随着心理健康状况的上升而攀升,这些可预防的死亡原因推动了生殖精神病学领域必须转向识别有风险的妇女和其他分娩个体,并为其提供便利。这篇综述汇集了最近关于围产期抑郁风险的研究,并强调了一些重要的合并症,这些合并症使个体更容易出现不良围产期结局。
最近的研究表明,识别围产期抑郁的风险,包括抑郁、焦虑、创伤、合并物质使用和亲密伴侣暴力的既往诊断,可能会促使该领域将重点转向围产期人群的预防保健。新出现的数据显示,在历史上被卫生系统边缘化的少数族裔和其他弱势群体(如 LGBTQ+ 个人和严重精神疾病患者)中,存在明显的健康不平等现象。利用系统级方法的创新护理模式可以为有风险的围产期患者提供识别和风险分析的机会,并为治疗或预防干预措施提供便利。利用代际方法并利用深思熟虑地针对高风险妇女和其他分娩个体的多学科团队,可以促进母性健康的人群护理的重大变化。