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意大利精神卫生部门的围产期心理健康保健:一项全国性调查。

Perinatal mental health care in the Italian mental health departments: a national survey.

机构信息

National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanità - Italian National Institute of Health, Rome, Italy.

Care Policy and Evaluation Centre (CPEC), London School of Economics and Political Science, London, UK.

出版信息

Eur Psychiatry. 2024 May 24;67(1):e46. doi: 10.1192/j.eurpsy.2024.1749.

Abstract

BACKGROUND

Evidence on the negative outcomes of untreated mental disorders during pregnancy and in the first year after childbirth on women's and children's health has stimulated interest in how to develop and sustain high-quality mental health care during the perinatal period. In Italy, there is a lack of knowledge about how mental health services support women with perinatal mental disorders (PMDs). This study aims to describe the adoption of good practices for the prevention and care of PMDs by the Italian mental health departments (MHDs).

METHODS

This is a nationwide cross-sectional survey conducted online using LimeSurvey. Starting from the Ministry of Health Registry's 127 MHDs were invited to participate between February and March, 2023. Characteristics of the participating MHDs were reported as descriptive statistics.

RESULTS

One hundred nineteen MHDs participated, with a response rate of 93.7%. Regarding the prevention of PMDs, 69 (58.0%) MHDs offer preconception counseling, whereas only 6 (5.0%) have information material for this purpose. Written integrated care pathways for PMDs are not available in 94 (79.7%) MHDs. A reference professional for psychopharmacological treatment during pregnancy or breastfeeding is available in 55 (46.2%) MHDs, while a specific treatment plan for women with PMDs is adopted by 27 (22.7%) MHDs. Thirty-four (28.6%) MHDs have established an outpatient clinic for PMDs, whereas there are no inpatient psychiatric facilities designed for mothers and infants (mother-baby units).

CONCLUSIONS

There is a need to improve the care of women with PMDs in Italy. The provision of pre-conception counseling, integrated care pathways, and specialist skills and facilities for PMDs should be prioritized.

摘要

背景

未经治疗的孕期和产后第一年精神障碍对妇女和儿童健康的不良后果的证据,激发了人们对如何在围产期发展和维持高质量精神卫生保健的兴趣。在意大利,人们对精神卫生服务如何支持围产期精神障碍(PMD)妇女知之甚少。本研究旨在描述意大利精神卫生部门(MHD)采用预防和治疗 PMD 的良好做法。

方法

这是一项全国性的横断面调查,使用 LimeSurvey 在线进行。从卫生部登记处邀请了 127 个 MHD 参加,调查于 2023 年 2 月至 3 月进行。参与 MHD 的特征以描述性统计数据报告。

结果

有 119 个 MHD 参与,应答率为 93.7%。关于 PMD 的预防,69 个(58.0%)MHD 提供孕前咨询,而仅有 6 个(5.0%)为此目的提供信息材料。94 个(79.7%)MHD 没有针对 PMD 的书面综合护理路径。55 个(46.2%)MHD 有妊娠期或哺乳期精神药理学治疗的参考专业人员,而 27 个(22.7%)MHD 采用了针对 PMD 妇女的特定治疗计划。34 个(28.6%)MHD 为 PMD 设立了门诊诊所,但没有专为母婴设计的住院精神病设施(母婴单位)。

结论

意大利需要改善 PMD 妇女的护理。应优先提供孕前咨询、综合护理路径以及 PMD 的专科技能和设施。

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