Department of Psychology, University of Victoria, Victoria, Canada.
Corresponding Author: Fanie Collardeau, PhD, Department of Psychology, University of Victoria, PO Box 1700 STN CSC, Victoria, BC V8W 2Y2, Canada (
J Clin Psychiatry. 2024 Aug 14;85(3):23m15145. doi: 10.4088/JCP.23m15145.
Unwanted, intrusive thoughts (UITs) of infant-related harm are a common postpartum phenomenon and can be classified into thoughts of accidental harm (TAHs) and thoughts of intentional harm (TIHs). Our study's objective was to complete a comprehensive, comparative analysis of TAHs and TIHs by commenting on their prevalence, course, characteristics (time, distress, and impairment) and most intense period. A total of 763 English-speaking pregnant women across British Columbia were recruited to participate in a prospective cohort study. Study data were collected between February 2014 and February 2017. UITs were assessed by semistructured interviews twice during the postpartum period. The prevalence of TAHs and TIHs in the postpartum period was 95.8% and 53.9%, respectively. The most common TAHs included thoughts of the baby suffocating or dying from sudden infant death syndrome; the most common TIHs included thoughts of neglect. On average, TAHs are more prevalent, time-consuming, and result in greater interference compared to TIHs. The most intense period for TAHs (5.74 weeks postpartum) and TIHs (within first 8 weeks postpartum) was identified. During this period, over 40% of participants reported moderate or extreme distress related to UITs. For most, UITs decreased in frequency or completely resolved by 6 months postpartum, and most participants did not report clinically significant symptoms. UITs are a normative and typically self-resolving occurrence in the postpartum period. UITs' most intense period signifies a time of heightened vulnerability. Increased education is necessary to normalize and reduce distress associated with UITs. .
产后出现的不想要的、侵入性的与婴儿相关的伤害想法（UITs）是一种常见的产后现象，可分为意外伤害（TAHs）和故意伤害（TIHs）。我们的研究目的是通过对 TAHs 和 TIHs 的流行率、病程、特征（时间、苦恼和损害）和最强烈时期进行全面、比较分析。
我们共招募了不列颠哥伦比亚省的 763 名讲英语的孕妇参与一项前瞻性队列研究。研究数据收集于 2014 年 2 月至 2017 年 2 月。在产后期间通过半结构化访谈两次评估 UITs。产后 TAHs 和 TIHs 的流行率分别为 95.8%和 53.9%。最常见的 TAHs 包括婴儿窒息或死于婴儿猝死综合征的想法；最常见的 TIHs 包括疏忽的想法。平均而言，TAHs 比 TIHs 更为普遍、耗时，且干扰更大。确定了 TAHs（产后 5.74 周）和 TIHs（产后前 8 周内）的最强烈时期。在此期间，超过 40%的参与者报告与 UITs 相关的中度或极度苦恼。对于大多数人来说，UITs 的频率在产后 6 个月内下降或完全消失，且大多数参与者未报告出现临床上显著的症状。
UITs 是产后时期的一种正常且通常可自行缓解的现象。UITs 的最强烈时期表明此时易受伤害。需要增加教育以规范化和减少与 UITs 相关的苦恼。
