Int J Gynaecol Obstet. 1993 Nov;43(2):203-11.
Depression is a common, often overlooked, illness in women that should be recognized and treated. The obstetrician-gynecologist should be aware of factors that contribute to the high prevalence of depression in women, and particular attention should be given to family and work roles, victimization, early childhood loss of parent, personality variables, and reproductive-related events such as pregnancy, childbirth, and menopause. It is also important to distinguish between a grief reaction and major depression. Grief occurs secondary to losses such as abortion, miscarriage, still-birth, or infertility and is generally self-limiting; self-esteem is preserved. In major depression, changes in sleeping patterns, appetite, energy, and mood persist, along with loss of self-esteem. As a part of patient education, it should be emphasized that depression is a medical illness and not a character defect or weakness and that in most cases it can be treated effectively. However, the risk of recurrence is significant; patients should be alert to early signs and symptoms of recurrence and seek treatment. Antidepressants that are well tolerated are now available, and appropriate use of these medications, along with psychotherapy as needed, will provide effective treatment for most patients.
抑郁症是女性中一种常见但常被忽视的疾病，应予以识别和治疗。妇产科医生应了解导致女性抑郁症高发的因素，尤其应关注家庭和工作角色、受害经历、童年早期父母离世、人格变量以及与生殖相关的事件，如怀孕、分娩和更年期。区分悲伤反应和重度抑郁症也很重要。悲伤是在堕胎、流产、死产或不孕等损失之后发生的，通常是自限性的，自尊得以保留。在重度抑郁症中，睡眠模式、食欲、精力和情绪的变化会持续存在，同时伴有自尊的丧失。作为患者教育的一部分，应强调抑郁症是一种医学疾病，而非性格缺陷或弱点，并且在大多数情况下可以得到有效治疗。然而，复发风险很大；患者应警惕复发的早期迹象和症状并寻求治疗。现在有耐受性良好的抗抑郁药，合理使用这些药物并根据需要进行心理治疗，将为大多数患者提供有效的治疗。
