Susman J L
University of Nebraska, Department of Family Practice, Omaha 68198-3075, USA.
J Fam Pract. 1996 Dec;43(6 Suppl):S17-24.
Despite the high prevalence of postpartum depressive disorders, many signs and symptoms of this illness are dismissed as normal physiologic changes associated with childbirth. Prompt recognition and treatment are imperative in order to limit the negative impact on both the mother and infant. Mood disturbances may have a minor functional impact that respond well to social support (eg. postpartum blues) or cause significant functional compromise requiring more aggressive therapy (eg. postpartum depression). The most extreme case of postpartum depressive disorder, postpartum psychosis, occurs when patients develop psychosis, mania, or thoughts of infanticide. Depression during pregnancy or the presence of risk factors suggests the need for careful follow-up. If postpartum depression develops, psychotherapy is the first-line treatment. Antidepressant treatment may be warranted for some patients, and the risks and benefits to both the mother and infant should be considered in the decision to institute pharmacotherapy.
尽管产后抑郁障碍的患病率很高，但这种疾病的许多体征和症状被认为是与分娩相关的正常生理变化而被忽视。为了限制对母亲和婴儿的负面影响，及时识别和治疗至关重要。情绪障碍可能产生轻微的功能影响，对社会支持（如产后情绪低落）反应良好，或导致严重的功能损害，需要更积极的治疗（如产后抑郁症）。产后抑郁障碍最极端的情况是产后精神病，即患者出现精神病、躁狂或杀婴念头。孕期抑郁或存在危险因素提示需要仔细随访。如果发生产后抑郁症，心理治疗是一线治疗方法。对于一些患者可能有必要进行抗抑郁治疗，在决定进行药物治疗时应考虑对母亲和婴儿的风险和益处。
