小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 情绪低落
- 兴趣缺乏
- 精力下降或疲劳感增加
- 自杀观念
- 丧失信心或自尊
- 不合理的自责或过度且不恰当的内疚
- 注意力不集中
其他诊断因素
- 精神运动性改变
- 睡眠障碍
- 食欲变化
- 体重改变
- 强迫思维
- 显著的自伤或对孩子的忽视及不当对待
- 轻躁狂或躁狂的个人史或家族史
- 精神病性症状
危险因素
- 情绪低落或抑郁、焦虑病史
- 近期应激性生活事件
- 社会支持不良
- 精神科药物治疗中断
- 睡眠减少
- 产后轻躁狂
- 人格特征
- 妊娠和分娩相关并发症
- 社会经济状况差
- 年龄小于16岁
- 家族和遗传因素
- 孕期伴侣暴力
诊断性检查
首要检查
- 抑郁症鉴别问题
需考虑的检查
- 爱丁堡产后抑郁量表(Edinburgh Postnatal Depression Scale,EPDS)
- 心境障碍问卷调查 (MDQ)
- 甲状腺功能检测
- 全血细胞计数 (FBC)
- 尿液药物筛查
- 脑CT(电子计算机X射线断层扫描技术)或MRI(核磁共振成像)
治疗流程
单相抑郁
双相抑郁
撰稿人
作者
Arianna Di Florio, MD, PhD
Professor of Psychiatry
MRC Centre for Neuropsychiatric Genetics and Genomics
Cardiff University
Cardiff
UK
Adjunct assistant professor
University of North Carolina at Chapel Hill
Chapel Hill
NC
利益声明
ADF is an author of references cited in this topic.
Ian Jones, MB BS, MRCPsych, PhD
Professor of Psychiatry
MRC Centre for Neuropsychiatric Genetics and Genomics
Cardiff University
Cardiff
UK
利益声明
IJ has received grant income from Takeda. He has participated in an advisory board meeting for Sanofi and, is a trustee of the Maternal Mental Health Alliance and of Action on Postpartum Psychosis. IJ is an author of references cited in this topic.
同行评议者
Donna Stewart, MD
Centre for Mental Health
University of Toronto
Toronto
Canada
利益声明
DS declares that she has received author royalties from UptoDate on depression in pregnancy. DS has been an expert witness in a lawsuit related to postnatal depression.
Margaret Spinelli, MD
Associate Professor of Psychiatry
Columbia University
New York
NY
利益声明
MS declares that she has no competing interests.
Anne-Laure Sutter, MD, PhD
Head of the Perinatal Psychiatry Network
University Department of Adult Psychiatry
CH Charles Perrens
Bordeaux
France
利益声明
ALS declares that she has no competing interests.
鉴别诊断
- 轻度情绪障碍(产后忧郁或“婴儿忧郁”)
- 产后(产褥期)精神病
- 强迫症
更多 鉴别诊断指南
- 出生后护理
- 让伴侣和其他家庭成员参与和支持专科围产期心理健康服务:良好实践指南
更多 指南患者教育信息
产后抑郁
产后抑郁:询问医生
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