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Jingdong book

产后抑郁障碍理论与实践

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Books Medical Science Obstetrics and Gynecology
Jingdong book

产后抑郁障碍理论与实践

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产后抑郁障碍是女性中比较常见的一类精神疾病。与普通人群抑郁障碍发病率相比，产后抑郁的发病率在产后前5周是普通人群的3倍，对产后抑郁患者的早识别、早发现、早干预，可极大程度地减轻产后抑郁对于母儿的危害，产生深远的意义。
为了满足人们对精神、心理保健的巨大需求，提高广大医务人员对于产后抑郁的诊治水平，尤其是妇产、妇幼医务工作者对于产后抑郁的认识和筛查水平，组织编写了《产后抑郁障碍理论与实践》。
《产后抑郁障碍理论与实践》从孕产期的生理心理变化，产后抑郁障碍的概述、病因与发病机制、临床表现、诊断及鉴别诊断、治疗，产后抑郁障碍的三级预防、司法问题及男性产后抑郁障碍等多方面进行了梳理和阐述。
Catalogue

第一章 产后抑郁障碍概述
第一节 基本概念
第二节 流行病学
第三节 疾病危害
第四节 国内外研究现状

第二章 孕产期生理心理变化
第一节 生理变化
第二节 心理变化

第三章 病因与发病机制
第一节 生物学因素
第二节 心理社会因素

第四章 临床表现
第一节 核心症状群
第二节 心理症状群
第三节 躯体症状群
第四节 产后抑郁障碍与普通抑郁症的不同点
第五节 需要甄别的症状
第六节 典型病例

第五章 诊断及鉴别诊断
第一节 诊断方法
第二节 分类与诊断标准
第三节 鉴别诊断

第六章 治疗
第一节 药物治疗
第二节 心理治疗
第三节 物理治疗及其他治疗方法
第四节 中医及中西医结合治疗
第五节 心理危机干预

第七章 产后抑郁障碍的三级预防
第一节 一级预防
第二节 二级预防
第三节 三级预防

第八章 男性产后抑郁障碍
第一节 概述
第二节 临床表现、诊断与治疗

第九章 产后抑郁障碍的司法问题
第一节 司法精神鉴定
第二节 精神残疾鉴定

附录
一、抑郁自评量表
二、汉密尔顿焦虑量表
三、蒙哥马利抑郁量表
四、贝克抑郁问卷
五、焦虑自评量表
六、简明精神病评定量表
七、90项症状清单
八、生活事件量表
九、防御方式问卷
十、汉密尔顿抑郁量表
十一、明尼苏达多项人格问卷
十二、艾森克人格测定
十三、简易精神状态检查
十四、社会功能筛选表
十五、哥伦比亚一自杀严重程度评定量表
索引
Book Abstract

《产后抑郁障碍理论与实践》：
因为起病时间对于疾病的诊断、治疗与预后判断有比较大的意义，特别是要明确分娩到患者情绪出现问题的时间间隔。
（2）发病形式：起病急缓对诊断与预后有重要关系，主要依据为出现第一个精神症状到PPD诊断确立的时间，一般2周以内为急性起病，2周～3个月为亚急性起病，3个月以上为慢性起病。
（3）致病可能原因及诱因：作为产后起病的抑郁障碍除妊娠、分娩外，还要了解有无其他的影响因素，包括生理、心理及社会环境等诸多方面。生理方面需要了解：患者分娩方式、身体恢复情况、分娩年龄是否过小或过大、有无躯体合并症、是否哺乳、是否使用药物或其他精神活性物质、有无不良嗜好、有无恢复性生活等；心理方面需要了解：患者对角色的转变适应情况、抚养孩子的难易程度、孩子的性别与家族的期望是否一致、与丈夫或婆家关系如何、社会支持够不够、有无不良的生活事件、是否为非婚生育或其他意外妊娠、有无他人能够帮助分担育儿操劳等；社会环境方面需要了解：社会地位高低、生活压力大小、经济是否拮据、有无稳定住所、有无职业及个人收入等。有研究显示，婚姻关系不和谐的产妇PPD发病率婚姻关系和谐的高4倍以上。配偶和家庭是孕产妇精神上最大支持者。研究发现，社会支持与PPD的发病率高度负相关。了解各种致病因素对产妇的影响，对今后的心理治疗有指导作用。
（4）早期症状：PPD的早期症状不典型，易被误认为产后正常的情绪反应或适应不良所致。通常应注意了解患者发病前、后在生活习性、卫生习惯、学习及工作能力、人际交往、日常兴趣、睡眠、个性、行为等方面有无变化。
（5）症状的发生、发展与演变：按发生时间次序，从首发症状开始描述，逐一记录各种症状的具体表现、背景条件、变化特点、持续时间、相互联系和造成后果等方面的内容。
（6）既往诊治经过：历次就诊的时间、地点，诊断（有变化者应了解诊断改变的理由）与处理，特别是用药的品种、剂量、治疗效果及副作用等。
（7）发病后的一般情况：发病后患者的日常生活、工作学习、饮食起居与社会交往等方面的整体情况。
（8）有无伤人、毁物、自伤、自杀及其他暴力行为：这些行为对患者及他人的人身安全和造成的不良社会影响很大，并容易导致法律问题，所以必须详细询问。
……

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