Deaths from psychiatric causes
Deaths from psychiatric causes
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DOI：
10.1111/j.1471-0528.2010.02847.x
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发表时间：
2011-03-01
影响因子：
5.8
通讯作者：
Cantwell, R.
中科院分区：
文献类型：
--
作者：
Oates, M.;Cantwell, R.
·正如之前建议的，但在这里再次强调，所有女性在产前预约时都应该被问及以前的精神障碍史以及她们目前的精神健康状况。有严重情感障碍或其他精神病病史的妇女应该在怀孕期间接受精神评估和治疗，即使她们身体状况良好。管理的最低要求应是分娩后至少3个月的定期监测和支持。·精神科服务应为孕妇和产后妇女提供优先护理途径。这些措施将包括降低怀孕后期和分娩后头6周的妇女的转诊和干预门槛，包括入院和快速反应时间。应避免由多个精神病科团队进行护理。对孕妇或产后妇女的风险评估应该加以修改，以考虑到与既往病史、围产期疾病的独特临床图景以及暴力自杀方法相关的风险。·所有心理健康信托基金都应拥有专门的社区围产期心理团队，以照顾孕妇和产后妇女。这些医院应与区域母婴病房紧密结合，以便所有在怀孕后期和产后需要精神科住院的妇女与其婴儿一起入院。·在诊断精神障碍时，如果唯一的症状是无法解释的身体症状或痛苦和不安，则需要谨慎行事。当妇女没有精神病史，或当她不会说英语或来自少数民族时，情况尤其如此。
• As has been recommended before, but re-emphasised here, all women should be asked at their antenatal booking visit about a previous history of psychiatric disorder as well as their current mental health. Women with a previous history of serious affective disorder or other psychoses should be referred in pregnancy for psychiatric assessment and management even if they are well. A minimum requirement for management should be regular monitoring and support for at least 3 months following delivery.• Psychiatric services should have priority care pathways for pregnant and postpartum women. These will include a lowered threshold for referral and intervention, including admission and a rapid response time, for women in late pregnancy and the first 6 weeks following delivery. Care by multiple psychiatric teams should be avoided. Risk assessments of pregnant or postpartum women should be modified to take account of risk associated with previous history, the distinctive clinical picture of perinatal disorders and the violent method of suicide.• All mental health trusts should have specialised community perinatal mental teams to care for pregnant and postpartum women. These should be closely integrated with regional mother and baby units so that all women requiring psychiatric admission in late pregnancy and the postpartum period can be admitted together with their infants.• Caution needs to be exercised when diagnosing psychiatric disorder if the only symptoms are either unexplained physical symptoms or distress and agitation. This is particularly so when the woman has no prior psychiatric history or when she does not speak English or comes from an ethnic minority.