Recent Advances and Controversies in Peripartum Depression.
Recent Advances and Controversies in Peripartum Depression.
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DOI：
10.1007/s13669-016-0167-x
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发表时间：
2016-09
影响因子：
0.5
通讯作者：
Payne, Jennifer L
中科院分区：
文献类型：
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作者：
Payne, Jennifer L
这篇综述的目的是更新读者对围产期抑郁症的潜在生物学和临床管理的最新争议和调查结果。讨论的主题包括围产期抑郁症的两个表观遗传生物标志物的发现和复制，两项对照良好的研究没有发现子宫内抗抑郁药暴露与新生儿心脏缺陷和持续性肺动脉高压之间的关联，以及关于妊娠期间使用抗抑郁药是否可以预防围产期抑郁症以及激素治疗是否在产后抑郁症的管理中占有一席之地的持续争议。围产期抑郁症，或抑郁症期间和/或紧接在怀孕是一种独特的精神疾病，不仅可能有独特的生物学基础，但需要独特和周到的方法来管理由于发展中的新生儿。在这一领域存在许多争议，从最近精神病学诊断和统计手册中的术语从“产后”到“围产期”抑郁症，到怀孕期间使用抗抑郁药的安全性，以及抗抑郁药是否可以预防或减少围产期抑郁症。这一领域的研究正在增长，并出现了一些令人兴奋的发展，包括确定围产期抑郁症的两个表观遗传生物标志物，这可能最终导致早期识别和干预，激素治疗的潜力，以及建议和早期普遍筛查围产期抑郁症。这些主题进行了探讨，并从临床管理的角度纳入背景。
The purpose of this review is to update readers on recent controversies and findings on the underlying biology and clinical management of peripartum depression. Topics discussed include the discovery and replication of two epigenetic biomarkers of peripartum depression, two well controlled studies that do NOT find associations between in utero antidepressant exposure and cardiac defects and persistent pulmonary hypertension of the newborn and ongoing controversy on whether antidepressant use during pregnancy prevents peripartum depression and whether or not hormonal treatments have a place in the management of postpartum depression. Peripartum depression, or depression during and/or immediately following pregnancy is a unique psychiatric illness that not only may have unique biological underpinnings but demands unique and thoughtful approaches to management due to the developing neonate. A number of controversies exist in this area ranging from the recent terminology change in psychiatry’s Diagnostic and Statistical Manual from “postpartum” to “peripartum” depression, to the safety of antidepressant use during pregnancy, to whether or not antidepressants prevent or decrease peripartum depression. Research in this area is growing and a number of exciting developments have occurred including the identification of two epigenetic biomarkers of peripartum depression that may eventually lead to early identification and intervention, the potential for hormonal treatments and the recommendation for and early institution of universal screening for peripartum depression. These topics are explored and put into context from a clinical management perspective.