产后精神病:建议的治疗算法。

Focus (American Psychiatric Publishing) Pub Date : 2024-01-01 Epub Date: 2024-01-12 DOI:10.1176/appi.focus.23021033
Chaitra Jairaj, Gertrude Seneviratne, Veerle Bergink, Iris E Sommer, Paola Dazzan
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引用次数: 0

摘要

背景:产后精神病(PPP)是一种精神科急症,通常需要急性住院治疗。产后精神病的特点是突然出现情感和精神症状,精神状态迅速恶化。有证据表明,躁狂症是双相情感障碍谱系中的一种独立障碍,具有独特的治疗特征和预后:我们在 PubMed 数据库中搜索了涉及 PPP 及其治疗的各种术语,并收录了以英语发表的同行评审文章:目的:根据现有证据,为PPP的治疗提供一个治疗算法:药物治疗是 PPP 急性期治疗的主要方法。有证据表明,在 PPP 的急性期治疗中,应联合使用抗精神病药物和锂盐。必要时,电休克疗法可提供快速的治疗反应。锂似乎是预防 PPP 复发和预防性治疗的最佳药物。心理教育至关重要,用于双相情感障碍的社会心理干预可能对 PPP 有效:早期发现并及时使用抗精神病药物和锂进行治疗,然后使用锂进行维持治疗,与PPP的良好预后相关。Copyright © 2023.
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Postpartum Psychosis: A Proposed Treatment Algorithm.

Background: Postpartum psychosis (PPP) is a psychiatric emergency that generally warrants acute inpatient care. PPP is marked by the sudden onset of affective and psychotic symptoms with a rapid deterioration in mental state. Evidence suggests that PPP is a discrete disorder on the bipolar disorder spectrum with a distinct treatment profile and prognosis.

Methods: We conducted a PubMed database search for various terms involving PPP and its treatment and included peer-reviewed articles published in English.

Objective: To provide a treatment algorithm for the management of PPP based on available evidence.

Results: Pharmacological therapy is the mainstay of PPP management in the acute phase. Evidence points to a combination of antipsychotics and lithium in the acute treatment of PPP. Electroconvulsive therapy can offer a rapid treatment response where required. Lithium appears to have the best evidence for relapse prevention and prophylaxis in PPP. Psychoeducation is essential and psychosocial interventions used in bipolar disorder may be effective in PPP.

Conclusion: Early detection and prompt treatment with antipsychotics and lithium, followed by maintenance treatment with lithium, is associated with a favourable prognosis in PPP.Reprinted from J Psychopharmacol 2023; 37:960-970, with permission from Sage Journals. Copyright © 2023.

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