围产期抑郁症筛查与治疗的研究进展

Research Progress on Screening and Treatment of Perinatal Depression

摘要: 围产期抑郁症(Perinatal Depression, PND)指孕期至产后一年内发生的抑郁障碍，该疾病患病率高、致残性强，严重危害孕产妇、婴儿及家庭健康。PND的临床筛查面临多重挑战：早期发现存在障碍、症状与正常围产期状态相互重叠、缺乏标准化方案、患者异质性较大等等。此外，其治疗复杂性源于若干相互关联的因素，包括孕期与哺乳期的用药安全考量、精神卫生服务与产科儿科系统分离所致的信息壁垒，以及独特的社会文化障碍。由于缺乏系统整合的护理路径，常对母婴双方造成严重且不可逆的后果。因此，本综述梳理PND筛查与治疗的最新进展，强调向整合或协作护理模式转型的重要性。未来工作应聚焦于克服实施障碍、发展数字健康解决方案、建立任务共享框架、制定个性化治疗策略，以保障受影响人群公平获取上述创新成果。

Abstract: Perinatal depression (PND) refers to a depressive disorder occurring from pregnancy to one year postpartum. Characterized by high prevalence and significant disability, PND poses serious threats to the health of pregnant women, infants, and families. Clinical screening for PND faces multiple challenges, including barriers to early detection, symptom overlap with normal perinatal status, lack of standardized protocols, and considerable patient heterogeneity. Furthermore, treatment complexity arises from several interrelated factors, such as medication safety concerns during pregnancy and lactation, information fragmentation due to the separation of mental health services from obstetric and pediatric systems, and unique sociocultural barriers. In the absence of systematic and integrated care pathways, PND often leads to severe and irreversible consequences for both mother and child. Accordingly, this review summarizes recent advances in the screening and treatment of PND and highlights the importance of transitioning toward integrated or collaborative care models. Future efforts should focus on overcoming implementation barriers, developing digital health solutions, establishing tasksharing frameworks, and devising personalized treatment strategies to ensure equitable access to these innovations for affected populations.