Post-Partum Psychosis Which Women Are at Highest Risk 英文参考文献.docVIP

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Post-Partum Psychosis Which Women Are at Highest Risk 英文参考文献.doc

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Post-Partum Psychosis Which Women Are at Highest Risk 英文参考文献

Perspective Post-Partum Psychosis: Which Women Are at Highest Risk? Phillipa J. Hay A range of psychological disorders occur in women in the post- partum period. These include Linked Research Article these findings suggest that there is a specific independent risk for psychosis in the early post-partum period. This Perspective discusses the following new study published inPLoS Medicine: “the blues”, which occurs in the first days after birth and which is very common and self-limiting; severe psychoses often associated with mania or bipolar illness, occurring in the first weeks after birth [1]; and mild to moderate depression, occurring weeks to months after birth. Does Estrogen Play a Role? Valdimarsdóttir U, Hultman CM, Harlow B, Cnattingius S, Sparén P (2009) Psychotic illness in first-time mothers with no previous psychiatric hospitalizations: A population-based study. PLoS Med 6(2): e1000013. doi:10.1371/journal.pmed.1000013 Unnur Valdimarsdóttir and colleagues studied the risk factors for psychiatric illness following childbirth and found that, for women who had never previously been hospitalized for a psychiatric illness, the risk of mental illness was greatly increased following childbirth. The authors correctly recognise that their findings cannot determine why the risk of psychosis is highest in the first month after birth. They postulate several explanations, favouring a biological vulnerability due to the profound hormonal fluctuations, particularly falls in estrogen levels, in this period. There is some empirical support for this hypothesis, to the degree that estrogen replacement has been proposed as a potential therapeutic agent in treating schizophrenia, with preliminary albeit inconclusive and mixed support from controlled trials [4,5]. However, as the authors report, a controlled trial found no support for the use of estrogen to prevent psychosis after childbirth [6]. Valdimarsdóttir and colleagues propose several hypotheses to explain the protect