Psykologisk svangreprofylakse. Et tvaerfagligt netvaerk i sygehusregi

INTRODUCTION: Pregnancy and the puerperium are vulnerable periods in every woman's life. It is important to catch and treat signs of mental distress so as to prepare the woman for her approaching delivery, to optimize her role as a mother, and to prevent development of severe psychopathology. We describe a professional network (midwife, obstetrician, psychologist, and child psychiatrist) at a Danish county hospital, which offers the pregnant woman psychological therapy and/or psychiatric treatment when needed.

MATERIAL AND METHODS: The study includes a retrospective analysis of 106 consecutive referrals from the department of obstetrics to the department of psychiatry in the period 1994-1999. The variables were frequency and reason for referral, the diagnostic profile according to ICD-10, the number of therapeutic sessions, and registration of pregnancy/birth complications (PBC).

RESULTS AND DISCUSSION: Anxiety and crisis reactions owing to previous PBC, family problems, and concerns about the fetus were the predominant reasons for referral. A total of 87% met the ICD-10 criteria for adjustment disorder (F 43.2), whereas psychotic disorders were infrequent. In 52%, 1-4 sessions were sufficient to stabilise the condition. The frequency of PBC in the 106 women was significantly higher when compared to the background sample (n = about 15,000). The establishment of an effective network is recommended for pregnant women suffering from mental distress in order to prepare her for the approaching delivery, to optimise her forthcoming role as a mother, and to prevent development of severe psychopathology.