PDF(Pubmed)
Abstract：
This study examined (1) the availability and content of national CPGs for treatment of peripartum depression, including comorbid anxiety, with antidepressants and other psychotropics across Europe and (2) antidepressant and other psychotropic utilization data as an indicator of prescribers\' compliance to the guidelines. We conducted a search using Medline and the Guidelines International Network database, combined with direct e-mail contact with national Riseup-PPD COST ACTION members and researchers within psychiatry. Of the 48 European countries examined, we screened 41 records and included 14 of them for full-text evaluation. After exclusion of ineligible and duplicate records, we included 12 CPGs. Multiple CPGs recommend antidepressant initiation or continuation based on maternal disease severity, non-response to first-line non-pharmacological interventions, and after risk-benefit assessment. Advice on treatment of comorbid anxiety is largely missing or unspecific. Antidepressant dispensing data suggest general prescribers\' compliance with the preferred substances of the CPG, although country-specific differences were noted. To conclude, there is an urgent need for harmonized, up-to-date CPGs for pharmacological management of peripartum depression and comorbid anxiety in Europe. The recommendations need to be informed by the latest available evidence so that healthcare providers and women can make informed, evidence-based decisions about treatment choices.
摘要：
这项研究检查了（1）国家CPGs治疗围产期抑郁症的可用性和内容，包括共病焦虑，与整个欧洲的抗抑郁药和其他精神药物和（2）抗抑郁药和其他精神药物使用数据作为处方者遵守指南的指标。我们使用Medline和指南国际网络数据库进行了搜索，结合与全国Riseup-PPD成本行动成员和精神病学研究人员的直接电子邮件联系。在接受调查的48个欧洲国家中，我们筛选了41条记录,并将其中的14条纳入全文评价.排除不合格和重复的记录后，我们包括12个CPG。多个CPG建议根据产妇疾病的严重程度开始或继续使用抗抑郁药，对一线非药物干预无反应，并经过风险收益评估。关于共病焦虑症的治疗建议在很大程度上缺失或不明确。抗抑郁药配药数据表明一般处方者符合CPG的首选物质，尽管注意到特定国家的差异。最后，迫切需要协调，最新的CPG用于欧洲围产期抑郁症和共病焦虑的药物管理。这些建议需要通过最新的现有证据来提供信息，以便医疗保健提供者和妇女能够提供信息，关于治疗选择的循证决策。
