Professor Anita Riecher‐Rössler, MD, Ph.D.

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Early Intervention in the Perinatal Period

Mental disorders, especially mood and anxiety disorders are very common during the perinatal period. About ten percent of all mothers suffer from depression in pregnancy and the first post‐natal year. Bipolar and psychotic disorders have a very high rate of relapse postnatally.

This confronts us with specific needs regarding prevention, early detection and early intervention.

Unfortunately, help‐seeking is often delayed due to shame and stigma, and diagnosis is often missed due to misinterpretation of symptoms. Women in the fertile age group as well as professionals should therefore be educated about the symptoms of mental disorders and possibilities of early intervention. Women with a history of mental disorders and a wish for pregnancy should get special counselling. Services should meet the needs of the women concerned and take into account their specific situations, problems and fears. Mental disorders in the perinatal period need special attention and special treatments with modifications of the classical pharmacological, non‐pharmacological and psychotherapeutic approaches. All non‐pharmacological therapies including psychotherapy or light‐therapy should be used. In more severe disorders also psycho‐pharmacotherapy is needed, as the risk of ongoing disorder is higher than the potential risk of carefully chosen medication.

A good mother‐infant bonding should be a main concern from the start and fathers should be integrated as much as possible.

Therapy should be interdisciplinary, including not only psychiatrists/psychologists but also gynaecologists/obstetricians, paediatricians, midwives and social workers. This does not only concerns the period of pregnancy but also the planning of delivery and the post‐partum.

Untreated, peripartum disorders can have severe long‐term consequences, not only for the mother, but also for the whole family and can adversely influence a child’s early and later development. Prevention and early intervention in this area is therefore essential in the interest of the whole society.

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