MENTAL DISTURBANCES AND DISEASES AFTER CH ILDBIRTH

After childbirth, from about a quarter up to nearly one half of all pu erperae develop a short-lasting, mild affective distress, the so calle d blues. During the first months after delivery, about 10-15 % of all young mothers suffer from a longstanding depression which is so severe that they are in need of treatment. In one or two out of 1000 women e ven a psychotic disorder becomes manifest. These postpartal disturbanc es and diseases are often not diagnosed by doctors-on the one hand bec ause the women concerned often hide their complaints due to shame and a sense guilt regarding their supposed failure as a good mother, on th e other hand because these syndromes until now have not found enough a ttention in German-as opposed to Angloamerican medicine. Yet, these di sorders-apart from the blues-are very serious ones with potentially se vere consequences for the mother, the baby and possibly the whole fami ly. Women with mental disorders in their family history and especially their own history are at an increased risk. They should be informed a bout this and, in certain cases, be treated preventively. Women with d epressive and psychotic disorders are, especially in the postpartal ti me, in urgent need of treatment which, depending on type and severity of the disorder, should consist of psychotherapy, frequently also phar macotherapy, and social care. Special needs of the postpartal period s uch as breast-feeding or the mother-infant relationship have to be con sidered which often requires close cooperation of the psychiatrist/psy chotherapist, the gynaecologist and the pediatrician.