Depressionen in der Schwangerschaft

Depressionen kommen auch bei schwangeren Frauen häufig vor, die besondere Situation erfordert allerdings auch eine besondere Herangehensweise. Risiko-Nutzen-Abwägung und der Einbezug der ganzen Familie sowie Zusammenarbeit in einem multiprofessionellen, interdisziplinären und auch sektorenübergreifenden Hilfesystem sind hier von großer Bedeutung. Dieser Beitrag verschafft einen Überblick.

Kernaussaugen

• Depressionen in der Schwangerschaft sind ähnlich häufig bei Frauen wie in anderen Lebensphasen und betreffen ca. 8–12% aller Schwangeren.

• Über die Folgen einer Schwangerschaftsdepression für die Entwicklung der Kinder ist weniger bekannt als bei postpartalen Depressionen. Dennoch spricht alles dafür, dass es wichtig ist, auch Depressionen in der Schwangerschaft frühzeitig und suffizient zu behandeln, um negative langfristige Konsequenzen für die exponierten Kinder zu verhindern.

• Psychotherapie ist die erste Wahl bei leichten bis moderaten Schwangerschaftsdepressionen.

• Kognitive Verhaltenstherapie hat die robusteste Evidenz zur Behandlung einer Schwangerschaftsdepression.

• Bei schwerer ausgeprägten Depressionen ist auch eine medikamentöse Behandlung in der Schwangerschaft nach individueller Nutzen-Risiko-Analyse sinnvoll.

• Psychosoziale und familiäre Unterstützung ist äußert wichtig – bereits in der Schwangerschaft, und umso mehr nach der Geburt.

• Eine gute Geburts- und Wochenbettplanung ist wichtig zur Rezidivprophylaxe und sollte schriftlich fixiert werden, damit diese Informationen auch alle beteiligten Berufsgruppen erreichen.

• Alle Psychopharmaka erhöhen das Risiko für Anpassungsstörungen beim Kind nach der Geburt, daher sollte die Geburt in einer Klinik mit Perinatalzentrum erfolgen.

Schlüsselwörter

Depression - Psychosoziale Unterstützung - Pharmakotherapie - Psychotherapie - Schwangerschaft

Publication History

Article published online:
18 September 2023

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