妇女在治疗期间应定期随访以确保治疗有效。随访频率取决于抑郁的严重程度和个体的治疗方式。[47]Gelenberg AJ, Freeman MP, Markowitz JC, et al; American Psychiatric Association. Practice guideline for the treatment of patients with major depressive disorder, 3rd ed. November 2010. http://www.psychiatryonline.com/ (last accessed 21 October 2016).http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf
在哺乳期女性接受药物治疗期间,可能会对早产、年幼或患全身性疾病的婴儿产生更大的不良影响。应定期监测婴儿是否出现过度镇静、易怒以及睡眠、进食和生长变化。[1]Musters C, McDonald E, Jones I. Management of postnatal depression. BMJ. 2008;337:a736.http://www.ncbi.nlm.nih.gov/pubmed/18689433?tool=bestpractice.com
临床医生应努力与患者及其伴侣建立信任的关系,以了解她的想法、关注点和期望,并定期检查她对问题的认识。可讨论其伴侣、家人和照顾者是否能参与进来以支持她。[44]National Institute for Health and Care Excellence. Antenatal and postnatal mental health: clinical management and service guidance. June 2015. http://www.nice.org.uk/ (last accessed 21 October 2016).http://www.nice.org.uk/guidance/cg192[47]Gelenberg AJ, Freeman MP, Markowitz JC, et al; American Psychiatric Association. Practice guideline for the treatment of patients with major depressive disorder, 3rd ed. November 2010. http://www.psychiatryonline.com/ (last accessed 21 October 2016).http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf
对既往存在产后抑郁症发作的患者,应讨论在此后怀孕中复发的风险。[44]National Institute for Health and Care Excellence. Antenatal and postnatal mental health: clinical management and service guidance. June 2015. http://www.nice.org.uk/ (last accessed 21 October 2016).http://www.nice.org.uk/guidance/cg192也可在与生产无关的情况下讨论抑郁的复发风险。