Like many other primary care doctors, I sometimes sense the shadow of depres

游客2023-12-23  25

问题     Like many other primary care doctors, I sometimes sense the shadow of depression hovering at the edges of the exam room. I am haunted by one mother with severe postnatal depression. Years ago, I took proper care of the baby, but I missed the mother’s distress, as did everyone else.
    Nowadays it’s increasingly clear that pediatricians, obstetrician-gynecologists and internists must be more alert. Research into postnatal depression in particular has underscored the importance of checking up on parents’ mental health in the first months of a baby’s life. But a parent’s depression can be linked to many problems, even in the lives of older children. "Depression is an illness that feeds upon itself," said Dr. William Beardslee, professor of child psychiatry at Harvard Medical School. "Very often people who are depressed don’t seek the care they need. "
    In 2009, the Institute of Medicine and the National Research Council issued a report, "Depression in Parents, Parenting, and Children," that summarized a large and growing body of research on the ways that parental depression can affect how people take care of their children, and how those children fare. One in five Americans will suffer from depression, noted Dr. Beardslee, who was on the committee that issued the report. "Untreated, unrecognized parental depression can lead to negative consequences for kids," he said, ranging from poor school performance to increased visits to the emergency room to poorer peer relationships and adolescent depression. Moreover, there is evidence that when depressed parents get treatment and help with their parenting, families are much better off.
    Children with a depressed parent are themselves more likely to manifest symptoms of depression, research shows, along with other psychiatric problems and behavior issues. They are more likely to make visits to the emergency room and more likely to be injured.
    A depressed parent may have trouble following a preventive care plan if a child has a medical problem like asthma. But higher rates of depression in parents whose children have chronic medical problems may also reflect the stress of dealing with those problems, especially for psychologically vulnerable parents. Depression may become part of a vicious cycle: an overwhelmed and depressed parent is less able to follow a complex medical regimen, and a child ends up in the emergency room or the hospital, creating more pressure and more stress for the family. I often urge mothers to pay more attention to their medical problems and mental health. Pediatric colleagues tell stories of depressed parents who break down and cry during a child’s visit, but then say they’re too busy taking care of the family to get help for themselves.
    In looking for parental depression, in asking about it and discussing the risks, there may be a sense that doctors are placing blame. I think we fear that parents who are struggling with these shadows will feel accused and inadequate. [br] While taking care of small children, doctors should______.

选项 A、ask about their initial symptoms
B、prevent the disease from worsening
C、look out for their parents’ mental health
D、give them the right prescription

答案 C

解析
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