蒋成刚,黄河清,高 东,杨 辉,傅一笑

围产期抑郁障碍是发生于妊娠期及产后阶段的常见精神心理问题，具有发病隐匿、症状异质性强、共病焦虑与睡眠障碍比例高、主动就诊率低等特点，可持续影响孕产妇身心健康、治疗依从性、母婴关系、家庭功能及子代早期发育。当前临床实践中仍存在筛查时点不统一、阳性结果处置标准不一致、产科与精神心理专科转诊衔接不足、院外随访脱节以及数字化工具应用边界不清等问题。重庆市睡眠研究会组织妇产科、精神心理科、妇幼保健、睡眠医学、公共卫生及医学信息学等相关领域专家，以《围产期抑郁障碍精准化智能诊疗规范工作手册》为实践基础，结合国内外围产期精神卫生指南及相关研究，围绕标准化筛查、多维度风险评估、智能风险分层、精准化分层干预、危机处置、双向转诊、数字化随访、数据安全与质量控制形成共识。本共识建议将心理社会危险因素、抑郁与焦虑症状、睡眠状况、既往精神心理病史、家庭与社会支持等纳入综合评估；在有条件的医疗机构，可进一步结合性激素、炎症因子、神经营养因子、下丘脑-垂体-肾上腺轴相关指标及心率变异性等客观指标开展辅助评价。智能系统可用于数据整合、风险提示、随访管理、转诊提醒和个体化干预推荐，但不能替代临床诊断和专业人员决策。对中重度症状、明显功能受损、自伤自杀或伤婴风险、精神病性症状者，应及时进行精神心理专科评估或急诊处置。本共识旨在为妇幼保健机构、综合医院及基层医疗机构建立标准化、连续化、可追溯的围产期抑郁障碍智能诊疗闭环提供参考。

围产期抑郁障碍；产后抑郁；人工智能；心理筛查；风险分层；精准诊疗；数字化管理

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