92例产后精神障碍临床分析及随访

An analysis and follow—up of 92 patients with mental disorders associated with the puerperium.

通过92例产后精神障碍的临床分析及随访,发现产后一周是本病发病高峰,其临床表现形式多样,不典型者较多,治疗效果好。对发病机理、转归作一探讨。

Objective: To study the manifestations and outcome of mental disorders associated with the puerperium. Method: This was carried out by a clinical analysis and follow—up of 92 patients with mental disorders associated with the puerperium. Results: Before the onset of mental disorder, 18 cases (19.5%) had some kinds of infection and fever, 4 cases (4.3%) had physical disorder, 29 cases (31.5%) had psychosocial causes. Since symptoms were multiple and variegated, patients were 'atypical' clinically. Based on the CCMD—2, 15 patients were diagnosed as affective disorders (16.3%), 19 as schizophrenia (20.7%), 6 as reactive mental disorders (6.5%), 8 as mental disorders caused by physical diseases (8.7%), and 44 remained unclassified (47.8%). Prognosis was good. The response to treatment was good, and the relapse rate was lower than that of schizophrenia and affective disorders. Discussion: The term 'mental disorder associated with puerperium' is discarded in CCMD—2—R and DSM—Ⅳ, but remains in the ICD—10. Its etiology and nosological status are discussed.