精神科医师与产科医师对产后忧郁症识别情况及治疗效果调查

Investigation on the Recognition of Post-natal Depression by Psychiatrists and by Obstetricians and the Therapeutic Effect

目的了解精神科和产科医师对产后抑郁症的识别情况及对产后抑郁症的治疗效果,为制定精神卫生服务政策提供相关依据。方法收集来自精神科、产科门诊中的产后抑郁症患者47例,分为专科医师组20例和产科医师组27例,在入组时、治疗第2周、第4周、第8周、第12周时,进行汉密顿抑郁量表24项(HAMD24)、汉密顿焦虑量表(HAMA)、健康状况调查问卷(SF-36)、修订社会功能缺陷筛选量表(SDSS)、自编的药物依从性评估等量表评定。结果(1)精神科门诊中专科医师对抑郁症的识别显著高于产科医师组(P<0.01)。(2)专科医师组对产后抑郁症的治疗效果优于产科医师组(P<0.01),两者在治疗后第8周及第12周HAMD、HAMA总分减分率有显著性差异。(3)两组在治疗第12周时SF-36各因子分均较入组时有显著提高(P<0.01)。结论精神科门诊中专科医师在对抑郁症的识别、治疗效果上优于产科医师;产科医师对产后抑郁症的识别及诊治能力有待进一步提高,相关的卫生管理体系作用需要进一步加强。

Objective To investigate the recognition of post-natal depression by psychiatrists and by obstetricians and the therapeutic effect. Methods 47 cases with post-natal depression were divided into 2 groups ： psychiatrist group and obstetrician group. HAMD24, HAMA, SF-36 and SDSS were used to evaluate the therapeutic effect. Results （ 1 ） The recognition of post-natal depression by psychiatrists was much better than that by obstetricians （ P 〈 0. 01 ）. （2） The treatment in psychiatrist group was much more effective than that in obstetrician group （P 〈0.01 ）, there existed a significant difference in HAMD and HAMA score reduction between the 2 groups 8 weeks and 12 weeks after treatment. （3）The factor scores of SF-36 in both groups after being treated for 12 weeks were raised greatly （ P 〈 0. 01 ）. Conclusions The recognition and treatment for patients with post-natal depression of obstetricians should be further improved;related management system should be strengthened.