产后精神障碍84例临床分析

Clinical analysis on 84 cases of postpartum psychiatric disorder

目的:探讨产后精神病的临床特点及对策。方法:对84例产后精神病作回顾性研究,根据中国精神疾病分类方案与诊断标准(CCMD-2-R)对84例产后精神病进行重新诊断分类并对其中30例进行随访调查。结果:84例产后精神病中产后二周内起病73.81%,二周后起病26.19%;急性起病89.29%。按CCMD-2-R的症状标准对84例患者进行分类诊断,符合精神分裂症46.43%,器质性精神障碍29.76%,神经症14.29%,抑郁症9.52%。17例(56.67%)复发精神障碍改诊为精神分裂症7例(43.5%),抑郁症3例(13%),分裂情感性精神病2例,双相情感障碍1例,周期性精神病2例。随访结果17例复发精神障碍患者中有14例与分类诊断相符。结论:产后精神病以急性起病,临床症状不典型,易变性和混乱为特点;提倡心理支持与安慰,并针对有关婚姻、家庭问题进行咨询,并对婴儿护理提供必要的帮助。

Objective：Discuss the clinical trait and solution of postpartum psychiatric disease. Methods：Doing retrospective research on 84 cases of postpartum psychiatric disease, diagnose and classify the 84 cases of postpartum psychiatric disease again according to CCMD -2 - R, choose 30 cases carrying out follow - up survey. Results：73.81% of the 84 cases access in 2 weeks,26.19% of the 84 cases access after 2 weeks. 89.29% of the 84 cases are acute onset, diagnose and classify the 84 cases according to CCMD -2 -R,46.43% of them fit in schizophrenia,29.76% of them fit in organic mental disorder,14.29% of them fit in neurosis,9.52% of them fit in depression. 17 cases （56.67%） of recurrent psychiatric disorder are diagnosed again. 7 cases （43.5%） of them are diagnosed as Schizophrenia,3 cases （ 13% ） of them are diagnosed as depression,2 cases of them are diagnosed as Schizoaffective psychosis, 1 case of them is diagnosed as Bipolar disorder,2 case of them are diagnosed as Periodic psychosis. 14 out of the 17 recurrent psychiatric disorder cases fit in diagnosis and classification in follow - up survey. Conclusion ： Postpartum psychiatric disease characterized as acute onset, atypical symptom, inconstancy and diathesis. Psychological support and consolation are promoted. Questions about marriage and family need to be consulted. Essential help need to be provided towards babies.