妊娠与分娩对首发精神疾病患者病情复发的影响

Influence of pregnancy and parturition on patients with first episode psychosis

目的 探讨妊娠与分娩对首发精神疾病患者病情复发的影响。方法 对 2 0 3例女性首发精神疾病患者进行 5年随访。将实访的 174例按患病后有无妊娠及分娩分为妊娠及分娩组 (以下简称妊产组 ,119例 )和非妊产组 (5 5例 ) ,比较 2组的临床资料。结果 妊产组中有 98例 (82 4% )病情复发 ,其农村患者、发病次数和住院次数多于非妊产组 (P <0 0 5～ 0 0 1) ;有家庭或社会支持者、遵医嘱服药及维持治疗者的比例 (分别为 40 3%、12 6 %和 33 6 % )低于非妊产组 (分别为 6 5 5 %、2 9 1%和 5 6 4% ;P <0 0 1) ,应用抗精神病药和抗抑郁药的剂量 [分别为 (2 14 7± 96 2 )mg/d和(15 6 2± 5 7 8)mg/d]低于非妊产组 [分别为 (4 5 6 3± 10 2 4)mg/d和 (2 0 4 3± 6 4 2 )mg/d ;P <0 0 1]。结论 妊娠与分娩对精神疾病的复发有关 。

Objective The intent of this study was to explore the influence of pregnancy and parturition on women with psychosis Methods 203 women with first episode psychosis were followed up for five years and 174 cases of the total were analyzed They were divided into pregnancy parturition group( n =119) and non pregnancy parturition group( n =55) The pregnancy parturition group were subdivided into pregnancy recurrence group( n =54), postpartum recurrence group( n =56), and state stable group( n =21) according to the state whether psychosis was recurred(including aggravated) Clinical data of each group were compared with other and analyzed by statistics Results There were 98 cases(82 4%)of recurrence in 119 cases of pregnancy parturition group The peasant patients, attack frequency, hospitalization frequency in pregnancy parturition group were higher than in non pregnancy parturition group( P <0 05 0 01) The scale of family and social support, medicine compliance, keeping treatment in pregnancy parturition group(40 3%, 12 6%, 33 6% respectively)were lower than in none pregnancy parturition group(65 5%, 29 1%, 56 4% respectively; P <0 01) The dose of antipsychotic drug and antidepressant in pregnancy parturition group [(214 7±96 2)mg/d,(156 2±57 8)mg/d respectively] were lower than in none pregnancy parturition group [(456 3±102 4)mg/d,(204 3±64 2)mg/d respectively; P <0 01] Conclusion Pregnancy and parturition are related to the recurrence of psychosis It is required to investigate whether that is or not the direct factors for recurrence