Strouse T B, Szuba M P, Baxter L R
Department of Psychiatry and Biobehavioral Sciences, University of California, School of Medicine, Los Angeles.
J Clin Psychiatry. 1992 Jun;53(6):204-6.
Postpartum psychotic disorders are rare and poorly understood phenomena occurring after approximately 1 in 2000 births. Increasing attention has been given to the concept of postpartum psychosis as an affective spectrum disorder. We sought to characterize the responses to sleep deprivation of three women with postpartum psychotic and mood symptoms.
Three hospitalized postpartum women with no prior history of psychotic disorder were treated according to a partial sleep deprivation protocol. Each patient was awakened at 2:00 a.m. and kept awake until 9:00 p.m. the following night. A full and an abbreviated Hamilton Rating Scale for Depression (HAM-D) were completed for each patient before and after partial sleep deprivation.
Two of the three patients became transiently manic and the third became hypomanic after sleep deprivation. HAM-D scores decreased drastically for each patient. After recovery sleep, each patient de-escalated but required further treatment with mood-stabilizing agents.
These findings suggest that postpartum psychosis in our patients may represent a variant of bipolar affective disorder.
产后精神障碍是一种罕见且了解甚少的现象，大约每2000例分娩中会出现1例。产后精神病作为一种情感谱系障碍的概念已受到越来越多的关注。我们试图描述三名患有产后精神病和情绪症状的女性对睡眠剥夺的反应。
三名既往无精神障碍病史的住院产后女性按照部分睡眠剥夺方案进行治疗。每位患者于凌晨2点被唤醒，并保持清醒至次日晚上9点。在部分睡眠剥夺前后，为每位患者完成一份完整的和一份简化的汉密尔顿抑郁量表（HAM-D）。
三名患者中有两名在睡眠剥夺后出现短暂躁狂，第三名出现轻躁狂。每位患者的HAM-D评分大幅下降。恢复睡眠后，每位患者的症状有所缓解，但仍需要用情绪稳定剂进一步治疗。
这些发现表明，我们患者中的产后精神病可能代表双相情感障碍的一种变体。
