Battle Cynthia L, Zlotnick Caron, Miller Ivan W, Pearlstein Teri, Howard Margaret
Brown Medical School, Department of Psychiatry and Human Behavior, Providence, Rhode Island, USA.
J Nerv Ment Dis. 2006 May;194(5):369-77. doi: 10.1097/01.nmd.0000217833.49686.c0.
Although postpartum depression and other perinatal disorders have been the subject of increased research attention, important questions remain regarding women who actively seek psychiatric treatment during pregnancy and the postpartum period. In this study, we examined clinical records of 500 perinatal psychiatric patients who received treatment in a psychiatric day hospital (N = 398) or outpatient behavioral health clinic (N = 102). Patients' presenting diagnoses, psychiatric history, treatment course, and depressive symptoms were recorded. The majority of women had major depression as their primary diagnosis, with an average Edinburgh Postnatal Depression Scale score of over 20. Many depressed patients were diagnosed with comorbid anxiety and substance abuse disorders. Although most women were willing to take psychotropic medications, a sizable minority were not, particularly those who were breast-feeding. For more than a third of the sample, the treatment sought while pregnant or postpartum represented their first contact with the mental health system. Treatment implications are discussed.
尽管产后抑郁及其他围产期疾病已受到越来越多的研究关注，但对于在孕期及产后积极寻求精神科治疗的女性，仍存在一些重要问题。在本研究中，我们检查了500名围产期精神科患者的临床记录，这些患者在一家精神科日间医院（N = 398）或门诊行为健康诊所（N = 102）接受治疗。记录了患者的初诊诊断、精神病史、治疗过程及抑郁症状。大多数女性的主要诊断为重度抑郁，爱丁堡产后抑郁量表平均得分超过20分。许多抑郁患者还被诊断患有共病焦虑和物质滥用障碍。尽管大多数女性愿意服用精神药物，但仍有相当一部分人不愿意，尤其是那些正在哺乳的女性。超过三分之一的样本在孕期或产后寻求的治疗是她们与心理健康系统的首次接触。本文还讨论了治疗的意义。
