Farquhar F, Le Noury J, Tschinkel S, Harris M, Kurien R, Healy D
North Wales Department of Psychological Medicine, Cardiff University, Hergest Unit, Bangor, UK.
Acta Psychiatr Scand Suppl. 2007(433):37-43. doi: 10.1111/j.1600-0447.2007.00961.x.
Against a background of recent interest in the concept of melancholia, we report data on the incidence and prevalence of manic, melancholic and postpartum syndromes from North West Wales.
We have utilized a database of the complete records of all admission to the North Wales Asylum from 1875 to 1924, and compared the findings for mania, melancholia, and postpartum psychoses from this sample, with admissions for these disorders to the North West Wales mental health services between 1995 and 2005.
The incidence of bipolar disorder, as well as melancholia with and without psychotic features appears stable from 1875 to 2005 but there has been a dramatic decline in the incidence of de novo onset psychoses in the postpartum period. The prevalence of admissions for bipolar disorder, and for severe depressive disorders has increased dramatically during this period.
There are some grounds for revisiting the concept of manic-melancholic disorder put forward by Rafaelsen. The changes in the incidence of postpartum psychoses may have a wider significance for the affective disorders in general.
在近期对忧郁症概念产生兴趣的背景下，我们报告了来自威尔士西北部的躁狂、忧郁和产后综合征的发病率及患病率数据。
我们利用了一个包含1875年至1924年期间所有入住北威尔士精神病院完整记录的数据库，并将该样本中躁狂症、忧郁症和产后精神病的研究结果，与1995年至2005年期间威尔士西北部心理健康服务机构收治的这些疾病患者进行了比较。
从1875年到2005年，双相情感障碍以及伴有或不伴有精神病性特征的忧郁症发病率似乎保持稳定，但产后新发精神病的发病率急剧下降。在此期间，双相情感障碍和重度抑郁症的入院患病率大幅上升。
有理由重新审视拉费尔森提出的躁狂 - 忧郁症概念。产后精神病发病率的变化可能对一般情感障碍具有更广泛的意义。
