Friedman Susan H, Sorrentino Renee M, Stankowski Joy E, Holden Carol E, Resnick Phillip J
Case Western Reserve University, School of Medicine/University Hospitals of Cleveland, 11100 Euclid Ave., Cleveland, OH 44106, USA.
Compr Psychiatry. 2008 Jan-Feb;49(1):106-10. doi: 10.1016/j.comppsych.2007.07.001. Epub 2007 Oct 18.
Child murder by mentally ill mothers is an important public health and psychiatric concern. However, the authors' clinical and forensic experience has been that psychiatrists often do not inquire about maternal thoughts of harming their children. This study sought to elucidate the perceptions of psychiatrists and psychiatric residents regarding the frequency of such thoughts, and to clarify whether they inquire specifically about maternal filicidal thoughts. Psychiatrists were expected to underestimate the prevalence maternal thoughts of harming their children. It was hypothesized that psychiatrists often do not ask their patients about these thoughts.
This study surveyed psychiatrists and psychiatric residents at 2 academic institutions. Respondents were asked whether they routinely query women about motherhood, to estimate the frequency of thoughts of child harm, and whether they inquire about filicidal thoughts in psychotic or suicidal mothers.
Two hundred twenty surveys (67%) were returned. Most psychiatrists underestimated the frequency of depressed mothers who experienced thoughts of harming their young children. Almost one half indicated that they do not ask specifically about filicidal ideation but rather ask about general homicidal thoughts only.
Psychiatrists should have further education about the prevalence of filicidal thoughts and more frequently inquire about them.
患有精神疾病的母亲杀害儿童是一个重要的公共卫生和精神病学问题。然而，作者的临床和法医经验表明，精神科医生常常不会询问母亲是否有伤害自己孩子的想法。本研究旨在阐明精神科医生和精神科住院医师对这类想法出现频率的看法，并明确他们是否会专门询问母亲的杀子想法。预计精神科医生会低估母亲伤害孩子这类想法的普遍程度。研究假设精神科医生常常不会询问患者这些想法。
本研究对两家学术机构的精神科医生和精神科住院医师进行了调查。受访者被问及他们是否会常规询问女性关于为人母的情况，估计伤害孩子想法的出现频率，以及他们是否会询问患有精神病或有自杀倾向的母亲的杀子想法。
共收回220份调查问卷（67%）。大多数精神科医生低估了有伤害幼儿想法的抑郁母亲的比例。近一半的人表示，他们不会专门询问杀子意念，而是只询问一般的杀人想法。
精神科医生应接受关于杀子想法普遍程度的进一步教育，并更频繁地询问这些想法。
