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产后强迫症:患病率及临床特征。

Postpartum obsessive-compulsive disorder: prevalence and clinical characteristics.

机构信息

Department of Neuropsychiatry of Federal University Pernambuco, Recife 50670901, Brazil.

出版信息

Compr Psychiatry. 2009 Nov-Dec;50(6):503-9. doi: 10.1016/j.comppsych.2008.11.014. Epub 2009 Jan 20.

Abstract

OBJECTIVE

The principal aims of this study were to examine the prevalence rate, clinical characteristics, and related factors of postpartum obsessive-compulsive disorder (OCD).

METHOD

The subjects were a nonclinical sample of 400 postpartum women. They were interviewed from the 2nd up to the 26th week after birth. The Mini International Neuropsychiatric Interview was used for diagnosis of OCD, the Yale-Brown Obsessive-Compulsive Symptom Checklist was used to determine the types of obsessions and compulsions, and the Structured Clinical Interview for DSM-IV Axis I Disorders was used to diagnose comorbid depressive episode.

RESULTS

Thirty-six (9%) of the sample met the diagnostic criteria for OCD according to the Mini International Neuropsychiatric Interview, and 9 (2.3%) reported postpartum onset OCD. Obsessive-compulsive disorder was more frequent in mothers with personal history of previous psychiatric disorder, somatic disease, or obstetric complication in pregnancy/birth, and who were multiparous. The most common obsessions were aggressive, contamination and miscellaneous, and compulsion for washing/cleaning and checking, and 38.9% have a comorbid depressive episode.

CONCLUSION

Women have increased risk of OCD or obsessive-compulsive symptoms in the postpartum period. For this reason, all women, particularly women with previous psychiatric history, somatic disease, or with complications in pregnancy or at the birth should be carefully screened for OCD in the postpartum period.

摘要

目的

本研究的主要目的是调查产后强迫症(OCD)的患病率、临床特征和相关因素。

方法

研究对象为 400 名非临床产后妇女。她们在产后第 2 周到第 26 周接受访谈。采用 Mini 国际神经精神访谈进行 OCD 诊断,采用耶鲁-布朗强迫症症状清单确定强迫观念和强迫行为的类型,采用 DSM-IV 轴 I 障碍的结构临床访谈进行共病抑郁发作的诊断。

结果

根据 Mini 国际神经精神访谈,36 名(9%)样本符合 OCD 的诊断标准,9 名(2.3%)报告产后 OCD 发作。强迫症在有既往精神病史、躯体疾病或妊娠/分娩并发症、多胎妊娠的母亲中更为常见。最常见的强迫观念是攻击、污染和杂类,强迫行为是洗涤/清洁和检查,38.9%有共病抑郁发作。

结论

女性在产后期间患 OCD 或强迫症状的风险增加。因此,所有女性,特别是有既往精神病史、躯体疾病或妊娠或分娩并发症的女性,应在产后期间仔细筛查 OCD。

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