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产后创伤后应激障碍:分娩对经产妇创伤后应激障碍(PTSD)患病率的影响。

Post-traumatic Stress Disorder Post Partum: The Impact of Birth on the Prevalence of Post-traumatic Stress Disorder (PTSD) in Multiparous Women.

作者信息

Schwab W, Marth C, Bergant A M

机构信息

Universitätsklinik für Frauenheilkunde Innsbruck (University Clinic of Gynaecology Innsbruck), Innsbruck.

出版信息

Geburtshilfe Frauenheilkd. 2012 Jan;72(1):56-63. doi: 10.1055/s-0031-1280408.

Abstract

Traumatic birth experiences may lead to serious psychological impairment. Recent studies show that a considerable number of women can develop post-traumatic stress disorder (PTSD), in some cases in a subsyndromal form. Until now, the possibility that postpartum psychological symptoms might be a continuum of a pre-existing disorder in pregnancy has rarely been considered. This study therefore aimed to evaluate the proportion of women who develop post-traumatic stress disorder as a result of childbirth. 56 multiparous women were recruited for the study. The diagnosis of PTSD was made according to the criteria for psychological disorders in the DSM-IV (Diagnostics and Statistical Manual of Mental Disorders). The data were collected in structured interviews in the 30th to 38th week of gestation and in the 6th week post partum. Of the 56 women participating, 52 (93 %) completed the survey. Uncontrolled results showed that 21.15 % of the multiparous women met the full diagnostic PTSD criteria in the 6th week post partum. After the exclusion of all cases already characterised by all criteria or a subsyndromal form of PTSD caused by previous traumatisation, the PTSD rate was below 8 % at 6 weeks postpartum (= incidence rate of PTSD post partum). The present study is the first prospective longitudinal study to demonstrate the occurrence of full criteria PTSD in multiparous women as a result of childbirth after having excluded pre-existing PTSD. The results of our study show a high prevalence rate of PTSD during pregnancy. A number of women report all aspects of post-traumatic stress disorder as a result of childbirth.

摘要

创伤性分娩经历可能导致严重的心理损害。最近的研究表明,相当多的女性会患上创伤后应激障碍(PTSD),在某些情况下为亚综合征形式。到目前为止,产后心理症状可能是孕期已存在疾病的延续这一可能性很少被考虑。因此,本研究旨在评估因分娩而患上创伤后应激障碍的女性比例。56名经产妇被招募参加该研究。PTSD的诊断依据《精神疾病诊断与统计手册》第四版(DSM-IV)中的心理障碍标准进行。数据在妊娠第30至38周以及产后第6周通过结构化访谈收集。参与研究的56名女性中,52名(93%)完成了调查。未控制的结果显示,21.15%的经产妇在产后第6周符合PTSD的完整诊断标准。在排除所有已符合所有标准或由先前创伤导致的PTSD亚综合征形式的病例后,产后6周时PTSD发生率低于8%(=产后PTSD发病率)。本研究是第一项前瞻性纵向研究,在排除先前存在的PTSD后,证明经产妇因分娩出现符合完整标准的PTSD。我们的研究结果显示孕期PTSD患病率较高。许多女性报告了因分娩出现创伤后应激障碍的各个方面。

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