Burgerhout Karin M, Kamperman Astrid M, Roza Sabine J, Lambregtse-Van den Berg Mijke P, Koorengevel Kathelijne M, Hoogendijk Witte J G, Kushner Steven A, Bergink Veerle
Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands.
Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands.
J Clin Psychiatry. 2017 Jan;78(1):122-128. doi: 10.4088/JCP.15m10204.
Postpartum psychosis is an acute and severe mood disorder. Although the prognosis is generally good, postpartum psychosis is a highly stressful life-event presumed to have a major impact on functioning and well-being beyond the acute stage of the illness. We studied functional recovery, including psychosocial functioning and the presence of psychological distress, in patients with a recent diagnosis of postpartum psychosis.
Seventy-eight patients with postpartum psychosis consecutively admitted for inpatient hospitalization between 2005 and 2011 were assessed 9 months postpartum. Included were patients with DSM-IV-TR diagnoses of psychotic disorder not otherwise specified, brief psychotic disorder, or mood disorder with psychotic features, each requiring the additional specifier "with postpartum onset." Functioning was assessed in 4 domains by the Longitudinal Interval Follow-up Evaluation-Range of Impaired Functioning Tool (LIFE-RIFT). Symptomatology was measured by the Brief Symptom Inventory and compared to a matched population-based cohort.
Nine months postpartum, 74% (58/78) of women with postpartum psychosis reported good functioning on the domains of work, interpersonal relations, recreation, and global satisfaction. Moreover, 88% (69/78) of patients with postpartum psychosis had resumed their premorbid employment and household responsibilities. Compared to the general population, patients with postpartum psychosis reported a higher burden of depression and anxiety (effect sizes r ≤ 0.14). Patients who had a relapse episode (18%) experienced considerable functional impairments across several domains.
Nine months postpartum, the majority of patients with postpartum psychosis reported good functional recovery. Our relatively improved functional outcomes compared to nonpostpartum onset could be attributed to the postpartum onset and/or more favorable risk factor profile.
产后精神病是一种急性重症心境障碍。尽管其预后总体良好，但产后精神病是一种压力极大的生活事件，被认为在疾病急性期过后对功能和幸福感有重大影响。我们研究了近期诊断为产后精神病的患者的功能恢复情况，包括心理社会功能以及心理困扰的存在情况。
对2005年至2011年间连续住院治疗的78例产后精神病患者在产后9个月进行评估。纳入的患者符合DSM-IV-TR中未另行规定的精神障碍、短暂精神病性障碍或伴有精神病性特征的心境障碍的诊断标准，每种诊断均需附加“产后起病”的说明。通过纵向间隔随访评估-功能受损范围工具（LIFE-RIFT）在4个领域评估功能。通过简明症状量表测量症状，并与匹配的基于人群的队列进行比较。
产后9个月，74%（58/78）的产后精神病女性在工作、人际关系、娱乐和总体满意度方面报告功能良好。此外，88%（69/78）的产后精神病患者已恢复病前的工作和家庭责任。与普通人群相比，产后精神病患者报告的抑郁和焦虑负担更高（效应量r≤0.14）。有复发发作的患者（18%）在多个领域经历了相当程度的功能损害。
产后9个月，大多数产后精神病患者报告功能恢复良好。与非产后起病相比，我们相对改善的功能结局可能归因于产后起病和/或更有利的风险因素特征。
