Dean C, Williams R J, Brockington I F
Department of Psychiatry, University of Manchester.
Psychol Med. 1989 Aug;19(3):637-47. doi: 10.1017/s0033291700024235.
The first degree relatives of three groups of women were interviewed; 51 women who had had an illness within two weeks of childbirth and no non-puerperal episodes (the puerperal group), 33 who had puerperal and non-puerperal episodes (the mixed group), and 19 women with bipolar manic-depressive disorder who had non-puerperal episodes only (the manic-depressive group). Over 60% of the affected relatives in all three groups had affective illnesses; in the main these were not puerperal. There were significantly more first degree relatives who had had general practitioner or hospital treatment for psychiatric illness in the puerperal group and in the mixed group than in the manic-depressive group. The puerperal patients had a better prognosis in terms of their illness (number of relapses and time on medication), work functioning and social functioning than the manic-depressive group and the mixed group. The mixed group had an earlier age of onset than the manic-depressive group and the puerperal group. The hypothesis that puerperal psychosis is the same as bipolar manic-depressive disorder was not upheld. The mixed group and the puerperal group were similar with respect to the risk in first degree relatives but differed in terms of prognosis. There were no significant differences between the groups with respect to puerperal episodes in first-degree relatives, although the rate of puerperal psychosis in the first-degree relatives of the puerperal patients was significantly greater than in the general population. The hypothesis that there is a specific genetically determined puerperal psychosis was not supported. Women who had had an illness with an onset within two weeks of childbirth (mixed and puerperal) subsequently had an illness following 36% of their childbirths. In women who had had puerperal and non-puerperal episodes (mixed) the risk was higher; over 50% of deliveries in these women were followed by psychiatric illness.
对三组女性的一级亲属进行了访谈；51名在分娩后两周内患病且无非产褥期发作的女性（产褥期组），33名有产褥期和非产褥期发作的女性（混合组），以及19名仅患有非产褥期发作的双相躁狂抑郁症女性（躁狂抑郁症组）。所有三组中超过60%的受影响亲属患有情感性疾病；主要这些并非产褥期疾病。与躁狂抑郁症组相比，产褥期组和混合组中因精神疾病接受全科医生或医院治疗的一级亲属明显更多。就疾病（复发次数和用药时间）、工作功能和社会功能而言，产褥期患者的预后比躁狂抑郁症组和混合组更好。混合组的发病年龄比躁狂抑郁症组和产褥期组更早。产褥期精神病与双相躁狂抑郁症相同的假设未得到支持。混合组和产褥期组在一级亲属的风险方面相似，但在预后方面有所不同。在一级亲属的产褥期发作方面，各组之间没有显著差异，尽管产褥期患者的一级亲属中产褥期精神病的发生率明显高于一般人群。存在特定基因决定的产褥期精神病的假设未得到支持。在分娩后两周内发病（混合组和产褥期组）的女性，其后36%的分娩后会患病。在有产褥期和非产褥期发作（混合组）的女性中，风险更高；这些女性超过50%的分娩后会出现精神疾病。
