VanderKruik Rachel, Barreix Maria, Chou Doris, Allen Tomas, Say Lale, Cohen Lee S
Department of Psychology and Neuroscience, University of Colorado, Boulder, 345 UCB Muenzinger, Office D314D, Boulder, CO, 80309, USA.
UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland.
BMC Psychiatry. 2017 Jul 28;17(1):272. doi: 10.1186/s12888-017-1427-7.
Mental health is a significant contributor to global burden of disease and the consequences of perinatal psychiatric morbidity can be substantial. We aimed to obtain global estimates of puerperal psychosis prevalence based on population-based samples and to understand how postpartum psychosis is assessed and captured among included studies.
In June 2014, we searched PubMed, CiNAHL, EMBASE, PsycINFO, Sociological Collections, and Global Index Medicus for publications since the year 1990. Criteria for inclusion in the systematic review were: use of primary data relevant to pre-defined mental health conditions, specified dates of data collection, limited to data from 1990 onwards, sample size >200 and a clear description of methodology. Data were extracted from published peer reviewed articles.
The search yielded 24,273 publications, of which six studies met the criteria. Five studies reported incidence of puerperal psychosis (ranging from 0.89 to 2.6 in 1000 women) and one reported prevalence of psychosis (5 in 1000). Due to the heterogeneity of methodologies used across studies in definitions and assessments used to identify cases, data was not pooled to calculate a global estimate of risk.
This review confirms the relatively low rate of puerperal psychosis; yet given the potential for serious consequences, this morbidity is significant from a global public health perspective. Further attention to consistent detection of puerperal psychosis can help provide appropriate treatment to prevent harmful consequences for both mother and baby.
心理健康是全球疾病负担的重要因素，围产期精神疾病的后果可能很严重。我们旨在基于人群样本获得产褥期精神病患病率的全球估计，并了解在纳入研究中产后精神病是如何评估和记录的。
2014年6月，我们检索了PubMed、护理学与健康领域数据库（CiNAHL）、荷兰医学文摘数据库（EMBASE）、心理学文摘数据库（PsycINFO）、社会学文集数据库和全球医学索引数据库，以查找1990年以来的出版物。纳入该系统评价的标准为：使用与预先定义的心理健康状况相关的原始数据、明确的数据收集日期、限于1990年以后的数据、样本量>200以及对方法的清晰描述。数据从已发表的同行评审文章中提取。
检索共得到24,273篇出版物，其中六项研究符合标准。五项研究报告了产褥期精神病的发病率（每1000名女性中为0.89至2.6），一项研究报告了精神病的患病率（每1000名中有5例）。由于各研究在用于识别病例的定义和评估方法上存在异质性，因此未汇总数据以计算全球风险估计值。
本综述证实产褥期精神病的发病率相对较低；然而，鉴于其可能产生严重后果，从全球公共卫生角度来看，这种发病率具有重要意义。进一步关注产褥期精神病的一致检测有助于提供适当治疗，以防止对母婴造成有害后果。
