Women's College Hospital, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
Women's College Research Institute, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
Psychiatry Res. 2018 Apr;262:452-458. doi: 10.1016/j.psychres.2017.09.023. Epub 2017 Sep 11.
Almost 40% of postpartum psychiatric hospital admissions are brief, lasting 72h or less. We aimed to identify unique subgroups of women within this group to inform better intervention. All women in Ontario, Canada with a brief postpartum psychiatric admission (≤ 72h) (2007-2012)(N = 631) were studied using latent class analysis. We identified distinct subtypes of women and compared women within each subtype on post-discharge mental health indicators: physician visits, emergency department (ED) visits and readmissions. We identified four clinically distinct classes: (1)women with no diagnosed mental illness (2 years before delivery) (n = 179; 28.4% of the sample); (2)women with pre-existing history of severe mental illness (i.e. psychosis) (n = 161; 25.5%); (3)women with pre-existing history of non-psychotic mental illness (n = 211; 33.4%); and (4)adolescent rural-dwelling women with alcohol and substance use disorders (n = 80; 12.7%). In the 1 year post-discharge, women in classes 1-3 were more likely to have post-discharge physician visit than women in class 4 (p < 0.05) and were less likely to have a psychiatric ED visit (p < 0.05). Women in class 2 were most likely to be readmitted (p < 0.05). We identified clinically distinct subgroups of women with brief postpartum psychiatric admissions who may each benefit from differing targeted preventive strategies and post-discharge treatment planning.
近 40%的产后精神科住院患者的住院时间较短,持续时间为 72 小时或更短。我们旨在确定该组内具有独特亚组特征的女性,以便提供更好的干预措施。对加拿大安大略省所有在产后 72 小时内(2007-2012 年)接受短暂产后精神病住院治疗的女性(N = 631)进行了潜在类别分析。我们确定了不同的女性亚组,并比较了每个亚组中女性的出院后心理健康指标:就诊次数、急诊就诊次数和再入院率。我们确定了四个具有临床意义的不同类别:(1)无诊断性精神疾病(两年前分娩)的女性(n = 179;样本的 28.4%);(2)有严重精神病史(即精神病)的女性(n = 161;25.5%);(3)有非精神病性精神病史的女性(n = 211;33.4%);(4)患有酒精和物质使用障碍的农村青少年女性(n = 80;12.7%)。在出院后 1 年内,第 1-3 类女性的就诊次数比第 4 类女性更有可能(p < 0.05),而第 4 类女性的精神科急诊就诊次数较少(p < 0.05)。第 2 类女性再入院的可能性最大(p < 0.05)。我们确定了具有短暂产后精神病住院经历的女性具有临床意义的亚组,每个亚组可能受益于不同的有针对性的预防策略和出院后治疗计划。