Palacios-Hernández Bruma, Ramírez-Alvarado Gabriela, Téllez-Alanís Bernarda, Lino-González Ana Luisa, Penagos-Rivera Miriam, Hernández-Galván Adela
Cuerpo Académico "Cognición y Afectos" (UAEMor CA-81), Centro de Investigación Transdisciplinar en Psicología, Universidad Autónoma del Estado de Morelos, Cuernavaca, Mexico.
Escuela de Estudios Superiores del Jicarero, Universidad Autónoma del Estado de Morelos, Jojutla de Juárez, Mexico.
Front Psychiatry. 2024 Jan 5;14:1296638. doi: 10.3389/fpsyt.2023.1296638. eCollection 2023.
Previous scientific evidence has shown a relationship between hormones and the onset and relapse of perinatal psychotic disorders (PPD) in women during pregnancy, childbirth, and the postpartum period. In healthy women the interaction between hormones and cognitive changes has been confirmed mainly in memory, attention, and executive function during pregnancy and postpartum, which respond to adaptive demands related to parenting tasks. In women with psychotic episodes there is a significant impairment in several cognitive functions, but studies of the perinatal period are limited. The objective of this mini review is to analyze the main findings to identify whether hormonal changes interact with the onset of PPD and cognitive impairment in perinatal women. The studies included samples of women with psychosis, risk of developing psychosis, bipolar psychosis, schizoaffective psychosis, and psychotic symptoms, during pregnancy and postpartum. Findings contributed to knowledge about five hypotheses regarding the relationship between hormones in the perinatal period and the appearance of PPD. Nevertheless, this review did not find reports of evidence of a relationship between hormonal production and cognitive function among women with clinically diagnosed PPD, suggesting a research gap. Clinical implications of assessing hormonal production and cognitive function in PPD are discussed. Although the evidence identified is scarce and heterogeneous, the findings call for further research with clinical samples on the role of hormones in perinatal psychotic disorders, especially as they relate to the study of cognition. This will promote more consistent evidence and understanding of PPD etiopathology that can guide early and effective multidisciplinary interventions.
先前的科学证据表明,激素与女性在孕期、分娩期及产后围产期精神障碍(PPD)的发病和复发之间存在关联。在健康女性中,激素与认知变化之间的相互作用主要在孕期和产后的记忆、注意力及执行功能方面得到了证实,这些认知功能会对与育儿任务相关的适应性需求做出反应。在患有精神病发作的女性中,多种认知功能存在显著损害,但关于围产期的研究有限。本综述的目的是分析主要研究结果,以确定激素变化是否与围产期女性PPD的发病及认知障碍相互作用。纳入研究的样本包括孕期和产后患有精神病、有患精神病风险、双相精神病、分裂情感性精神病及有精神病症状的女性。研究结果有助于了解关于围产期激素与PPD出现之间关系的五个假说。然而,本综述未发现临床诊断为PPD的女性中激素分泌与认知功能之间存在关联的证据报道,这表明存在研究空白。文中讨论了评估PPD中激素分泌和认知功能的临床意义。尽管所确定的证据稀少且具有异质性,但研究结果呼吁对临床样本进一步开展关于激素在围产期精神障碍中作用的研究,尤其是与认知研究相关的作用。这将促进获得更一致的证据,加深对PPD病因病理学的理解,从而指导早期有效的多学科干预。