Cohen Lee S, Arakelian Miranda, Church Taylor R, Dunk Madison M, Gaw Margaret L, Yoon Hannah E, Kobylski Lauren A, Vanderkruik Rachel, Freeman Marlene P
Ammon-Pinizzotto Center for Women's Mental Health, Massachusetts General Hospital, Boston, MA, USA.
Department of Psychological & Brain Sciences, George Washington University, Washington, DC, USA.
Mol Psychiatry. 2025 Jun;30(6):2537-2544. doi: 10.1038/s41380-024-02856-3. Epub 2024 Dec 6.
Postpartum psychosis (PP) is a severe psychiatric disorder-with limited data or consensus on diagnostic criteria and clinical presentation-that affects thousands of people each year. The Massachusetts General Hospital Postpartum Psychosis Project (MGHP3) was established to: 1) describe the phenomenology of PP, and 2) identify genomic and clinical predictors in a large cohort. Results thus far point to a richer understanding of the heterogeneity and complexity of this often-misunderstood illness and its nature over time. Data are collected from those who experienced PP within 6 months of delivery and within the 10 years prior to the MGHP3 interview. Participants provide information via the Mini International Neuropsychiatric Interview for Psychotic Disorders Studies (MINI-PDS), MGHP3© Questionnaire (including assessment of episode onset, duration, symptoms, and treatment received), and other relevant history. This retrospective study uses validated diagnostic tools to evaluate psychiatric history across participants' lifetimes. Descriptive statistics (e.g., median values, frequencies) were conducted to describe the phenomenology of PP. As of November 3, 2022, 248 participants with histories of at least one episode of PP completed the MGHP3 interview. Most participants met criteria for Bipolar I Disorder with psychotic features (71.8%). During PP episode(s), participants reported odd beliefs or delusions (87.6%), persecutory delusions (75.2%), ideas of reference (55.8%), and visual (52.3%) and/or auditory (48.1%) hallucinations. The median time between delivery and symptom onset was 10 days (SD = 43.72). Most participants reported receiving medication (93.0%) and/or psychotherapy (65.9%). This report describes findings regarding the phenomenology of postpartum psychosis among the MGHP3 cohort, the largest cohort with validated PP studied to date. This ongoing effort to refine the phenotype of PP and to delineate underlying genetic determinants of the disorder will contribute to an enhanced understanding of this serious illness. It also underscores areas for further rigorous assessment using other research methods and sets the stage for translational reproductive neuroscience - including ongoing analyses of neuroimaging and genetic data from the MGHP3 cohort.
产后精神病（PP）是一种严重的精神障碍，关于其诊断标准和临床表现的数据有限且缺乏共识，每年影响数千人。马萨诸塞州总医院产后精神病项目（MGHP3）的设立目的是：1）描述产后精神病的现象学，2）在一个大型队列中识别基因组和临床预测因素。迄今为止的结果表明，随着时间的推移，人们对这种常被误解的疾病的异质性、复杂性及其本质有了更深入的了解。数据收集自分娩后6个月内以及MGHP3访谈前10年内经历过产后精神病的人。参与者通过用于精神病性障碍研究的迷你国际神经精神病学访谈（MINI-PDS）、MGHP3问卷（包括发作起始、持续时间、症状及接受治疗情况的评估）以及其他相关病史提供信息。这项回顾性研究使用经过验证的诊断工具来评估参与者一生中的精神病史。进行描述性统计（如中位数、频率）以描述产后精神病的现象学。截至2022年11月3日，248名有至少一次产后精神病发作史的参与者完成了MGHP3访谈。大多数参与者符合伴有精神病性特征的双相I型障碍标准（71.8%）。在产后精神病发作期间，参与者报告有怪异信念或妄想（87.6%）、被害妄想（75.2%）、牵连观念（55.8%）以及视觉（52.3%）和/或听觉（48.1%）幻觉。分娩与症状发作之间的中位时间为10天（标准差=43.72）。大多数参与者报告接受过药物治疗（93.0%）和/或心理治疗（65.9%）。本报告描述了MGHP3队列中产后精神病现象学的研究结果，MGHP3队列是迄今为止研究的最大的经过验证的产后精神病队列。这项不断完善产后精神病表型并描绘该疾病潜在遗传决定因素的工作，将有助于加深对这种严重疾病的理解。它还强调了使用其他研究方法进行进一步严格评估的领域，并为转化生殖神经科学奠定了基础——包括对MGHP3队列的神经影像学和基因数据的持续分析。
