Raty-Vohsen D
Acta Psychiatr Belg. 1982;82(6):596-616.
We have reviewed actual forms of postpartum psychoses from three clinical cases, hospitalized for six weeks in an open service. The frequency is declining and the clinical picture can be threefold: oniroidconfusional, pure affective and schizophreniform. The short term course and long term prognosis are generally good, with the exception of latent underlying psychosis. Nevertheless, there is a real risk for further pregnancies necessitating birth control. The etiology is multifactorial: heredo-constitutional factors, reactional, psychodynamic and somatic. The most difficult differential diagnosis is that of early schizophrenia or onset of manic-depression and often the ultimate course permits to assess the diagnosis. Treatment is with psychotropic drugs, electroconvulsive treatment and psychotherapy emphasizing the early mother-child relationship.
我们回顾了3例产后精神病的实际病例形式,这些病例在开放式病房住院六周。其发病率正在下降,临床表现可分为三种类型:梦样混乱型、单纯情感型和精神分裂样型。除潜在的隐匿性精神病外,短期病程和长期预后通常良好。然而,再次怀孕确实存在风险,因此需要采取避孕措施。病因是多因素的:遗传体质因素、反应性因素、心理动力学因素和躯体因素。最困难的鉴别诊断是早期精神分裂症或躁狂抑郁症的发作,通常最终病程有助于评估诊断。治疗方法包括使用精神药物、电休克治疗以及强调早期母婴关系的心理治疗。