Wisner K L, Peindl K S, Hanusa B H
Mood Disorders Program, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA.
J Affect Disord. 1995 Apr 16;34(1):1-11. doi: 10.1016/0165-0327(94)00097-s.
An historical cohort study was performed. Subjects were 118 pregnant women or mothers of children of < 3 years who were assessed at presentation to a psychiatric hospital and 5 years later. The relationship of episode onset to childbearing (during pregnancy or within 3 months of birth) was derived from psychiatric records at presentation and retrospectively determined by interview and life-event charting at follow-up. Determining childbearing status from records yielded an error rate of 30% compared with the status derived from direct interview. A change in diagnosis in the ChildBearing-Related Onset Illness (CBROI) category occurred in 50% of subjects. When Research Diagnostic Criteria were applied retrospectively to the presenting episodes, 95% of women with CBROI had affective disorder diagnoses. Clinicians in our intake setting often missed episodes of mania or hypomania in our subjects' histories.
进行了一项历史性队列研究。研究对象为118名孕妇或3岁以下儿童的母亲，她们在初次到精神病院就诊时接受了评估，并在5年后再次评估。发作与生育（孕期或分娩后3个月内）的关系来自初次就诊时的精神病记录，并在随访时通过访谈和生活事件记录进行回顾性确定。根据记录确定生育状况与直接访谈得出的状况相比，错误率为30%。50%的研究对象在与生育相关的发作性疾病（CBROI）类别中出现了诊断变化。当将研究诊断标准追溯应用于初次发作时，95%患有CBROI的女性被诊断为情感障碍。在我们的接诊环境中，临床医生常常遗漏了研究对象病史中的躁狂或轻躁狂发作。
