Coble P A, Reynolds C F, Kupfer D J, Houck P R, Day N L, Giles D E
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, PA 15213-2593.
Compr Psychiatry. 1994 May-Jun;35(3):205-14. doi: 10.1016/0010-440x(94)90193-7.
Psychiatric symptoms and morbidity were examined prospectively in 34 obstetrically healthy volunteers recruited early in pregnancy. All women were free of current psychiatric disorder. Fourteen women had a history of affective disorder, and 20 had no lifetime history of any psychiatric disorder. Symptoms were assessed using both clinician- and self-administered ratings at specified points from 12 weeks of gestation through 8 months' postpartum. All women reported mild symptom elevation during pregnancy and the early puerperium, regardless of psychiatric history. The most frequently endorsed symptoms in both groups were somatic. However, women with a history of affective disorder reported more psychic and somatic distress than women with no psychiatric history. Onset of a psychiatric disorder did not occur during pregnancy in this sample, and only one woman, with both a personal and family history of affective disorder, met criteria for a new episode postpartum. Brief periods of symptom elevation occurred postpartum for 14.7% of the sample (five women, two with and three without a personal history of affective disorder) in the context of additional life stressors combining with the stress of new motherhood. These findings suggest that the impact of childbearing alone on psychiatric symptoms and morbidity is modest among women who are psychiatrically healthy at pregnancy onset and have sound social support networks.
对34名在妊娠早期招募的产科健康志愿者进行了前瞻性的精神症状和发病率检查。所有女性目前均无精神疾病。14名女性有情感障碍病史，20名女性无任何精神疾病终生史。在妊娠12周直至产后8个月的特定时间点，使用临床医生评定和自我评定两种方式对症状进行评估。所有女性均报告在孕期和产褥早期有轻度症状加重，无论其精神病史如何。两组中最常出现的症状均为躯体症状。然而，有情感障碍病史的女性比无精神病史的女性报告了更多的精神和躯体困扰。在该样本中，孕期未发生精神疾病，只有一名有情感障碍个人史和家族史的女性符合产后新发发作的标准。在额外的生活压力源与初为人母的压力相结合的情况下，14.7%的样本（5名女性，2名有情感障碍个人史，3名无情感障碍个人史）在产后出现了短暂的症状加重期。这些发现表明，对于妊娠开始时精神健康且有良好社会支持网络的女性，生育本身对精神症状和发病率的影响较小。
