Tsai S J, Lee Y C, Yang C H, Sim C B
Department of Psychiatry, Veterans General Hospital-Taipei, Taiwan, ROC.
J Obstet Gynaecol Res. 1996 Dec;22(6):603-7. doi: 10.1111/j.1447-0756.1996.tb01078.x.
The purpose of this study was to investigate the psychiatric consultation condition in the obstetric ward with particular attention paid to the reasons for referral, psychiatric diagnoses and recommendations.
This study was conducted in a medical center with 73 obstetric beds. All psychiatric consultations of obstetric inpatients during a 3-year period were included in this study. Data were derived from clinical charts and consultation records that included demographic data, reasons for referral, psychiatric diagnoses and treatment recommendations.
Within the 3-year period, 28 patients were referred for psychiatric consultation, or 0.3% of the 9,972 obstetric admissions. The obstetric group represented 0.7% of all the psychiatric consultations. The most common reason for the referral was anxiety. Many obstetric problems, medical histories and psychiatric histories were found in these 28 patients. The most common diagnoses were depression or dysthymia, and schizophrenia. The diagnosis of organic mental disorders was rarely found. The vast majority of the psychiatric consultants were likely to recommend medication and psychological intervention.
Even though there is a low psychiatric consultation rate among the obstetric inpatients, it does not mean that the prevalence rate of mental disorders is low in the obstetric patients. Psychiatric problems may be neglected or happen after patients are discharged. Organic mental disorders were rarely found in the obstetric patients which suggested a different pattern of mental disorders in the obstetric patients compared to other patients. The stress during child delivery needs further study for it may exacerbate or predispose a mental disorder. It is suggested that collaboration between obstetric staff and the consultation-liaison psychiatrists may provide better care for pregnant women patients.
本研究旨在调查产科病房的精神科会诊情况，特别关注转诊原因、精神科诊断及建议。
本研究在一家拥有73张产科床位的医疗中心进行。纳入该研究的为3年内所有产科住院患者的精神科会诊情况。数据来源于临床病历和会诊记录，包括人口统计学数据、转诊原因、精神科诊断及治疗建议。
在这3年期间，有28例患者被转诊进行精神科会诊，占9972例产科住院患者的0.3%。产科组占所有精神科会诊的0.7%。最常见的转诊原因是焦虑。在这28例患者中发现了许多产科问题、病史和精神病史。最常见的诊断是抑郁症或心境恶劣障碍以及精神分裂症。很少发现器质性精神障碍。绝大多数精神科会诊医生可能会建议药物治疗和心理干预。
尽管产科住院患者的精神科会诊率较低，但这并不意味着产科患者精神障碍的患病率较低。精神科问题可能被忽视或在患者出院后发生。产科患者中很少发现器质性精神障碍，这表明与其他患者相比，产科患者的精神障碍模式有所不同。分娩期间的压力可能会加重或诱发精神障碍，需要进一步研究。建议产科工作人员与会诊联络精神科医生之间的合作可为孕妇患者提供更好的护理。
