Pfuhlmann B, Stöber G, Franzek E, Beckmann H
Department of Psychiatry, University of Würzburg, Germany.
J Affect Disord. 1998 Sep;50(2-3):125-34. doi: 10.1016/s0165-0327(98)00107-4.
The nosological status of postpartum psychoses has remained controversial because of their often 'atypical' symptomatology. A polydiagnostic approach may further clarify this issue.
In a retrospective study, we applied the ICD-10 and Leonhard's classification to 39 patients with severe postpartum psychiatric disorders. The patients were personally reexamined on average 12.5 years (6-26 years) after the onset of the illness.
An acute onset and a polymorphous psychotic symptomatology with rapid changes characterized the majority of our cases. Unipolar depressive disorders (28%) and acute polymorphous psychotic disorders (21%) represented the largest proportions within the ICD-10-classification. Applying Leonhard's classification, over half the patients (54%) suffered from a cycloid psychosis. Among cycloid psychoses, motility psychoses clearly predominated. Schizophrenias occurred rarely (10%) according to both classifications.
Due to the unknown prevalence of the various diagnoses among women of child-bearing age, it is impossible to statistically infer a specific association between childbirth and a distinct diagnosis from our data.
Our findings suggest that cycloid psychoses, in particular motility psychoses, account for the majority of postpartum psychoses, and do not support the hypothesis of a nosological independence of postpartum psychoses.
产后精神病的疾病分类地位一直存在争议，因为其症状往往“不典型”。多诊断方法可能会进一步澄清这个问题。
在一项回顾性研究中，我们对39例患有严重产后精神障碍的患者应用了国际疾病分类第10版（ICD - 10）和莱昂哈德分类法。患者在发病后平均12.5年（6 - 26年）接受了个人复查。
大多数病例的特点是急性起病和具有快速变化的多形性精神病症状。在ICD - 10分类中，单相抑郁症（28%）和急性多形性精神病性障碍（21%）占比最大。应用莱昂哈德分类法，超过一半的患者（54%）患有环性精神病。在环性精神病中，运动性精神病明显占主导。根据两种分类法，精神分裂症的发生率都很低（10%）。
由于育龄女性中各种诊断的患病率未知，无法从我们的数据中统计推断分娩与特定诊断之间的具体关联。
我们的研究结果表明，环性精神病，尤其是运动性精神病，占产后精神病的大多数，不支持产后精神病在疾病分类上具有独立性的假设。
