摘要
目的分析有主观抑郁症状的孕产妇精神障碍的发生率状况。方法2020年3月1日至2021年2月28日,对在某三甲医院建档的孕妇和产妇分别使用9项患者健康问卷和爱丁堡产后抑郁量表进行心理筛查。对PHQ-9≥5分的孕妇、EPDS≥9分的产妇进行随访,使用简明国际精神神经访谈确认其精神障碍的发生状况。结果随访342名女性中抑郁症现患24例(7.0%),既往抑郁症17例,其中3例孕前有抑郁症病史,14例在妊娠发生后首发,孕中期抑郁症发生率比孕早、晚期高。(轻)躁狂发作目前发作9例(2.6%),惊恐障碍6例(1.8%),广场恐怖症13例(3.8%),社交恐惧症3例(0.9%),广泛性焦虑障碍15例(4.4%),强迫症6例(1.8%)。患两种及以上精神障碍的共18例,占确诊精神障碍总人数的29.0%。结论有主观抑郁症状的孕产妇中各类精神障碍均有发生,共病现象常见,患有抑郁症的孕产妇在孕期和产后可能会有多次发作,对孕产妇的精神状态进行专业的评估是非常必要的。
Objective To analyze the detection rates of mental disorders in women with subjective depressive symptoms during pregnancy and the postnatal period.Methods From March 1st 2020 to February 28th 2021,Patient Health Questionnaire-9 items(PHQ-9)and Edinburgh Postnatal Depression Scale(EPDS)were used to screen pregnant women and mothers who were established in a third-grade hospital.The women with PHQ-9≥5 or EPDS≥9 were followed up.Mini-International Neuropsychiatric Interview(MINI)was used to confirm the detection rates of mental disorders.Results Of the 342 women who were followed up,24(7.0%)were diagnosed with depressive episodes.There were 17 cases had depression in the past.Among them 3 women had a history of depression before pregnancy,and 14 had the first episode after pregnancy.The detection rate of depression in the second trimester is higher than that in the first and third trimester;9(2.6%)with(hypo)manic episodes;6(1.8%)with panic disorder;13(3.8%)with agoraphobia;3(0.9%)with social phobia;15(4.4%)with generalized anxiety disorder;6(1.8%)with obsessive-compulsive disorder.Eighteen women suffered from two or more mental disorders,accounting for 29.0%of the total number of diagnosed mental disorders.Conclusions A variety of mental disorders occur in women with subjective depressive symptoms during pregnancy and the postnatal period,and comorbidity is a common finding.Pregnant women with depression may have several episodes during this period.So it is necessary to evaluate their mental status professionally.
作者
赵明喆
魏镜
段艳平
赵月
马良坤
ZHAO Ming-zhe;WEI Jing;DUAN Yan-ping;ZHAO Yue;MA Liang-kun(Department of Psychological Medicine,Peking Union Medical College Hospital,CAMS&PUMC,Beijing 100730,China;Department of Obstetrics and Gynecology,Peking Union Medical College Hospital, CAMS & PUMC, Beijing 100730, China)
出处
《基础医学与临床》
2022年第2期301-305,共5页
Basic and Clinical Medicine
基金
北京协和医院院内基金(ZC201902261)。
关键词
孕产妇
精神障碍
发生率
pregnant women
mental disorders
incidence
