产后精神病42例的临床分析及随访

目的 探讨产后精神病的临床特点及产后精神病是否为独立的疾病单元。方法 对42例产后精神病作回顾性研究，根据中国精神疾病分类方案与诊断标准（CCMD－2－R）对42例产后精神病进行重新诊断分类并对其中23例进行随访调查。结果 42例产后精神病中30例在产后二周内起病，39例呈急性起病，28例有躯体或心理因素作为起病诱因。根据CCMD－2－R诊断为精神分裂症19例，器质性精神障碍13例，抑郁症5例，神经症5例；27例临床短期疗效达痊愈；随访到23例患者7例未再出现精神异常，改诊为精神分裂症10例，情感障碍4例，分裂情感性精神病1例，周期性精神病1例。结论 产后精神病以急性起病，临床症状不典型，易变性和混乱为特点；按国内现有诊断标准本组42例产后精神病均可归类，未发现区别于其它精神障碍的特有症状，提示产后精神病并非独立的疾病单元。

Clinical analysis and follow-up study of 42 postpartum psychoses.

Objective The study is order to research the character and the nosology of postpartum psychoses.Methods In a retrospective study,we applied the classification of Chinese mental disease to classify the syndrom of 42 postpartum psychoses.A followe up study applied to 23 patients of them.Results In our cases,30 patients onseted acutely,28 patients onseted with physical or psychological factors.According to CCMD-2-R,all cases can classified to schizophrenia (19),organic psychoses(13),depression(5)and neurosis(5).27 patients psychiatric symptoms disappeared after hospitalizative treatment.With regard to the follow up study of 23 patients,there are 10 patients with schizophrenia,7 patients without mental disorder,4 patients with affective disorder,1 patient with schizo affective psychoses and 1patient with periodic psychoses.Conclusions Acute onset,atypical symptoms,confusion and changability charactered postpartum psychoses.Our study don't find special psychoiatric symptom belong to postpartum psychoses and don't support the hypothesis of a nosological independence of postpartum psychoses.