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产后精神分裂症患者临床特征分析

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背景 分娩可能使女性产生强烈的应激反应,并在一定程度上诱发精神心理问题,甚至导致女性精神分裂症患者疾病复发.目前国内关于产后精神分裂症临床特征及治疗的研究有限.目的 探讨产后精神分裂症患者的临床特征,为其临床治疗提供参考.方法 纳入2012年—2020年在广州医科大学附属脑科医院成人精神科女病区住院治疗的、符合《精神障碍诊断与统计手册(第4版)》(DSM-IV)精神分裂症诊断标准的24例产后精神分裂症患者(产后组),同期纳入住院治疗的48例非产后女性精神分裂症患者(对照组).收集两组患者基本资料、阳性和阴性症状量表(PANSS)评定结果及出院带药情况.结果 产后组首次发病及精神疾病家族史阳性的比例均高于对照组,差异均有统计学意义(χ2=9.321、5.240,P<0.05或0.01).与对照组相比,产后组PANSS兴奋因子评分更高(t=-2.220,P<0.05),阴性症状因子评分更低(t=3.377,P<0.01).出院带药方面,产后组抗精神病药物剂量高于对照组(t=-2.095,P<0.05),联合苯二氮䓬类药物和抗抑郁药物的比例均高于对照组,差异均有统计学意义(χ²=21.316、5.114,P<0.05或0.01).结论 产后精神分裂症患者表现出更多的兴奋症状和更少的阴性症状,需要使用更大剂量的抗精神病药物,联合苯二氮䓬类药物或抗抑郁药物的情况也更多.
Clinical characteristics of patients with puerperal schizophrenia
Background Women may develop severe symptoms of stress disorder following childbirth,which may be exposed to a risk of developing mental health problems,and even lead to the recurrence of the illness in female patients with schizophrenia,while comparatively limited research has been undertaken concerning the clinical characteristics and treatment of puerperal schizophrenia in China.Objective To explore the clinical characteristics of puerperal schizophrenia,so as to provide references for the clinical treatment.Methods A total of 24 patients with puerperal schizophrenia who were hospitalized in the female ward of adult psychiatry department of the Affiliated Brain Hospital of Guangzhou Medical University from 2012 to 2020 and met the Diagnostic and Statistical Manual of Mental Disorders,fourth edition(DSM-IV)diagnostic criteria for schizophrenia were included as puerperal group.Another 48 non-puerperal women with schizophrenia were concurrently enrolled as control group.Then the basic data,scores on Positive and Negative Symptom Scale(PANSS)and the discharge medication were recorded.Results The percentages of newly onset and positive family history of psychosis in puerperal group were larger than those in control group,with statistical significance(χ2=9.321,5.240,P<0.05 or 0.01).Puerperal group scored higher on PANSS excitement factor(t=-2.220,P<0.05)and lower on negative factor(t=3.377,P<0.01)compared with control group.In terms of discharge medication,puerperal group reported a higher dosage of antipsychotic drugs(t=-2.095,P<0.05),and a larger proportion of combined use of benzodiazepines or antidepressants(χ²=21.316,5.114,P<0.05 or 0.01)compared with control group,with statistical significance.Conclusion Patients with puerperal schizophrenia display increased ratings of excitement symptoms and decreased ratings of negative symptoms,which necessitates the use of high doses of antipsychotic drugs,and combined use of benzodiazepines and antidepressants.

Puerperal schizophreniaClinical characteristicsPositive symptomsNegative symptoms

卢晓桦、李海静、邝启杰、易文英、夏雨、周女楠、郑英君、佘生林

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广州医科大学附属脑科医院,广东 广州 510370

产后精神分裂症 临床特征 阳性症状 阴性症状

2024

四川精神卫生
绵阳市精神卫生中心

四川精神卫生

CSTPCD
影响因子:0.565
ISSN:1007-3256
年,卷(期):2024.37(1)
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