围产期和分娩是精神疾病失代偿的一个因素:一例新分娩的喀麦隆妇女的抑郁状态

G. Moyo
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引用次数: 8

摘要

精神病学中的失代偿是指先前稳定的患者或易感个体可能突然出现症状或经历疾病恶化的过程。这是由生理、病理、内源性或外源性因素引起的,这些因素是造成心理失衡的原因。围产期的特点是多种激素的变化和压力,这可能构成精神失衡的风险。婴儿忧郁是产后的一种早熟和短暂的抑郁状态,可能是一种临界状态,预示着精神失代偿。这项研究旨在调查易患精神障碍的女性的现象,她们在产后立即表现出婴儿忧郁。2015年,在喀麦隆雅温得的两家教学医院进行了一项为期四个月的病例对照研究,Kennerley和Gath蓝调筛查允许将“病例”组与“对照组”分开。经过各种分析,具有心理和精神危险因素的女性包括:既往抑郁史(OR=6.8;p<0.001)、既往产后忧郁史(OR=2.3;p=0.002)、既往其他精神疾病史(OR=10.21;p<0.01)、抑郁症家族史(OR=3.58;p<0.001)和其他精神疾病家族史(OR=4.39;p<0.001),目前的慢性疾病(OR=2.33,p值<0.001)、妊娠期疾病或并发症(OR=2.53,p值=0.0211)更容易在产后立即表现出婴儿忧郁。因此,有心理倾向的妇女在围产期有失代偿的风险,包括产后精神障碍。咨询、密切监测和调整治疗等预防措施可能有助于防止这种现象。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Perinatality and Childbirth as a Factor of Decompensation of Mental Illness: The Case of Depressive States in Newly Delivered Cameroonian Women
Decompensation in psychiatry refers to the process by which a previously stable patient or predisposed individual may suddenly manifest symptoms or experience exacerbation of a sickness. This is prompted by factors which may be physiological, pathological, endogenous or exogenous, being responsible for psychic disequilibrium. Perinatality is characterized by multiple hormone variation and stress, which may constitute a risk for mental imbalances. The baby blues is a precocious and transient depressive state of the postpartum, which may occur as a borderline, signalling psychic decompensation. This study aims to investigate the phenomenon in women predisposed to mental disorders, having manifested the baby blues during immediate postpartum. In a case control study conducted in 2015 in two teaching hospitals of Yaoundé, Cameroon over four months, the Kennerley and Gath blues screening permitted to separate the group of “cases” from that of “controls”. After various analyses, women with psychological and psychiatric risk factors including: past history of depression (OR=6.8; p<0.001), past history of postpartum blues (OR=2.3; p=0.002), past history of other psychiatric illnesses (OR=10.21; p<0.01), family history of depression (OR=3.58; p<0.001), family history of other psychiatric illnesses (OR=4.39; p<0.001), current chronic diseases (OR=2.33, p-value<0.001), sickness or complication during pregnancy (OR=2.53, p-value<0.0211) were more susceptible to manifest the baby blues during immediate postpartum. Therefore, women with psychological predispositions, stand a risk of decompensation during the perinatal period including psychiatric disorders of postpartum. Preventive measures such as counselling, keen monitoring and treatment adjustment may help to prevent this phenomenon.
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