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美国西北大学医学院妊娠合并糖尿病中心每年有75例入院,进行精神病学方面的检查和治疗,及围产期护理,并长期观察和治疗其婴儿。本文报道100例于孕中期进行检查,通过1～2个特别设计的精神病咨询方案,以发现过去有过的发作类型及妊娠期的感情损伤。精神病学咨询目的是:①使病人的心理状态与最佳的内科及产科护理相适应;②尽可能地在妊娠早期发现隐匿的精神障碍;③收集与特异性糖尿病有关的精神病学资料。根据调查资料作出精神病学的分级:①焦虑反应;②抑郁;③精神病;④正常。结果本组2/3病例有明显的精神病理学方面的异常。100例中33例有抑郁症,25例有焦虑反应,7例有精神病症状。糖尿病的分型与精神病理学的异常有明显关系,按 White 分型,B、D、F 型糖尿病有精神病学障碍者分别占76%、82%、67%,明显高于A(50%)和 C(55%)型。
Northwestern University School of Medicine, pregnancy-associated diabetes mellitus center each year, 75 cases were admitted for psychiatric examination and treatment, and perinatal care, and long-term observation and treatment of infants. This article reports 100 cases in the second trimester for examination, through 1 to 2 specially designed mental illness counseling programs to find the type of past episodes and emotional damage during pregnancy. Psychiatric counseling aims to: (1) adapt the patient’s psychology to the best medical and obstetric care; (2) detect as many occult mental disorders as possible during the first trimester of pregnancy; (3) collect psychiatric data on specific diabetes mellitus. According to the survey data to make psychiatric classification: ① anxiety; ② depression; ③ mental illness; ④ normal. Results 2/3 of the cases in this group have obvious psychopathological abnormalities. 33 of the 100 patients had depression, 25 had an anxiety reaction and 7 had psychotic symptoms. The classification of diabetes was significantly related to the abnormality of psychopathology. According to White classification, those with psychiatric disorders of type B, D and F accounted for 76%, 82% and 67% respectively, significantly higher than A (50%) and C (55%) type.