Systematic review of the association between adverse life events and the onset and relapse of postpartum psychosis.
Systematic review of the association between adverse life events and the onset and relapse of postpartum psychosis.
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DOI：
10.3389/fpsyt.2023.1154557
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发表时间：
2023
影响因子：
4.7
通讯作者：
Cullen, Alexis E.
中科院分区：
文献类型：
--
作者：
Reilly, Thomas J.;Roberts, Emma;De La Bastida, Vanessa Charlotte Sagnay;McGuire, Philip;Dazzan, Paola;Cullen, Alexis E.
关键词：
产后精神病被定义为分娩后4至6周内发生的精神病发作。虽然有强有力的证据表明，不良生活事件与产后精神病的发作和复发有关，但这些事件对产后精神病的影响程度尚不清楚。本系统性综述研究了不良生活事件是否与产后精神病或产后精神病复发的可能性增加有关。从开始到2021年6月检索了以下数据库：MEDLINE、EMBASE、PsycInfo。提取研究水平数据，包括设置，参与者人数，不良事件类型和组间差异。使用改良版的Newcastle-Ottawa质量评估量表评估偏倚风险。总共确定了1933份记录，其中17份符合纳入标准，包括9项病例对照研究和8项队列研究。大多数研究（16/17）检查了不良生活事件与产后精神病发作之间的关系，只有其中的结局是精神病复发。总的来说，有63种不同的逆境测量方法（其中大部分仅在一项研究中进行了检查），这些测量方法与产后精神病之间的关联有87种。在与产后精神病发作/复发的统计学显著相关性方面，15例（17%）为阳性（即，不良事件增加发作/复发的风险），4例（5%）为阴性，68例（78%）无统计学显著性。我们的综述强调了在这一领域研究的危险因素的多样性，很少尝试复制，因此限制了得出任何单一危险因素与产后精神病发作密切相关的结论的能力。迫切需要进一步的大规模研究，试图复制早期的研究，以确定不良生活事件是否在产后精神病的发作和恶化中发挥作用。[网址：https://www.crd.york.ac.uk/prospero/display_record.php? RecordID=260592]，标识符[CRD 42021260592]。
Postpartum psychosis is defined as a psychotic episode occurring within 4 to 6 weeks of childbirth. While there is robust evidence that adverse life events are associated with the onset and relapse of psychosis outside the postpartum period, the extent to which these contribute to postpartum psychosis is less clear. This systematic review examined whether adverse life events are associated with an increased likelihood of developing postpartum psychosis or subsequent relapse in women diagnosed with postpartum psychosis. The following databases were searched from inception to June 2021: MEDLINE, EMBASE, PsycInfo. Study level data were extracted including setting, number of participants, type of adverse event, and differences between groups. A modified version of the Newcastle-Ottawa Quality Assessments Scale was used to assess risk of bias. In total, 1933 records were identified, of which 17 met the inclusion criteria, comprising nine case–control studies and eight cohort studies. Most studies (16/17) examined the association between adverse life events and the onset of postpartum psychosis, with only in which the outcome was relapse of psychosis. Overall, there were 63 different measures of adversity examined (most of which were examined in a single study only) and 87 associations between these measures and postpartum psychosis tested across the studies. In terms of statistically significant associations with onset/relapse of postpartum psychosis, 15 (17%) were positive (i.e., the adverse event increased the risk of onset/relapse), 4 (5%) were negative, and 68 (78%) were not statistically significant. Our review highlights the diversity of risk factors examined in this field, with few attempts at replication, hence limiting the ability to conclude that any single risk factor is robustly associated with the onset of postpartum psychosis. Further large-scale studies, that attempt to replicate earlier studies, are urgently needed to determine whether adverse life events play a role in the onset and exacerbation of postpartum psychosis. [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=260592], identifier [CRD42021260592].
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DOI：
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发表时间：
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