An evaluation of symptom domains in the 2 years before pregnancy as predictors of relapse in the perinatal period in women with severe mental illness.
An evaluation of symptom domains in the 2 years before pregnancy as predictors of relapse in the perinatal period in women with severe mental illness.
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DOI：
10.1192/j.eurpsy.2021.18
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发表时间：
2021-03-19
期刊：
影响因子：
--
通讯作者：
Taylor C
中科院分区：
文献类型：
--
作者：
Khapre S;Stewart R;Taylor C
症状可能是比诊断更有用的精神疾病预后标志。我们试图调查患有严重精神疾病（SMI；精神病性和双相情感障碍）的女性的症状领域，作为围产期复发风险的预测因素。数据取自伦敦南部一家大型心理保健提供者的 399 名患有 SMI 诊断的孕妇的电子健康记录。使用自然语言处理算法识别怀孕前 2 年临床记录中记录的与 SMI 特征相关的六个领域的症状（阳性、阴性、紊乱、躁狂、抑郁和紧张症），以从文本中提取数据，并调查与怀孕期间和产后 3 个月住院期间的关联。 76 名女性 (19%) 在怀孕期间复发，107 名女性 (27%) 在产后复发。调整协变量后，紊乱症状与妊娠期复发呈临界显着正相关（调整后比值比 [aOR] = 1.36；95% 置信区间 [CI] = 每单位症状数量增加 0.99–1.87），而抑郁症状与产后复发呈负相关（0.78；0.62–0.98）。将样本限制为在任何给定领域至少有一种记录症状的女性，较高的紊乱（1.84；1.22-2.76）、阳性（1.50；1.07-2.11）和躁狂（1.48；1.03-2.11）症状与怀孕期间复发相关，紊乱（1.54；1.08-2.20）症状域与复发相关。产后。怀孕前两年记录的阳性、混乱和躁狂症状与怀孕期间和产后复发的风险增加相关。文本字段中的常规健康记录的特征相对可转移，并且可以帮助为预测风险建模提供信息。
Symptoms may be more useful prognostic markers for mental illness than diagnoses. We sought to investigate symptom domains in women with pre-existing severe mental illness (SMI; psychotic and bipolar disorder) as predictors of relapse risk during the perinatal period. Data were obtained from electronic health records of 399 pregnant women with SMI diagnoses from a large south London mental healthcare provider. Symptoms within six domains characteristically associated with SMI (positive, negative, disorganization, mania, depression, and catatonia) recorded in clinical notes 2 years before pregnancy were identified with natural language processing algorithms to extract data from text, and associations investigated with hospitalization during pregnancy and 3 months postpartum. Seventy-six women (19%) relapsed during pregnancy and 107 (27%) relapsed postpartum. After adjusting for covariates, disorganization symptoms showed a positive association at borderline significance with relapse during pregnancy (adjusted odds ratio [aOR] = 1.36; 95% confidence interval [CI] = 0.99–1.87 per unit increase in number of symptoms) and depressive symptoms negatively with relapse postpartum (0.78; 0.62–0.98). Restricting the sample to women with at least one recorded symptom in any given domain, higher disorganization (1.84; 1.22–2.76), positive (1.50; 1.07–2.11), and manic (1.48; 1.03–2.11) symptoms were associated with relapse during pregnancy, and disorganization (1.54; 1.08–2.20) symptom domains were associated with relapse postpartum. Positive, disorganization, and manic symptoms recorded in the 2 years before pregnancy were associated with increased risk of relapse during pregnancy and postpartum. The characterization of routine health records from text fields is relatively transferrable and could help inform predictive risk modelling.
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影响因子：
4.3
作者：
Cunningham H;Tablan V;Roberts A;Bontcheva K
通讯作者：
Bontcheva K
影响因子：
4.4
作者：
Stewart, Robert;Soremekun, Mishael;Lovestone, Simon
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DOI：
10.1111/j.1471-0528.2010.02847.x
发表时间：
2011-03-01
影响因子：
5.8
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影响因子：
17.7
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通讯作者：
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影响因子：
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作者：
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