上海市产科和妇保医务人员对孕产妇产后抑郁和精神分裂症的识别情况调查

目的：了解现阶段上海市产科和妇保专业人员对孕产妇常见心理行为问题的识别率及处理方法。方法：共有332例上海市产科和妇保专业人员完成了《孕产妇常见心理行为问题案例分析》。该问卷包括2个案例,第一个为产后抑郁症,第二个为精神分裂症。每个案例后设置了同样的3个相关问题,分别为最可能的诊断、需要补充的资料和最合适的处理。结果：调查对象中91.0%能够正确识别产后抑郁症;多数受访者（81.9%）能够意识到信息不够,需要补充选项所列全部资料,10.8%的受访者只关心孕产期相关因素;18.1%的受访者选择转入精神科专科机构接受住院治疗。调查对象中仅13.9%能够正确识别精神分裂症,高达69.9%的受访者将其误判为产后抑郁症;78.3%认为需要补充选项所列全部资料;有24.7%的受访者认为目前最合适的处理方法是转入精神科专科机构接受住院治疗。医生比护士和助产士对孕产妇常见心理行为问题的识别能力高,二级医院的识别率比三级医院高。结论：上海市产科和妇保专业人员对产后抑郁症的识别率较高,但对精神分裂症的识别率还有待提高,且对孕产妇心理行为问题的处理方式不够恰当。职业类型（医生、护士或助产士）和单位级别为识别率的影响因素。

Identification of Postnatal Depression and Schizophrenia among Obstetric and Maternal Care Professionals in Shanghai

Objective： The aim of the study was to investigate the knowledge of identifying and treatment of common perinatal psycho-behaviour problems among maternal care professionals in Shanghai.Methods： A total number of 332 clinicians,nurses and midwives of maternal care institutions in Shanghai completed a questionnaire of Common Perinatal Psycho-behaviour Problems Case Vignettes.Respondents were presented with 2 case vignettes describing postnatal depression and schizophrenia.Three related questions were asked about identification,seeking supplementary information and management.Results： Rates of identification of postnatal depression were relatively high,with 91.0 % of respondents using the correct label.Most of the respondents（81.9 %） were aware of the insufficiency of information offered by the case vignette and the need of information offered by all options,but 10.8 % of respondents only cared about perinatal life events.Mental health institutions were recognized as a useful resource by 18.1 % of respondents.Only 13.9 % of respondents were able to correctly label schizophrenia while 69.9 % of respondents identified it as postnatal depression.78.3 % of respondents were aware of the need of supplementary information offered by all options.Mental health institutions were recognized as a useful resource by 24.7 % of respondents.Clinicians identified the vignettes more correctly than nurses and midwives.In addition,staff of secondary hospitals identified the vignettes more correctly than those of tertiary hospitals.Conclusions： While the identification of postnatal depression among maternal care professionals in Shanghai is relatively high,there is still potential for mental health literacy gains in the areas of identification of schizophrenia and management of perinatal psycho-behaviour problems.The professions of clinicians,nurses or midwives and the level of hospitals impact the ability of identification.