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| | Women Psychiatry in China | | 2005-2-22 0:39:52 ShanghaiFudan University,Medical School Shi Shenxun M.D |  Psychiatry Department of Huashan Hospital of Fudan University
No.12 Wu Lu Mu Qi Zhong Road 200040 Shanghai, China
Shenxun @online.sh.cn
Women Psychiatry is one of branches of psychiatry, there is also a branch of women psychiatry in Chinese Psychiatry Society. The women psychiatry group of Chinese Psychiatry Society was created in 1994 and had the first national meeting of women Psychiatry of China in Changzhou city of China in 1995. Professor Shutao Zhai working at the Nanjing Brain Hospital is the director of the Group at present. Some specialists like the Chairman of Women Psychiatry Group of WPA, Professor Ian Brockington from Birminghan University of the British, and other 80 represents from different places of China, attending the Meeting. Several national meetings of women psychiatry were held late since 1995.
The studies of women psychiatry in mainland of China are developed as the psychiatry developing in China. Especially in recent ten years, there were many articles dealing with this topic. We reviewed the studies of women psychiatry of China in 2002 according to fifty papers published from 1988-2001, which were selected from 190 studies at that time within six kinds of mental health magazines like Chinese Psychiatry Journal, Chinese Neuro and Psychia, China Psychology, China Clinical Mental Health Journal, China Clinical Psychology and Shanghai Archives of Psychiatry.
All studies of mental health in women of China dealt with different fields of mental health. Most studies related to the problems of menstruations, abortion, pregnancy, postpartum and climaterium. Some involved the problems of psycho-social factors. First we introduce the studies of mental health problems occurring in the different physical period of women.
It is true that there are some women with mild mental health problems when they have menstrual cycle according to 15 studies. Change of interesting, wave of mood, difficulty of concentration, problem of sleep, and feeling of fatigue were popular complaints. Wave of mood, irritability, anxiety and depressed feeling were the most symptoms of affect problems. These conditions might interfere with womens working efficacy, relationship with partner and their quality of life. Most of them just had mild problems above and kept short time with these conditions, usually they recovered completely after their menstrual cycle beginning or several days. Shenxun Shi et al (1996) reported that 81.8% persons of 302 women had mild wave of their mood, 16.9% with moderate change, but only 1.3% with severe change of mood. Most of them about 88.7% had their problems within one week before their menstruation beginning and 86.4% got recovery completely after it starting. Haolong Yuan et al (1996) found that near 90% of women during the stage of productive age would have some symptoms of premenstrual syndrome (PMS). So there is no study of cognition and attitude to mental health problems with menstruation cycle at present, that means how people consider the womens mental health problem with menstruation cycle, including women, husband, gynecologist and others. So we need to do a multiple center study of the PMS in the future.
Pregnancy and production are the most important things for women during their whole lives. Therefore the mental health problems were paid more attention to in recent decade years, there were 51 articles dealing with the issues. The rate of postpartum depressive symptom was about 5.45%-17% according to Professor Shutao Zhais review. The reason of the rate different from was the different evaluating tools used, some paper with SDS, others using SCL-90, CES-D or EPDS. Fen Li et al (1997) foud that the rate of postpartum depressive symptoms was significant higher of 31% in women with forceps delivery than that of 3% in ones with cesarean section or 2% with regular delivery by vagina according to CES-D total score over 16-49. Shenxun Shi et al (2004) reported that the women with the age of 35 group was 21.1% significant higher rate of postpartum depressive symptoms than 4.6% that of low 35 years old one on first week after delivery according to EPDS score over 13. At same time the rate of anxiety and depressive symptoms was much more high 15.8% and 21.1% during the period of pregnancy in 35 years old group than that of young group 4.6% and 4.4% according to HAD scale evaluation. Most risk factors related to postpartum depressive symptoms were relationship with husband, mother-in-law, parents; condition of living; problem of caring baby; high age; sex of baby and different delivery fashion. There were few studies with multiple centers and standard diagnostic criterion at present, only Dominic Lee‘s study (2001, AJP) used the Structured Clinical Interview for DSM-III-R criterion in Hong Kong. He reported that the 1-month prevalence rates for major and minor depression were 5.5% and 4.7%, respectively. At 3-months the rates were 6.1% and 5.1%. So we need further to do a large sample, multiple center, prospective, standard diagnostic criterion and special evaluated tool like EPDS study. We also need international collaborating study of postpartum depression.
There were 19 studies of mental health after abortion, researcher found that those women often had pressure of mind before the operation of abortion e.g. worrying about pain of operation, the rest after abortion, work, unable to be pregnancy again, self-guilt. The risk factors like the age of abortion, degree of education, times of delivery were related with the pressure of mind before operation. But factors of the skill of doctor, degree of education, relationship with husband, the amount of bleeding, the weeks of pregnancy were connected with clinical symptoms of these women.
As the age growing up, the level of hormone in women is also changed largely low. Some women will present mental health problems due to the lower level of hormone during the period of climaterium. There were 13 papers dealing with the topics. Ying Xu et al (2000) reported that anxiety symptoms, negative life events were related positively with climaterium affective disorder.
Yongling Fong et al (2001) found that 8% of 5340 women living in community with 45-55 years old was 16-19 score of CES-D, and 11.6% of women was over 20score of the scale. So the problems of mental health in these women should be paid more attention, especial to the problems of anxiety and depression. We need more researching on this field.
There were few studies of mental health problems in aging women at present. We need to do more works of the field as the population is growing up older.
There have been many studies of mental health in women at present, but we need further research in the future because the tool different, the result different, the unit of the study alone, the sample different, lack of diagnostic criterion in the studies early.
(Edited by Shuping,Tan) | | [CLOSE] |
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Ministry of Health, (2003) No.013
ICP:No.040657