Horowitz June Andrews, Goodman Janice
Boston College, William F Connell School of Nursing, Chestnut Hill, MA 02467, USA.
Res Theory Nurs Pract. 2004 Summer-Fall;18(2-3):149-63. doi: 10.1891/rtnp.18.2.149.61285.
The purpose of this study was to examine changes in maternal depression symptoms over time from the postpartum period to 2 years after delivery among a sample of women identified with elevated depression symptoms at 2 to 4 weeks postpartum, a longitudinal within-subjects design was used to examine changes in maternal depression symptoms. Two years after delivery, 62 women who had elevated depression scores at 2 to 4 weeks postpartum completed mailed questionnaires including a Demographic Information Sheet, the Beck Depression Inventory II, and the Parenting Stress Index. Among this sample of women, 30.6% scored in the depressed range 2 years after delivery. Although depression scores decreased over time, the significant change in mean scores occurred from 4 to 8 weeks to 10 to 14 weeks postpartum, and mean scores did not change significantly from 10 to 14 weeks, to 14 to 18 weeks, to 2 years after delivery. Depression history, lower overall social support, and higher parental distress were associated with higher depression scores among mothers at 2 years after delivery. Initial decrease in depression scores suggests that postpartum depression symptoms posed a time-limited problem for many women with peak occurrence from 4 to 8 weeks after delivery. However, for many women depression symptoms persisted at 2 years after delivery. Previous depression, limited current support, and parental distress increased depression symptom severity. Additional longitudinal research is needed to determine factors that increase and ameliorate risk for chronic maternal depression. Clinical assessment of maternal depression beyond the early postpartum weeks is warranted for at-risk women.
本研究的目的是,在产后2至4周被确定为抑郁症状加重的女性样本中,考察从产后到分娩后2年期间母亲抑郁症状随时间的变化情况,采用纵向受试者内设计来考察母亲抑郁症状的变化。分娩后两年,62名在产后2至4周抑郁评分升高的女性完成了邮寄问卷,包括一份人口信息表、贝克抑郁量表第二版和育儿压力指数。在这个女性样本中,30.6%在分娩后2年的抑郁评分处于抑郁范围。尽管抑郁评分随时间下降,但平均评分的显著变化发生在产后4至8周和10至14周之间,从10至14周、14至18周直到分娩后2年,平均评分没有显著变化。抑郁病史、总体社会支持较低以及父母困扰与分娩后2年母亲的抑郁评分较高有关。抑郁评分最初下降表明,产后抑郁症状对许多女性来说是一个有时间限制的问题,在分娩后4至8周出现峰值。然而,对许多女性来说,抑郁症状在分娩后2年仍然存在。既往抑郁、当前支持有限以及父母困扰会增加抑郁症状的严重程度。需要更多纵向研究来确定增加和改善慢性母亲抑郁风险的因素。对有风险的女性而言,在产后早期几周之后对母亲抑郁进行临床评估是必要的。