Mann Joshua R, McKeown Robert E, Bacon Janice, Vesselinov Roumen, Bush Freda
Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia 29203, USA.
Int J Psychiatry Med. 2007;37(3):301-13. doi: 10.2190/PM.37.3.g.
Depression during pregnancy has potential repercussions for both women and infants. Religious and spiritual characteristics may be associated with fewer depressive symptoms. This study examines the association between religiosity/spirituality and depressive symptoms in pregnant women.
Pregnant women in three southern obstetrics practices were included in a cross sectional study evaluating religiosity, spirituality, and depressive symptoms. Symptoms of depression were measured using the Edinburgh Postnatal Depression Scale (EPDS). The depression outcome was measured in two ways: the EPDS score as a continuous outcome, and a score at or above the recommended EPDS cutoff (> 14). A wide array of potential confounders was addressed. Special attention was given to the interplay between religiosity/spirituality, social support, and depressive symptoms.
The mean EPDS score was 9.8 out of a maximum possible score of 30. Twenty-eight women (8.1%) scored above the recommended EPDS cutoff score. Overall religiosity/spirituality was significantly associated with fewer depressive symptoms when controlling for significant covariates, but there was a significant interaction such that the association became weaker as social support increased. Social support did not appear to be an important mediator (intermediate step) in the pathway between religiosity/spirituality and depressive symptoms.
Religiosity and spirituality may help protect from depressive symptoms when social support is lacking. Longitudinal research is needed to assess the directionality of the observed relationships.
孕期抑郁对女性和婴儿都有潜在影响。宗教和精神特质可能与较少的抑郁症状相关。本研究探讨孕妇宗教信仰/精神性与抑郁症状之间的关联。
对南方三家产科诊所的孕妇进行一项横断面研究，评估宗教信仰、精神性和抑郁症状。使用爱丁堡产后抑郁量表（EPDS）测量抑郁症状。抑郁结局通过两种方式测量：EPDS得分作为连续结局，以及EPDS得分达到或高于推荐临界值（>14）。考虑了一系列潜在的混杂因素。特别关注宗教信仰/精神性、社会支持和抑郁症状之间的相互作用。
EPDS的最高可能得分为30分，平均得分为9.8分。28名女性（8.1%）的得分高于推荐的EPDS临界值。在控制显著协变量时，总体宗教信仰/精神性与较少的抑郁症状显著相关，但存在显著的交互作用，即随着社会支持的增加，这种关联变得较弱。社会支持似乎不是宗教信仰/精神性与抑郁症状之间路径中的重要中介因素（中间步骤）。
当缺乏社会支持时，宗教信仰和精神性可能有助于预防抑郁症状。需要进行纵向研究来评估所观察到的关系的方向性。
