Bergner Annekathrin, Beyer Reinhard, Klapp Burghard F, Rauchfuss Martina
Medizinische Klinik mit Schwerpunkt Psychosomatik und Psychotherapie, Charité-Universitätsmedizin Berlin.
Psychother Psychosom Med Psychol. 2009 Feb;59(2):57-67. doi: 10.1055/s-2008-1067353. Epub 2008 Apr 22.
A few weeks after miscarriage 232 women were questioned with standardized questionnaires and symptom scales about the way in which they coped with an early miscarriage (up to the 16th week of gestation) about mourning processes and subjective attribution as well as anamnestic and psychosocial characteristics. Seven and fourteen months after pregnancy loss and if necessary in the first trimester of a following pregnancy the psychological symptoms of the women (fear and depressive symptoms) were evaluated. A few weeks after miscarriage we found with main component analysis three patterns of coping. The pattern of "depressive coping" could be diagnosed as a predictor of increased depression seven months after the miscarriage and in a new pregnancy. Depressive pathology in a new pregnancy of the women with early pregnancy loss can be predicted also over the pattern of "anxious grieving". On the other hand, the pattern of "active coping" is associated with lower state anxiety in a new pregnancy. Lack of perceived partner support and past divorces or separations are risk factors for increased fears in a new pregnancy. These results suggest that women who have had an early miscarriage especially if they have maladaptive coping patterns and psychosocial risk factor for maladjustment need prevention of psychological disturbances with an integrated psychosomatic concept.
流产几周后,对232名女性进行了标准化问卷调查和症状量表询问,内容涉及她们应对早期流产(妊娠16周以内)的方式、哀伤过程、主观归因以及既往史和心理社会特征。在流产后7个月和14个月,必要时在随后妊娠的头三个月,对这些女性的心理症状(恐惧和抑郁症状)进行评估。流产几周后,通过主成分分析我们发现了三种应对模式。“抑郁应对”模式可被诊断为流产后7个月以及再次怀孕时抑郁加重的一个预测指标。早期流产女性再次怀孕时的抑郁病理情况也可通过“焦虑哀伤”模式进行预测。另一方面,“积极应对”模式与再次怀孕时较低的状态焦虑有关。感知到的伴侣支持不足以及过去的离婚或分居是再次怀孕时恐惧增加的风险因素。这些结果表明,经历过早期流产的女性,尤其是那些具有适应不良应对模式和心理社会适应不良风险因素的女性,需要采用综合的心身概念来预防心理障碍。