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产后最初三个月的产后情绪低落作为DSM-IV抑郁和焦虑症的预测指标。

Maternity blues as a predictor of DSM-IV depression and anxiety disorders in the first three months postpartum.

作者信息

Reck Corinna, Stehle Eva, Reinig Katja, Mundt Christoph

机构信息

Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany.

出版信息

J Affect Disord. 2009 Feb;113(1-2):77-87. doi: 10.1016/j.jad.2008.05.003. Epub 2008 Jun 24.

Abstract

BACKGROUND

Maternity blues have been described as a relevant risk factor for postpartum depression. Information regarding the influence of maternity blues on the onset and course of clinical postpartum anxiety disorders is scarce. The goal of this study was to determine whether maternity blues significantly predict postpartum depression and anxiety disorders in the first 3 months after delivery in a German sample. Demographic, psychiatric, and obstetric correlates of maternity blues were also investigated.

METHODS

Maternity blues were assessed 2 weeks after delivery in a community sample of 853 women using a telephone interview and the Patient Health Questionnaire-Depression. Depression and anxiety disorders were diagnosed according to DSM-IV criteria over the first 3 months following delivery. A two-stage screening procedure was applied. In a first stage, the Patient Health Questionnaire-Depression, the Edinburgh Depression Scale, and two anxiety-screening instruments were employed. In the case of clinically relevant scores, the Structured Clinical Interview for DSM-IV was administered in a second stage.

RESULTS

The estimated prevalence rate of maternity blues among German women was 55.2%. We found a significant association between maternity blues and postpartum depression (odds ratio: 3.8) and between maternity blues and anxiety disorders (odds ratio=3.9).

LIMITATIONS

Based on our predominantly middle class low-risk sample, maternity blues prevalence may be underestimated. Retrospective assessment of maternity blues 2 weeks postpartum might lead to biased results.

CONCLUSIONS

Women with maternity blues should be carefully observed in the first weeks postpartum with the aim of identifying those at risk of developing postpartum depression/anxiety disorders and providing treatment at an early stage of the disorder.

摘要

背景

产后情绪低落被认为是产后抑郁症的一个相关风险因素。关于产后情绪低落对临床产后焦虑症的发病及病程影响的信息较少。本研究的目的是确定在德国样本中,产后情绪低落是否能显著预测分娩后前3个月的产后抑郁症和焦虑症。同时还调查了产后情绪低落的人口统计学、精神病学及产科相关因素。

方法

在一个由853名女性组成的社区样本中,于产后2周通过电话访谈和患者健康问卷抑郁量表对产后情绪低落进行评估。在分娩后的前3个月,根据《精神疾病诊断与统计手册》第四版标准诊断抑郁症和焦虑症。采用两阶段筛查程序。在第一阶段,使用患者健康问卷抑郁量表、爱丁堡抑郁量表和两种焦虑筛查工具。对于临床相关评分,在第二阶段进行《精神疾病诊断与统计手册》第四版的结构化临床访谈。

结果

德国女性产后情绪低落的估计患病率为55.2%。我们发现产后情绪低落与产后抑郁症之间存在显著关联(优势比:3.8),以及产后情绪低落与焦虑症之间存在显著关联(优势比 = 3.9)。

局限性

基于我们主要为中产阶级低风险的样本,产后情绪低落的患病率可能被低估。产后2周对产后情绪低落进行回顾性评估可能会导致有偏差的结果。

结论

产后情绪低落的女性在产后最初几周应受到密切观察,以便识别出有患产后抑郁症/焦虑症风险的人群,并在疾病早期提供治疗。

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