Harville Emily W, Xiong Xu, Pridjian Gabriella, Elkind-Hirsch Karen, Buekens Pierre
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
BMC Pregnancy Childbirth. 2009 Jun 8;9:21. doi: 10.1186/1471-2393-9-21.
Natural disaster is often a cause of psychopathology, and women are vulnerable to post-traumatic stress disorder (PTSD) and depression. Depression is also common after a woman gives birth. However, no research has addressed postpartum women's mental health after natural disaster.
Interviews were conducted in 2006-2007 with women who had been pregnant during or shortly after Hurricane Katrina. 292 New Orleans and Baton Rouge women were interviewed at delivery and 2 months postpartum. Depression was assessed using the Edinburgh Depression Scale and PTSD using the Post-Traumatic Stress Checklist. Women were asked about their experience of the hurricane with questions addressing threat, illness, loss, and damage. Chi-square tests and log-binomial/Poisson models were used to calculate associations and relative risks (RR).
Black women and women with less education were more likely to have had a serious experience of the hurricane. 18% of the sample met the criteria for depression and 13% for PTSD at two months postpartum. Feeling that one's life was in danger was associated with depression and PTSD, as were injury to a family member and severe impact on property. Overall, two or more severe experiences of the storm was associated with an increased risk for both depression (relative risk (RR) 1.77, 95% confidence interval (CI) 1.08-2.89) and PTSD (RR 3.68, 95% CI 1.80-7.52).
Postpartum women who experience natural disaster severely are at increased risk for mental health problems, but overall rates of depression and PTSD do not seem to be higher than in studies of the general population.
自然灾害常常是精神病理学的一个成因,女性易患创伤后应激障碍(PTSD)和抑郁症。产后抑郁症也很常见。然而,尚无研究探讨自然灾害后产后女性的心理健康状况。
2006年至2007年,对在卡特里娜飓风期间或之后不久怀孕的女性进行了访谈。对292名新奥尔良和巴吞鲁日的女性在分娩时及产后2个月进行了访谈。使用爱丁堡抑郁量表评估抑郁情况,使用创伤后应激检查表评估创伤后应激障碍。询问女性关于她们经历飓风的情况,问题涉及威胁、疾病、损失和破坏。采用卡方检验和对数二项式/泊松模型来计算关联和相对风险(RR)。
黑人女性和受教育程度较低的女性更有可能有过严重的飓风经历。18%的样本在产后两个月符合抑郁症标准,13%符合创伤后应激障碍标准。感觉自己生命受到威胁与抑郁症和创伤后应激障碍相关,家庭成员受伤和财产受到严重影响也与之相关。总体而言,经历两次或更多次严重的风暴经历与抑郁症(相对风险(RR)1.77,95%置信区间(CI)1.08 - 2.89)和创伤后应激障碍(RR 3.68,95% CI 1.80 - 7.52)的风险增加相关。
经历严重自然灾害的产后女性心理健康问题风险增加,但抑郁症和创伤后应激障碍的总体发生率似乎并不高于普通人群的研究。