Culture, Community, and Health Studies, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
Curr Opin Psychiatry. 2010 Jul;23(4):342-8. doi: 10.1097/YCO.0b013e32833ad721.
Although there has been an increase in research on postpartum depression (PPD), an inadequate focus has been placed on immigrant women. This is a significant limitation given the rapidly changing demographics in North America.
Immigrants face unique and multiple layers of challenges that may compromise their mental health and prevent them from receiving adequate and equitable care. For immigrant women, many of these stressors are especially compounded in the vulnerable postpartum period, resulting in PPD. Cultural values and practices may be protective in some instances, whereas in other instances they exacerbate PPD. There is a significant gap in existing literature regarding the complex psychosocial, cultural, and spiritual factors that may moderate the effects of the depression. Furthermore, the measurement of PPD is hampered by cross-cultural methodological challenges.
Given the complexity of the psychosocial issues facing immigrant women, there is a need to develop a comprehensive response toward addressing the multifaceted challenges, ensuring equitable immigration and related policies; adequate community resources and social services to address social determinants of health; inclusiveness in public health and prevention strategies; equitable access to a culturally competent healthcare system; capacity building of marginalized communities; and culturally competent interventions at the individual level. Additional research using the bidimensional model of acculturation is needed.
目的综述：尽管有关产后抑郁症（PPD）的研究有所增加，但对移民妇女的关注却不足。鉴于北美人口结构的迅速变化，这是一个重大的局限性。
最近发现：移民面临着独特的、多层次的挑战，这可能会损害他们的心理健康，并使他们无法获得充分和平等的护理。对于移民妇女来说，许多这些压力因素在脆弱的产后时期尤其严重，导致 PPD。在某些情况下，文化价值观和实践可能具有保护作用，而在其他情况下，它们会使 PPD 恶化。现有文献在复杂的社会心理、文化和精神因素方面存在很大差距，这些因素可能会调节抑郁的影响。此外，PPD 的测量受到跨文化方法学挑战的阻碍。
总结：鉴于移民妇女面临的社会心理问题的复杂性，需要制定全面的应对措施，解决多方面的挑战，确保移民和相关政策公平；提供足够的社区资源和社会服务，以解决健康的社会决定因素；在公共卫生和预防策略中包容；公平获得文化能力强的医疗保健系统；建设边缘化社区的能力；并在个人层面进行文化能力干预。需要使用双维度的文化适应模型进行更多的研究。
