Dept Psychiatry, University of Melbourne, Austin Health, Heidelberg 3081, Victoria, Australia.
J Affect Disord. 2011 Jun;131(1-3):277-83. doi: 10.1016/j.jad.2011.01.003. Epub 2011 Jan 26.
There are limited studies of generalized anxiety disorder (GAD) across pregnancy.
Women (n = 2793) were enrolled in the Yale Pink and Blue study, a cohort enriched with subjects who suffered from major depressive disorder (MDD) within the past five years or used antidepressants in the past year. Subjects were evaluated with the Composite International Diagnostic Interview at three time points: twice in pregnancy and once after delivery. We defined a generalized anxiety disorder (GAD) episode as per DSM IV but with required duration reduced to one month or longer. Course and correlates of GAD were examined in women who had: 1) no GAD during the 6 months prior or in pregnancy (Group A), 2) GAD in the 6 months prior to but not in pregnancy (Group B), 3) GAD in pregnancy only (Group C) and 4) GAD both in the 6 months prior to and during pregnancy (Group D).
9.5% of the cohort suffered from GAD at some point in pregnancy. Anxiety symptoms were highest in the first trimester and decreased across pregnancy. Regression analysis revealed that previous GAD episodes, education, social support and a history of child abuse distinguished between membership in the four groups.
The sample may not be representational, as it was enhanced with those at risk, and had relatively low representation of socio-economically disadvantaged women.
Identification of anxious patients during pregnancy may provide an opportunity to engage those in need of psychiatric treatment.
针对妊娠期广泛性焦虑障碍（GAD）的研究有限。
共有 2793 名女性参加了耶鲁大学的“粉色和蓝色研究”，该研究队列纳入了过去五年内患有重度抑郁症（MDD）或过去一年中使用过抗抑郁药的受试者。研究对象在三个时间点接受了复合国际诊断访谈：两次在妊娠期间，一次在分娩后。我们根据 DSM-IV 定义了广泛性焦虑障碍（GAD）发作，但将其必需的持续时间缩短至一个月或更长。在以下四种情况下，我们研究了 GAD 的发病情况和相关因素：1）在怀孕前 6 个月或怀孕期间没有 GAD（A 组）；2）在怀孕前 6 个月有 GAD，但怀孕期间没有（B 组）；3）仅在怀孕期间有 GAD（C 组）；4）在怀孕前 6 个月和怀孕期间都有 GAD（D 组）。
研究队列中有 9.5%的女性在某个时间点患有 GAD。焦虑症状在孕早期最高，并在整个孕期逐渐下降。回归分析显示，先前的 GAD 发作、教育程度、社会支持和儿童虐待史可区分四组的成员。
该样本可能无法代表所有人群，因为它是通过风险人群增强的，且在社会经济地位较低的女性中代表性相对较低。
在怀孕期间识别焦虑患者可能为需要精神治疗的患者提供了机会。
