Department of Family Medicine & Community Health, University of Minnesota, 580 Rice Street, St. Paul, MN 55103, USA.
J Womens Health (Larchmt). 2011 Mar;20(3):381-6. doi: 10.1089/jwh.2010.2355. Epub 2011 Feb 25.
To investigate mothers' changes in prevalence of postpartum depression (PPD) symptoms over 0-9 months postpartum and determine which symptoms best distinguish depressed from nondepressed women.
This was a prospective study of English-literate mothers of newborns, recruited from four family medicine clinics and three pediatric clinics. Mothers completed surveys at 0-1, 2, 4, 6, and 9 months postpartum, and surveys included demographic characteristics, a two-question depression screen, the 9-Item Patient Health Questionnaire (PHQ-9), and other health and work characteristics.
There were 506 participants (33% response rate), and 112 (22.1%) had a positive PHQ-9 (score ≥10) at some time within the first 9 months after delivery. The proportion of women with a positive PHQ-9 was greatest at 0-1 month (12.5%), then fell to between 5.0% and 7.1% at 2-6 months, and rose again to 10.2% at 9 months postpartum. Most of the PHQ-9 symptoms differentiated well between depressed and nondepressed women; items that were less discriminating were abnormal sleep, abnormal appetite/eating, and fatigue. Assessment of possible predictors of a change from negative to positive PHQ-9 between 6 and 9 months postpartum revealed only one significant predictor: prior history of depression.
Depressive symptoms in this sample were most frequent at 0-1 month and 9 months postpartum. Most PHQ-9 items differentiated well between depressed and nondepressed mothers; these findings support the use of the PHQ-9 for PPD screening. Future research is needed to confirm our observed secondary peak in depressive symptoms at 9 months postpartum and to investigate possible causes.
调查产妇产后 0-9 个月期间产后抑郁症（PPD）症状的变化，并确定哪些症状最能区分抑郁和非抑郁女性。
这是一项针对新生儿英语熟练母亲的前瞻性研究，从四家家庭医学诊所和三家儿科诊所招募。母亲在产后 0-1、2、4、6 和 9 个月时完成调查，调查包括人口统计学特征、两个问题的抑郁筛查、9 项患者健康问卷（PHQ-9）和其他健康和工作特征。
共有 506 名参与者（33%的回应率），112 名（22.1%）在产后 9 个月内的某个时间点 PHQ-9 呈阳性（得分≥10）。产后 0-1 个月时，女性 PHQ-9 阳性比例最高（12.5%），随后在 2-6 个月降至 5.0%-7.1%，产后 9 个月再次上升至 10.2%。PHQ-9 的大多数症状在抑郁和非抑郁女性之间区分良好；区分能力较差的项目包括睡眠异常、食欲/进食异常和疲劳。评估产后 6-9 个月 PHQ-9 从阴性转为阳性的可能预测因素，只有一个显著预测因素：既往抑郁史。
该样本中抑郁症状在产后 0-1 个月和 9 个月时最常见。大多数 PHQ-9 项目在抑郁和非抑郁母亲之间区分良好；这些发现支持使用 PHQ-9 进行 PPD 筛查。需要进一步研究来证实我们观察到的产后 9 个月时抑郁症状的二次高峰，并探讨可能的原因。
