Psychiatric Unit, Department of Neuropsychiatric Sciences, Florence University School of Medicine, Florence, Italy.
Arch Womens Ment Health. 2012 Feb;15(1):21-30. doi: 10.1007/s00737-011-0249-8. Epub 2011 Dec 29.
Accumulating evidence suggests that pregnancy does not protect women from mental illness. The aim of this study was to assess the prevalence, sociodemographic correlates, and the risks factors for perinatal depression and anxiety. Five hundred ninety women between 28th and the 32nd gestational weeks were recruited and submitted to a sociodemographic, obstetric, and psychological interview. The Edinburgh Postnatal Depression Scale (EPDS) and the state-trait anxiety inventory (STAI-Y) were also administered in antenatal period and 3 months postnatally. The Structured Clinical Interview for DSM-IV (SCID-I) was used to diagnose mood and anxiety disorders. Three months after delivery, EPDS was administered by telephone interview. Women with an EPDS score ≥10 were 129 in antenatal period (21.9%) and 78 in postnatal period (13.2%). During pregnancy 121 women (20.5%) were positive for STAI-Y state and 149 women (25.3%) for STAI-Y trait. The most important risk factors for antenatal depression are: foreign nationality, conflictual relationship with family and partner, and lifetime psychiatric disorders. The principal risk factors for postnatal depression are: psychiatric disorders during pregnancy and artificial reproductive techniques. Psychiatric disorders, during and preceding pregnancy, are the strongest risk factors for antenatal state and trait anxiety. Antenatal depressive and anxiety symptoms appear to be as common as postnatal symptoms. These results provide clinical direction suggesting that early identification and treatment of perinatal affective disorders is particularly relevant to avoid more serious consequences for mothers and child.
越来越多的证据表明,怀孕并不能保护女性免受精神疾病的影响。本研究旨在评估围产期抑郁和焦虑的患病率、社会人口学相关性以及危险因素。招募了 590 名处于 28 至 32 孕周的女性,并对其进行了社会人口学、产科和心理访谈。在产前和产后 3 个月还进行了爱丁堡产后抑郁量表(EPDS)和状态-特质焦虑量表(STAI-Y)评估。使用 DSM-IV 结构临床访谈(SCID-I)诊断心境和焦虑障碍。产后 3 个月通过电话访谈进行 EPDS 评估。在产前,EPDS 评分≥10 的女性有 129 人(21.9%),产后有 78 人(13.2%)。在怀孕期间,有 121 名女性(20.5%)STAI-Y 状态阳性,149 名女性(25.3%)STAI-Y 特质阳性。产前抑郁的最重要危险因素是:外国国籍、与家人和伴侣的冲突关系以及终生精神疾病。产后抑郁的主要危险因素是:怀孕期间和怀孕前的精神疾病以及人工生殖技术。怀孕期间和怀孕前的精神疾病是产前状态和特质焦虑的最强危险因素。产前抑郁和焦虑症状似乎与产后症状一样常见。这些结果为临床提供了指导,表明早期识别和治疗围产期情感障碍对于避免母亲和孩子出现更严重的后果尤为重要。