Centre for Public Health Research, Avda. Catalunya, 21, 46020, Valencia, Spain.
Eur Arch Psychiatry Clin Neurosci. 2013 Mar;263(2):143-51. doi: 10.1007/s00406-012-0336-5. Epub 2012 Jun 29.
The aim of this study was to determine the effect of isolated psychological intimate partner violence and psychosocial factors (social support and alcohol or drug use by a partner/family member) on psychological well-being (depression or poor self-perceived health status) at 5 and 12 months post-partum. A longitudinal cohort study was carried out with a consecutive sample of 1,400 women in their first trimester of pregnancy, who attended the prenatal programme in the Valencia Region (Spain) in 2008 and were followed up at 5 months and 12 months post-partum. A logistic regression model was fitted using generalized estimating equations, to assess the effect of isolated psychological intimate partner violence, social support, alcohol consumption and illicit drug use problems by a partner or family member on subsequent psychological well-being at follow-up. We observed a decrease in the incidence of poorer psychological well-being (post-partum depression and poor self-perceived health status) at 12 months post-partum. The strongest predictor of poor psychological well-being was depression (AOR = 6.83, 95 % CI: 3.44-13.58) or poor self-perceived health status (AOR = 5.34, 95 % CI: 2.37-12.02) during pregnancy. Isolated psychological IPV increased the risk of a deterioration in psychological well-being. Having a tangible social network was also a predictor of both post-partum depression and poor self-perceived health status. The effect of functional social support varied according to the type of psychological well-being indicator being used. Problems of alcohol consumption or illicit drug use by a partner or family member were a predictor of post-partum depression only. Psychological well-being during the first year after birth is highly affected by isolated psychological IPV and psychosocial factors.
本研究旨在确定孤立的心理亲密伴侣暴力和心理社会因素（社会支持以及伴侣/家庭成员的酒精或药物使用）对产后 5 个月和 12 个月心理健康（抑郁或自我感知健康状况不佳）的影响。采用纵向队列研究，对 2008 年在西班牙巴伦西亚地区参加产前计划的 1400 名处于妊娠第一 trimester 的连续样本进行研究，并在产后 5 个月和 12 个月进行随访。使用广义估计方程拟合逻辑回归模型，以评估孤立的心理亲密伴侣暴力、社会支持、伴侣或家庭成员的酒精使用和非法药物使用问题对随访时随后心理健康的影响。我们观察到产后 12 个月时较差的心理健康（产后抑郁和自我感知健康状况不佳）发生率有所下降。较差的心理健康的最强预测因子是抑郁（AOR=6.83，95%CI：3.44-13.58）或自我感知健康状况不佳（AOR=5.34，95%CI：2.37-12.02）在怀孕期间。孤立的心理 IPV 增加了心理健康恶化的风险。拥有有形的社交网络也是产后抑郁和自我感知健康状况不佳的预测因子。功能社会支持的影响根据所使用的心理健康指标的类型而有所不同。伴侣或家庭成员的酒精使用或非法药物使用问题仅预测产后抑郁。产后第一年的心理健康高度受孤立的心理 IPV 和心理社会因素的影响。
