Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, 16150 Kota Bharu, Kelantan, Malaysia.
Women Health Development Unit, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia.
J Affect Disord. 2015 Apr 1;175:34-52. doi: 10.1016/j.jad.2014.12.041. Epub 2014 Dec 31.
The prevalence of postpartum depression worldwide varies from 0.5% to 60.8% in the first 12 months postpartum using self-reported questionnaire. This review aims to update the current magnitude of postpartum depression based on self-reported questionnaire and clinical interview and explore its associated factors in developed and developing countries.
A literature search conducted between 2005 and 2014 identified 203 studies, of which 191 used self-reported questionnaire in 42 countries and 21 used structured clinical interview in 15 countries. Nine studies used a combination of self-reported questionnaire and clinical interview.
The prevalence of postpartum depression varies from 1.9% to 82.1% in developing countries and from 5.2% to 74.0% in developed countries using self-reported questionnaire. Structured clinical interview shows a much lower prevalence range from 0.1% in Finland to 26.3% in India. Antenatal depression and anxiety, previous psychiatric illness, poor marital relationship, stressful life events, negative attitude towards pregnancy, and lack of social support are significant contributors to postpartum depression.
All studies are included irrespective of the methodological quality, such as small sample size and their inclusion could affect the generalizability of the results.
The current prevalence of postpartum depression is much higher than that previously reported, and similar risk factors are documented. A culturally sensitive cut-off score with adequate psychometric properties of the screening instruments should be available. In future studies, examining the physical, biological, and cultural factors in qualitative studies and in those with adequate methodological qualities is recommended.
使用自我报告问卷，全球范围内产后抑郁症的患病率在产后 12 个月内从 0.5%到 60.8%不等。本综述旨在根据自我报告问卷和临床访谈更新当前产后抑郁症的严重程度，并探讨发达国家和发展中国家的相关因素。
2005 年至 2014 年期间进行了文献检索，共确定了 203 项研究，其中 191 项在 42 个国家使用自我报告问卷，21 项在 15 个国家使用结构化临床访谈。9 项研究同时使用自我报告问卷和临床访谈。
使用自我报告问卷，发展中国家产后抑郁症的患病率从 1.9%到 82.1%不等，发达国家从 5.2%到 74.0%不等。结构化临床访谈显示的患病率范围要低得多，从芬兰的 0.1%到印度的 26.3%不等。产前抑郁和焦虑、既往精神病史、不良婚姻关系、生活压力事件、对怀孕的消极态度和缺乏社会支持是产后抑郁症的重要促成因素。
所有研究均包括在内，无论其方法学质量如何，例如样本量小，其纳入可能会影响结果的普遍性。
目前产后抑郁症的患病率远高于以往报道，且有相似的风险因素。应该有一个具有适当心理计量学特性的文化敏感的截断分数和筛查工具。在未来的研究中，建议在定性研究和具有足够方法学质量的研究中检查身体、生物和文化因素。
