FHI 360, Washington, DC, USA. Now with Duke Global Health Institute at Duke University, Durham, NC, USA
University of North Carolina at Chapel Hill, Gillings School of Public Health, Chapel Hill, NC, USA.
Glob Health Sci Pract. 2014 Dec 10;2(4):482-6. doi: 10.9745/GHSP-D-14-00119.
Postpartum common mental disorders (CMD) such as depression and anxiety are increasingly recognized for their burden in low-resource countries such as Ethiopia. However, the magnitude of postpartum CMD in Ethiopia is not well-established. This short report describes the mental health status of women who had given birth in the last 24 months in the Amhara region of Ethiopia.
A cross-sectional survey was conducted among 1,319 women aged 15-49 years old who had a delivery in the previous 24 months from 30 randomly selected kebeles (smallest administrative unit in Ethiopia) across Amhara region. The survey included the Self-Reporting Questionnaire (SRQ-20) developed by the World Health Organization-a CMD screening instrument that includes 20 yes/no questions on depression, anxiety, and somatic symptoms experienced in the last 30 days. We used 2 cutoff scores to determine probable cases of mental disorder: (1) 4/5 (≤ 4 "yes" responses=non-case, ≥ 5 "yes" responses=case) based on a study that validated the SRQ-20 against a diagnostic tool in Butajira, Ethiopia, and (2) a more conservative and commonly used 7/8 cutoff.
Among the 1,294 women who completed the full survey including the SRQ-20, 32.8% had probable CMD using the 4/5 cutoff score versus 19.8% using the more conservative 7/8 cutoff. About 15% of the women responded affirmatively that they had had suicidal thoughts.
Poor mental health was common among the surveyed women who had given birth in the past 24 months in Amhara region, Ethiopia. Integrating mental health care into maternal and child health services could potentially alleviate the burden of CMD among women in the extended postpartum period.
产后常见精神障碍（CMD），如抑郁和焦虑，在埃塞俄比亚等资源匮乏的国家的负担日益加重。然而，埃塞俄比亚产后 CMD 的严重程度尚未得到充分证实。本简短报告描述了在埃塞俄比亚阿姆哈拉地区过去 24 个月内分娩的妇女的心理健康状况。
对来自阿姆哈拉地区 30 个随机选定的 kebeles（埃塞俄比亚最小的行政单位）中过去 24 个月内分娩的 1319 名 15-49 岁的妇女进行了横断面调查。该调查包括世界卫生组织（WHO）开发的自我报告问卷（SRQ-20），这是一种 CMD 筛查工具，包括过去 30 天内抑郁、焦虑和躯体症状的 20 个是/否问题。我们使用了 2 个截止分数来确定可能患有精神障碍的病例：（1）4/5（≤ 4“是”反应=非病例，≥ 5“是”反应=病例），这是基于一项在埃塞俄比亚布塔吉拉验证了 SRQ-20 与诊断工具的研究，（2）更保守且常用的 7/8 截止分数。
在完成了包括 SRQ-20 在内的完整调查的 1294 名妇女中，使用 4/5 截止分数，有 32.8%患有可能的 CMD，而使用更保守的 7/8 截止分数，则有 19.8%患有可能的 CMD。约 15%的妇女回答肯定有过自杀念头。
在埃塞俄比亚阿姆哈拉地区过去 24 个月内分娩的调查妇女中，精神健康状况不佳的情况很常见。将心理健康护理纳入母婴健康服务中，有可能减轻产后扩展期妇女的 CMD 负担。
