Holley Sarah R, Pasch Lauri A, Bleil Maria E, Gregorich Steven, Katz Patricia K, Adler Nancy E
Department of Psychology, San Francisco State University, San Francisco, California.
Department of Psychiatry, University of California, San Francisco, San Francisco, California.
Fertil Steril. 2015 May;103(5):1332-9. doi: 10.1016/j.fertnstert.2015.02.018. Epub 2015 Mar 18.
To examine the prevalence and predictors of major depressive disorder (MDD) for women and their partners during the course of fertility treatment.
Prospective cohort study during an 18-month period. Participants completed interviews and questionnaires at baseline and at 4, 10, and 18 months of follow-up.
Five community and academic fertility practices.
PATIENT(S): A total of 174 women and 144 of their male partners who did not have a successful child-related outcome during the time frame of the study.
INTERVENTION(S): No interventions administered.
MAIN OUTCOME MEASURE(S): The MDD was assessed using the Composite International Diagnostic Interview Major Depression module, a structured diagnostic interview. Additional variables were assessed with self-report questionnaire measures.
RESULT(S): Of the women 39.1% and of the men 15.3% met the criteria for MDD during the 18-month course of the study. A binary logistic covariate-adjusted model showed that, for both women and men, past MDD was a significant predictor of MDD during treatment. Past MDD further predicted significant risk for MDD during treatment after controlling for other well-established risk factors (i.e., baseline levels of depression, anxiety, and partner support).
CONCLUSION(S): The MDD was highly prevalent for fertility treatment patients and their partners. Past MDD predicted risk for MDD during treatment, and it contributed to MDD risk more than other commonly assessed risk factors. This suggests that patients and their partners would benefit from being routinely assessed for a history of MDD before the start of treatment to best direct psychosocial support and interventions to those most in need.
研究女性及其伴侣在生育治疗过程中重度抑郁症（MDD）的患病率及预测因素。
为期18个月的前瞻性队列研究。参与者在基线以及随访的第4、10和18个月完成访谈和问卷调查。
五个社区和学术性生育治疗机构。
共有174名女性及其144名男性伴侣，他们在研究期间未获得与孩子相关的成功结果。
未实施干预措施。
使用综合国际诊断访谈中的重度抑郁模块（一种结构化诊断访谈）评估MDD。通过自我报告问卷测量评估其他变量。
在18个月的研究过程中，39.1%的女性和15.3%的男性符合MDD标准。二元逻辑协变量调整模型显示，对于女性和男性而言，既往MDD都是治疗期间MDD的显著预测因素。在控制了其他已确定的风险因素（即抑郁、焦虑的基线水平以及伴侣支持）后，既往MDD进一步预测了治疗期间MDD的显著风险。
MDD在生育治疗患者及其伴侣中非常普遍。既往MDD可预测治疗期间患MDD的风险，并且它比其他常见评估的风险因素对MDD风险的影响更大。这表明，患者及其伴侣在治疗开始前接受MDD病史的常规评估将受益，以便将心理社会支持和干预措施最有效地指向最需要的人群。
