Wright Nicola, Hill Jonathan, Pickles Andrew, Sharp Helen
Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom.
School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom.
PLoS One. 2015 Dec 8;10(12):e0144131. doi: 10.1371/journal.pone.0144131. eCollection 2015.
The precipitating role of life events in the onset of depression is well-established. The present study sought to examine whether life events hypothesised to be personally salient would be more strongly associated with depression than other life events. In a sample of women making the first transition to parenthood, we hypothesised that negative events related to the partner relationship would be particularly salient and thus more strongly predictive of depression than other events.
A community-based sample of 316 first-time mothers stratified by psychosocial risk completed interviews at 32 weeks gestation and 29 weeks postpartum to assess dated occurrence of life events and depression onsets from conception to 29 weeks postpartum. Complete data was available from 273 (86.4%). Cox proportional hazards regression was used to examine risk for onset of depression in the 6 months following a relationship event versus other events, after accounting for past history of depression and other potential confounders.
52 women (19.0%) experienced an onset of depression between conception and 6 months postpartum. Both relationship events (Hazard Ratio = 2.1, p = .001) and other life events (Hazard Ratio = 1.3, p = .020) were associated with increased risk for depression onset; however, relationship events showed a significantly greater risk for depression than did other life events (p = .044).
The results are consistent with the hypothesis that personally salient events are more predictive of depression onset than other events. Further, they indicate the clinical significance of events related to the partner relationship during pregnancy and the postpartum.
生活事件在抑郁症发作中的促发作用已得到充分证实。本研究旨在探讨那些被认为对个人具有显著意义的生活事件是否比其他生活事件与抑郁症的关联更强。在首次经历为人父母转变的女性样本中，我们假设与伴侣关系相关的负面事件会特别显著，因此比其他事件更能有力地预测抑郁症。
以社区为基础，对316名首次生育的母亲按心理社会风险进行分层，在妊娠32周和产后29周进行访谈，以评估从受孕到产后29周生活事件和抑郁症发作的发生时间。273名（86.4%）有完整数据。在考虑抑郁症既往史和其他潜在混杂因素后，使用Cox比例风险回归分析来检验在发生关系事件与其他事件后的6个月内抑郁症发作的风险。
52名女性（19.0%）在受孕至产后6个月内出现抑郁症发作。关系事件（风险比=2.1，p = 0.001）和其他生活事件（风险比=1.3，p = 0.020）均与抑郁症发作风险增加相关；然而，关系事件显示出比其他生活事件显著更高的抑郁症风险（p = 0.044）。
结果与以下假设一致，即对个人具有显著意义的事件比其他事件更能预测抑郁症发作。此外，它们表明了孕期和产后与伴侣关系相关事件的临床意义。
