Fairbrother Nichole, Janssen Patricia, Antony Martin M, Tucker Emma, Young Allan H
Department of Psychiatry, Island Medical Program, University of British Columbia, Canada.
UBC School of Population and Public Health, Canada.
J Affect Disord. 2016 Aug;200:148-55. doi: 10.1016/j.jad.2015.12.082. Epub 2016 Apr 14.
Anxiety and related disorders (AD) disproportionately affect women, and are the most prevalent of all mental health conditions. The current research represents the first study of maternal postpartum AD prevalence in which all of the AD are assessed, and one of few studies of this type in which maternal prenatal AD incidence is assessed.
A Canadian sample of pregnant women (N=310) was recruited from a defined geographical area between November 2007 and November 2010. Participants were first administered postnatal mood and anxiety screening measures. Those who scored at or above cutoff on one or more of these measures were administered a diagnostic interview for depression and anxiety at approximately three months postpartum (n=115). Findings from the diagnostic interview were used to estimate the prevalence and incidence of mood and AD in pregnancy, as well as at and during the first three months postpartum. Period prevalence and incidence estimates were obtained retrospectively from interview data collected postnatally.
The prevalence of AD during pregnancy and the early postpartum period (15.8% and 17.1% respectively) exceeded that of depression (3.9% and 4.8% respectively). The prevalence of OCD in our sample exceeded that of OCD among adults aged 18-64. Parity was unrelated to AD prevalence. Slightly less than 5% of participants were comorbid for both AD, and depression.
This study is limited by a relatively small sample size for a prevalence study, and non-random sample selection. As only women who scored above cutoff on one or more screening measures were interviewed, prevalence estimates are conservative. Finally, prenatal prevalence estimates are based on retrospective report provided postpartum.
This study provides evidence that, as a group, anxiety and related conditions affect a significant proportion of postpartum women, and are more prevalent than is postpartum depression.
焦虑及相关障碍(AD)对女性的影响尤为严重,是所有心理健康状况中最为普遍的。当前的研究是首次对产后母亲AD患病率进行的研究,其中评估了所有的AD,也是少数此类研究中评估母亲产前AD发病率的研究之一。
2007年11月至2010年11月期间,从一个特定地理区域招募了一组加拿大孕妇样本(N = 310)。参与者首先接受产后情绪和焦虑筛查措施。在这些措施中一项或多项得分达到或高于临界值的参与者,在产后约三个月接受抑郁和焦虑的诊断访谈(n = 115)。诊断访谈的结果用于估计孕期以及产后头三个月及期间情绪和AD的患病率和发病率。时期患病率和发病率估计值是从产后收集的访谈数据中回顾性获得的。
孕期和产后早期AD的患病率(分别为15.8%和17.1%)超过了抑郁症的患病率(分别为3.9%和4.8%)。我们样本中强迫症的患病率超过了18 - 64岁成年人中强迫症的患病率。产次与AD患病率无关。略少于5%的参与者同时患有AD和抑郁症。
这项研究因患病率研究的样本量相对较小以及非随机样本选择而受到限制。由于仅对在一项或多项筛查措施中得分高于临界值的女性进行了访谈,患病率估计较为保守。最后,产前患病率估计基于产后提供的回顾性报告。
这项研究提供了证据,表明焦虑及相关状况作为一个群体,影响了相当比例的产后女性,并且比产后抑郁症更为普遍。