Munhoz Tiago N, Santos Iná S, Barros Aluísio J D, Anselmi Luciana, Barros Fernando C, Matijasevich Alicia
Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Faculty of Psychology, Federal University of Pelotas, Pelotas, Brazil.
Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
J Affect Disord. 2017 Jun;215:263-268. doi: 10.1016/j.jad.2017.03.040. Epub 2017 Mar 19.
To date, there have been few studies of DMDD examining the risk factors during gestation and during the first years of life. We assessed the perinatal and postnatal risk factors associated with the occurrence of disruptive mood dysregulation disorder (DMDD) by 11 years of age.
Prospective longitudinal study. Mothers completed a standardized questionnaire shortly after childbirth. We used the Development and Well-Being Assessment, administered to the mothers or legal guardians, to identify DMDD among the 11-year-old subjects. We also employed logistic regression to perform bivariate and multivariate analyses, using a theoretical model of conceptual analysis.
We evaluated data related to 3563 subjects at 11 years of age. The prevalence of DMDD was 2.5% (95% CI=2.0-3.0). After adjusting for potential confounders, we found that the early risk factors for the development of DMDD by 11 years of age were maternal mood symptoms during pregnancy, maternal depression during the first years after childbirth, and low maternal level of education.
We were unable to evaluate the genetic characteristics of the family at the birth of each subject, and there were no data available regarding the prenatal or postnatal mental health of the fathers.
The prevalence of DMDD in early adolescence is low and its risk factors are related to potentially modifiable maternal characteristics. Scientific evidence indicates that DMDD is a major predictor of other psychiatric disorders, especially depression and anxiety. Effective prenatal and postnatal mental health care could prevent mental disorders in offspring.
迄今为止,关于破坏性心境失调障碍(DMDD)在孕期及生命最初几年风险因素的研究较少。我们评估了与11岁时出现DMDD相关的围产期和产后风险因素。
前瞻性纵向研究。母亲在分娩后不久完成一份标准化问卷。我们使用向母亲或法定监护人发放的发育与幸福感评估量表,来确定11岁受试者中的DMDD。我们还采用逻辑回归进行双变量和多变量分析,并使用概念分析的理论模型。
我们评估了3563名11岁受试者的数据。DMDD患病率为2.5%(95%置信区间=2.0-3.0)。在对潜在混杂因素进行调整后,我们发现11岁时DMDD发生的早期风险因素为孕期母亲情绪症状、产后头几年母亲抑郁以及母亲低教育水平。
我们无法评估每个受试者出生时家庭的遗传特征,且没有关于父亲产前或产后心理健康的数据。
青春期早期DMDD患病率较低,其风险因素与潜在可改变的母亲特征有关。科学证据表明,DMDD是其他精神障碍尤其是抑郁和焦虑的主要预测因素。有效的产前和产后心理健康护理可预防后代精神障碍。