Pingo Janine, van den Heuvel Leigh L, Vythylingum Bavinisha, Seedat Soraya
Department of Psychiatry, Faculty of Medicine and Health Sciences, University of Stellenbosch, PO Box 241, Cape Town, 8000, South Africa.
Arch Womens Ment Health. 2017 Jun;20(3):427-437. doi: 10.1007/s00737-017-0719-8. Epub 2017 Apr 4.
The aim of this study was to evaluate the frequency of, and factors associated with, postpartum hypomania (PPH) and postpartum depression (PPD) in a South African sample. Data from 57 women were analysed as part of a larger prospective study of maternal stress in pregnancy. On day 3 postpartum, women were assessed for probable PPH using the Highs scale. On day 3 and at week 6, probable PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS), while social support was evaluated using the Multidimensional Scale of Perceived Social Support (MSPSS). PPH was present in 49.1% of the participants at day 3 postpartum whilst PPD was present in 33.3% of participants on day 3 postpartum and in 45.6% at week 6. Participants meeting the clinical cut-off for both PPH and PPD on day 3 (17.5%) had significantly higher depression scores at week 6 than those with only PPH (p = 0.010) or only PPD (p = 0.035) on day 3. Depression scores on day 3 and lower social support scores at week 6 were predictive of PPD at week 6. Consistent with findings in other settings, early-onset PPD and poor social support were predictive of persisting PPD (i.e. at week 6). Women meeting criteria for both PPH and PPD on day 3 had greater depressive symptomatology at week 6. This may be indicative of an underlying bipolar disorder and warrants further investigation.
本研究旨在评估南非样本中产后轻躁狂（PPH）和产后抑郁症（PPD）的发生频率及其相关因素。作为一项关于孕期母亲压力的大型前瞻性研究的一部分，对57名女性的数据进行了分析。产后第3天，使用情绪高涨量表对女性进行PPH可能性评估。在产后第3天和第6周，使用爱丁堡产后抑郁量表（EPDS）评估PPD可能性，同时使用领悟社会支持多维量表（MSPSS）评估社会支持。产后第3天，49.1%的参与者出现PPH，而产后第3天33.3%的参与者出现PPD，第6周时这一比例为45.6%。在产后第3天同时达到PPH和PPD临床临界值的参与者（17.5%）在第6周的抑郁得分显著高于仅在第3天出现PPH（p = 0.010）或仅出现PPD（p = 0.035）的参与者。产后第3天的抑郁得分和第6周较低的社会支持得分可预测第6周的PPD。与其他研究结果一致，早发型PPD和社会支持不足可预测持续性PPD（即第6周时）。在产后第3天符合PPH和PPD标准的女性在第6周有更严重的抑郁症状。这可能表明存在潜在的双相情感障碍，值得进一步研究。
