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生活压力对成年抑郁和焦虑的影响取决于性别和暴露的时间。

The impact of life stress on adult depression and anxiety is dependent on gender and timing of exposure.

机构信息

University of Western Australia,Perth.

出版信息

Dev Psychopathol. 2017 Oct;29(4):1443-1454. doi: 10.1017/S0954579417000372. Epub 2017 Apr 11.

Abstract

There is debate about the relative importance of timing of stressful events prenatally and over the life course and risk for subsequent depressive/anxious illness. The aim of this study was to examine the relative roles of prenatal stress and postnatal stress trajectories in predicting depression and anxiety in early adulthood in males and females. Exposure to life stress events was examined in the Western Australian Pregnancy Cohort (Raine) Study during pregnancy and ages 1, 2, 3, 5, 8, 10, 14, and 17 years. At age 20, offspring completed the Depression Anxiety Stress Scale. Prenatal stress and trajectories of stress events from age 1 to 17 were analyzed in linear regression analyses. Five postnatal stress trajectories were identified. In females, medium to high chronic stress exposure or exposure during puberty/adolescence predicted depression and anxiety symptoms while low or reduced stress exposure over the life course did not, after adjustment for relevant confounders. High stress early in pregnancy contributed to male depression/anxiety symptoms independent of postnatal stress trajectory. In females, postnatal stress trajectory was more important than prenatal stress in predicting depression/anxiety symptoms. Interventions focused on reducing and managing stress events around conception/pregnancy and exposure to chronic stress are likely to have beneficial outcomes on rates of depression and anxiety in adults.

摘要

关于产前和整个生命过程中的应激事件的时间以及随后抑郁/焦虑疾病风险的相对重要性存在争议。本研究旨在探讨产前应激和产后应激轨迹在预测男性和女性成年早期抑郁和焦虑中的相对作用。在西澳大利亚妊娠队列(Raine)研究中,在怀孕期间以及年龄为 1、2、3、5、8、10、14 和 17 岁时检查了生活应激事件的暴露情况。在 20 岁时,后代完成了抑郁焦虑压力量表。在线性回归分析中分析了产前应激和从 1 岁到 17 岁的应激事件轨迹。确定了五个产后应激轨迹。在女性中,中度至高度慢性应激暴露或青春期/青少年时期的暴露预测了抑郁和焦虑症状,而在整个生命过程中低或减少应激暴露则不会,在调整了相关混杂因素后。妊娠早期的高应激与男性的抑郁/焦虑症状有关,而与产后应激轨迹无关。在女性中,产后应激轨迹比产前应激更能预测抑郁/焦虑症状。针对受孕/怀孕前后减少和管理应激事件以及慢性应激暴露的干预措施可能对成年人的抑郁和焦虑发生率产生有益的影响。

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