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产后抑郁风险的医学和心理社会决定因素:一项横断面研究。

Medical and psychosocial determinants of risk of postpartum depression: a cross-sectional study.

机构信息

1Department of Obstetrics,Medical University of Gdańsk,Gdańsk,Poland.

2Institute of Psychology,University of Gdansk,Gdańsk,Poland.

出版信息

Acta Neuropsychiatr. 2017 Dec;29(6):347-355. doi: 10.1017/neu.2017.4. Epub 2017 May 31.

Abstract

OBJECTIVE

The aim of this study was to investigate the degree of risk of maternal postpartum depression during the second month of puerperium.

METHOD

In total, 387 postnatal women filled out a questionnaire concerning their health and social status, as well as the following tests: the Edinburgh Postnatal Depression Scale (EPDS), the Patient Health Questionnaire-9 (PHQ-9), the Neo Five-Factor Inventory (NEO-FFI) Personality Inventory and the Berlin Social Support Scales. After 4-8 weeks, patients responded to another questionnaire with the EPDS and the PHQ-9.

RESULTS

In total, 48 patients (12.40%) were found to be at risk of postpartum depression between the fourth and eighth weeks after delivery. Premenstrual syndrome [adjusted odds ratio (ORa)=2.93, confidence interval (CI) 1.30-6.63] and EPDS>12 points during the first week after the delivery (ORa=3.74, CI 1.59-9.04) increased the risk of postnatal depression. A similar role is played by a high result in neuroticism scale of the NEO-FFI (ORa=1.50, CI 1.17-1.92) and a positive family history of any psychiatric disorder (ORa=1.03, CI 1.01-1.06).

CONCLUSION

A history of premenstrual syndrome and a higher risk of affective disorder soon after a childbirth are associated with greater chances of depressive symptoms in the second month postpartum. This is also the case if a patient is neurotic and has a relative with a history of any psychiatric disorder. Such women should have their mental status carefully evaluated.

摘要

目的

本研究旨在调查产妇产后第二个月患产后抑郁症的风险程度。

方法

共有 387 名产后妇女填写了一份关于其健康和社会状况的问卷,以及以下测试:爱丁堡产后抑郁量表(EPDS)、患者健康问卷-9(PHQ-9)、新五因素人格量表(NEO-FFI)和柏林社会支持量表。4-8 周后,患者用 EPDS 和 PHQ-9 回答了另一份问卷。

结果

共有 48 名患者(12.40%)在产后第 4 至第 8 周被发现有产后抑郁症风险。经前期综合征[调整后的优势比(ORa)=2.93,置信区间(CI)1.30-6.63]和产后第一周 EPDS>12 分[调整后的优势比(ORa)=3.74,置信区间(CI)1.59-9.04]增加了产后抑郁症的风险。NEO-FFI 神经质量表的高分[调整后的优势比(ORa)=1.50,置信区间(CI)1.17-1.92]和任何精神障碍的阳性家族史[调整后的优势比(ORa)=1.03,置信区间(CI)1.01-1.06]也起着类似的作用。

结论

经前期综合征史和产后不久发生情感障碍的风险较高与产后第二个月出现抑郁症状的几率增加有关。如果患者神经质,且有亲属有任何精神障碍史,也是如此。这些妇女应仔细评估其精神状态。

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