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失去未出生的孩子:以色列妇女妊娠丢失后创伤后应激障碍和重度抑郁症。

To lose an unborn child: Post-traumatic stress disorder and major depressive disorder following pregnancy loss among Israeli women.

机构信息

Department of Psychology, Bar-Ilan University, Ramat Gan 5290002, Israel; Department Of Psychiatry, New York University School of Medicine, New York, NY 10016, USA.

Department of Obstetrics and Gynecology, Hadassah Ein-Kerem Medical Center, Jerusalem 91120, Israel.

出版信息

Gen Hosp Psychiatry. 2018 Jul-Aug;53:95-100. doi: 10.1016/j.genhosppsych.2018.02.003. Epub 2018 May 16.

Abstract

OBJECTIVES

Pregnancy loss (PL) can be a very difficult experience. However, the evidence regarding the prevalence and correlates of psychopathology following PL is inconsistent at best. The present study aimed to assess the prevalence of Post-Traumatic Stress Disorder (PTSD) and Major Depressive Disorder (MDD) following PL, and their differential predictors.

METHODS

Participants were 97 women, ages 23-47, who have experienced PL starting from the 2nd trimester. They were recruited at the Hadassah Ein-Kerem Medical Center in Jerusalem, Israel. The mean pregnancy week of loss was 27.92. Participants completed self-report questionnaires assessing PTSD (PCL-5), MDD (BDI-II), sociodemographic variables and factors related to the loss.

RESULTS

We have found high rates of probable PTSD (33.3%) and MDD (29.4%) among our sample, as well as high PTSD-MDD comorbidity. A more advanced gestational week of loss and shorter time since PL were positively associated with both PTSD and MDD. Younger age and lower religiosity were associated with more severe PTSD, but not MDD.

CONCLUSIONS

PL is a potentially-traumatic experience, entailing a heavy burden of PTSD and MDD. Mental health professionals are encouraged to closely monitor women following PL, particularly young mothers, who have experienced PL more recently, and at the advanced stages of pregnancy.

摘要

目的

妊娠丢失(PL)可能是一个非常困难的经历。然而,关于 PL 后精神病理学的患病率和相关性的证据充其量也是不一致的。本研究旨在评估 PL 后创伤后应激障碍(PTSD)和重度抑郁症(MDD)的患病率及其不同的预测因素。

方法

参与者为 97 名年龄在 23-47 岁之间的女性,她们经历了从妊娠第 2 个三个月开始的 PL。她们是在以色列耶路撒冷哈达萨伊肯克里姆医疗中心招募的。平均妊娠丢失周数为 27.92。参与者完成了自我报告问卷,评估 PTSD(PCL-5)、MDD(BDI-II)、社会人口统计学变量和与丢失相关的因素。

结果

我们发现,我们的样本中 PTSD(33.3%)和 MDD(29.4%)的患病率很高,而且 PTSD-MDD 共病率也很高。丢失的妊娠周数越晚,PL 后时间越短,与 PTSD 和 MDD 均呈正相关。年龄越小和宗教信仰越低与更严重的 PTSD 相关,但与 MDD 无关。

结论

PL 是一种潜在的创伤性经历,会带来 PTSD 和 MDD 的沉重负担。鼓励心理健康专业人员密切监测 PL 后的女性,特别是最近经历过 PL 且处于妊娠晚期的年轻母亲。

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