Department of Psychology, Lakehead University, Thunder Bay, Ontario, Canada.
Department of Psychiatry, University of Western Ontario, London, Ontario, Canada.
Arch Womens Ment Health. 2018 Dec;21(6):821-828. doi: 10.1007/s00737-018-0877-3. Epub 2018 Jun 26.
To examine postpartum recurrence rates of depression comparing women receiving antidepressant treatment to women not being treated with psychotropic medication. This was a prospective study of 130 women with major depressive disorder (MDD) who attended a tertiary care perinatal clinic during and after pregnancy. Depression recurrence was defined as a score of 13 or more on the Edinburgh Postnatal Depression Scale (EPDS) or a score of greater than 13 on the Hamilton Depression Rating Scale (HDRS). Over half of women (56.9%) were not receiving medication during pregnancy to treat their mood disorder, with the rate of medication use increasing over the 1-year postpartum period. When comparing women being treated with antidepressant medication (monotherapy or combination therapy) to women receiving no psychotropic medication, no significant differences in recurrence rates were observed during the postpartum period. However, we did observe that the occurrence of depression in our sample fluctuated between rates comparable to general population estimates to rates that were at times more than twofold higher, regardless of treatment with antidepressant medication. The findings of this study align with research which suggests that the postpartum period is a particularly vulnerable time for recurrence of depression. Moreover, our results suggest that this remains the case regardless of antidepressant treatment.
为了比较接受抗抑郁治疗的女性和未接受精神药物治疗的女性产后抑郁症的复发率,我们进行了这项前瞻性研究。该研究纳入了 130 名患有重度抑郁症(MDD)的女性,这些女性在怀孕期间和产后都在一家三级保健围产期诊所就诊。产后抑郁症复发的定义为爱丁堡产后抑郁量表(EPDS)得分为 13 分或以上,或汉密尔顿抑郁评定量表(HDRS)得分为 13 分或以上。超过一半的女性(56.9%)在怀孕期间没有服用药物来治疗其情绪障碍,而且在产后 1 年内,药物治疗的使用率逐渐增加。将接受抗抑郁药物(单药治疗或联合治疗)治疗的女性与未接受精神药物治疗的女性进行比较,发现在产后期间,复发率没有显著差异。然而,我们确实观察到,无论是否接受抗抑郁药物治疗,我们样本中的抑郁症发生率在一般人群估计的发生率和有时高出两倍以上的发生率之间波动。本研究的结果与研究结果一致,即产后是抑郁症复发的一个特别脆弱时期。此外,我们的研究结果表明,无论是否进行抗抑郁治疗,这种情况仍然存在。