Unitat de Salut Mental Perinatal CLINIC-BCN, Hospital Clínic, Barcelona, Spain; Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Psychiatry and Clinical Psychology, Universitat de Barcelona, Barcelona, Spain.
Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Bellaterra, Spain.
J Affect Disord. 2019 Feb 15;245:965-970. doi: 10.1016/j.jad.2018.11.062. Epub 2018 Nov 5.
Survival methodology has not already been used in studies about postpartum depression (PPD) course. The aims of the present study were to estimate the duration of a Major Postpartum Depressive Episode (MPDE) during 2 years, as well as to explore factors associated with the course.
This was a prospective, naturalistic, longitudinal study with a cohort of 165 women with a MPDE (DSM-IV criteria). Potential predictors of prognosis were recorded at baseline. Follow-up was conducted using the Longitudinal Interval Follow-up Evaluation (LIFE).
Of the total sample, 110 (66.7%) completed the 2 years follow-up. The mean time to full remission was 49.4 weeks (95% CI: 44.0-59.8). The probability of recovering was 30.2% (95% CI: 22.1%-37.4%) at 6 months of follow-up, 66.3% (95% CI: 57.4%-73.4%) at 12 months of follow-up, and 90.3% (95% CI: 79.8%-95.4%) at 24 months of follow-up. Mothers with financial difficulties, onset of depressive episode previous to birth, and those with prior treated depressive episodes took longer in achieving full remission.
Results are only generalizable to mothers with PPD treated in a psychiatric outpatient setting. Psychopharmacological treatment was uncontrolled and personality was not assessed.
Our findings suggest that PPD could become a chronic disorder, particularly in mothers with an onset of the episode previous to birth, with a history of depression or with financial problems. Knowledge of these factors may help to improve the guidelines of depression management and treatment during the perinatal period.
生存方法在产后抑郁症（PPD）研究中尚未得到应用。本研究旨在估计 2 年内重度产后抑郁发作（MPDE）的持续时间，并探讨与病程相关的因素。
这是一项前瞻性、自然主义、纵向研究，纳入了 165 名患有 MPDE（DSM-IV 标准）的女性队列。在基线时记录了预后的潜在预测因素。使用纵向间隔随访评估（LIFE）进行随访。
在总样本中，有 110 名（66.7%）完成了 2 年的随访。完全缓解的平均时间为 49.4 周（95%CI：44.0-59.8）。在随访 6 个月时，恢复的概率为 30.2%（95%CI：22.1%-37.4%），在随访 12 个月时为 66.3%（95%CI：57.4%-73.4%），在随访 24 个月时为 90.3%（95%CI：79.8%-95.4%）。有经济困难、产前发作抑郁和既往治疗过的抑郁发作的母亲，达到完全缓解的时间更长。
结果仅适用于在精神科门诊治疗的 PPD 母亲。精神药理学治疗未得到控制，人格未得到评估。
我们的研究结果表明，PPD 可能成为一种慢性疾病，特别是在产前发作、有抑郁史或有经济问题的母亲中。了解这些因素可能有助于改善围产期抑郁管理和治疗的指南。
