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孕期和产后身体不满与焦虑和抑郁的关系:一项纵向研究。

Associations of body dissatisfaction with anxiety and depression in the pregnancy and postpartum periods: A longitudinal study.

机构信息

Department of Psychiatry, The University of Hong Kong, Hong Kong, China; The Felizberta Lo Padilla Tong School of Social Sciences, Caritas Institute of Higher Education, Hong Kong, China.

Department of Psychiatry, The University of Hong Kong, Hong Kong, China; Department of Psychology, The University of Hong Kong, Hong Kong, China.

出版信息

J Affect Disord. 2020 Feb 15;263:582-592. doi: 10.1016/j.jad.2019.11.032. Epub 2019 Nov 12.

Abstract

BACKGROUND

Pregnancy is a time of increasing vulnerability to the development of body dissatisfaction, anxiety, and depression. The present study aims to examine associations of body dissatisfaction with anxiety and depression at the following points: 6 months before pregnancy (retrospective report); in the first, second, and third trimesters of pregnancy; and up to 6 weeks postpartum.

METHODS

A prospective longitudinal design with a quantitative approach was adopted. A consecutive sample of 1,371 Chinese pregnant women in Hong Kong was assessed using standardized instruments at four time points.

RESULTS

A mixed-effects model with repeated measures revealed that body dissatisfaction and depression symptoms changed across different stages of pregnancy. Hierarchical multiple regressions showed that, after adjusting for the identified risk factors, body dissatisfaction before and during pregnancy were positively associated with antenatal anxiety and depression symptoms. Concurrent body dissatisfaction was positively associated with postpartum depression symptoms.

LIMITATIONS

There was a high attrition rate in the follow-up assessments. Antenatal anxiety symptoms were assessed using the scale for general anxiety, which may not adequately capture the experience of anxiety among pregnant women.

CONCLUSIONS

Primary healthcare practitioners should be made aware of body dissatisfaction among pregnant women in order to facilitate early intervention for anxiety and depression, because untreated psychological disturbance during pregnancy may persist into the postpartum period.

摘要

背景

怀孕期是一个身体不满、焦虑和抑郁日益加剧的脆弱时期。本研究旨在探讨身体不满与怀孕前 6 个月(回顾性报告)、怀孕第一、二、三孕期以及产后 6 周时的焦虑和抑郁之间的关联。

方法

采用前瞻性纵向设计和定量方法。对香港的 1371 名连续的中国孕妇在四个时间点使用标准化工具进行评估。

结果

具有重复测量的混合效应模型显示,身体不满和抑郁症状在怀孕的不同阶段发生变化。分层多元回归显示,在调整了已确定的风险因素后,怀孕前和怀孕期间的身体不满与产前焦虑和抑郁症状呈正相关。同时,身体不满与产后抑郁症状呈正相关。

局限性

随访评估的流失率很高。产前焦虑症状采用一般焦虑量表评估,可能无法充分捕捉孕妇的焦虑体验。

结论

初级保健医生应该注意孕妇的身体不满,以便为焦虑和抑郁提供早期干预,因为怀孕期间未经治疗的心理困扰可能会持续到产后。

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