Department of Social Sciences, School of Arts and Social Sciences, The Open University of Hong Kong, Hong Kong, China.
Department of Clinical Psychology, School of Health in Social Science, The University of Edinburgh, Edinburgh, Scotland, United Kingdom.
PLoS One. 2020 Mar 20;15(3):e0227944. doi: 10.1371/journal.pone.0227944. eCollection 2020.
Pregnancy involves physiological changes in reproductive and endocrine systems, and social role changes that can increase the risk of mental health problems. In China, greater emphasis has been given to postpartum depression and its negative impact on infant development. This study examined depression in pregnant women in Inner Mongolia, who are under the influence of cultural values of collectivism and social factors specific to China. Chinese society adheres firmly to traditional values, while market reform, birth-control policy, together with high parental investment in childcare and rearing construct a unique and sometimes unfavorable environment for Chinese women that may influence their depression expression.
First, it validated the Chinese Multidimensional Depression Assessment Scale (MDAS), a holistic self-report questionnaire measuring depression severity in four domains of depression-emotional, somatic, cognitive and interpersonal in pregnant women in Inner Mongolia; second, it examined the influences of demographic characteristics (including age, education and employment), pregnancy characteristics (week of gestation, first pregnancy), self-esteem, social support, social activity, work stress, and work-family balance on depression.
A total of 234 pregnant women, mostly in their third trimester, were recruited in an antenatal hospital in Inner Mongolia and self-reported questionnaires were completed.
Using Confirmatory factor analysis (CFA), MDAS gave rise to a best-fit four-factor model corresponding to each subscale when it was first developed. MDAS also reported high Cronbach's alpha (0.96) and good convergent validity. Using hierarchical multiple linear regressions with significant demographic variables controlled for, self-esteem, work-family conflict, and social support were found to be significant predictors for depression.
MDAS is a valid scale to be used with Chinese pregnant women, especially in more collectivistic geographical areas. Risk factors specific to the Chinese context add insights to the experience of antenatal depression in China and contribute to understanding depression in from a global mental health perspective.
怀孕会引起生殖和内分泌系统的生理变化，以及社会角色的变化，这些都可能增加心理健康问题的风险。在中国，人们更加关注产后抑郁症及其对婴儿发育的负面影响。本研究考察了内蒙古孕妇的抑郁情况，她们受到集体主义文化价值观和中国特有社会因素的影响。中国社会坚决坚持传统价值观，而市场改革、计划生育政策，加上父母对育儿的高度投入，构成了一个独特且有时不利于中国女性的环境，可能会影响她们的抑郁表现。
首先，验证了多维抑郁评估量表（MDAS），这是一种整体自评问卷，用于测量内蒙古孕妇在抑郁的四个领域（情绪、躯体、认知和人际关系）的抑郁严重程度；其次，研究了人口统计学特征（包括年龄、教育和就业）、妊娠特征（妊娠周数、首次妊娠）、自尊、社会支持、社会活动、工作压力和工作家庭平衡对抑郁的影响。
在内蒙古的一家产前医院招募了 234 名孕妇，她们大多处于妊娠晚期，完成了自我报告问卷。
使用验证性因子分析（CFA），MDAS 最初开发时得出了一个最佳的四因素模型，对应于每个子量表。MDAS 还报告了较高的克朗巴赫系数（0.96）和良好的收敛效度。使用分层多元线性回归，在控制了显著的人口统计学变量后，自尊、工作家庭冲突和社会支持被发现是抑郁的显著预测因素。
MDAS 是一种适用于中国孕妇的有效量表，特别是在更具集体主义的地理区域。中国特有的风险因素为中国产前抑郁的体验增添了新的认识，并从全球心理健康的角度有助于理解抑郁。
