U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Primary Health Care, Office of Quality Improvement, Rockville, MD, United States of America.
PLoS One. 2020 Apr 8;15(4):e0231243. doi: 10.1371/journal.pone.0231243. eCollection 2020.
In 2017, 46.6 million U.S. adults aged 18 or older self-reported as having mental illness of which 52.0% or 24.2 million are women age 18-49. Perinatal depression and anxiety are linked to adverse outcomes concerning pregnancy, maternal functioning, and healthy child development.
Using the 2014 Health Center Patient Survey (HCPS), the objectives of the cross-sectional study are to assess the prevalence of self-reported mental health conditions among female patients of reproductive age and to examine the association between depression and physical health. Physical health conditions of interest included self-rated health, obesity, hypertension, smoking, and diabetes, which all have established associations with potential pregnancy complications and fetal health. The study found 40.8% of patients reported depression; 28.8% reported generalized anxiety; and 15.2% met the criteria for serious psychological distress on the Kessler 6 scale. Furthermore, patients with depression had two to three times higher odds of experiencing co-occurring physical health conditions.
This study expands the discourse on maternal mental health, throughout the preconception, post-partum, and inter-conception care periods to improve understanding of the inter-correlated physical and mental health issues that could impact pregnancy outcomes and life course trajectory. From 2014 to 2018, the Health Resources and Services Administration (HRSA) has supported investments of nearly $750 million to improve and expand access to mental health and substance use disorder services for prevention, treatment, health education and awareness through comprehensive primary care integration. Moving forward, HRSA will implement strategic training and technical assistance (T/TA) framework that is designed to accelerate the adoption of science driven solutions in primary care in addressing depression for patients with co-occurring chronic conditions and advancing positive maternal outcomes.
2017 年，4660 万美国成年人自报患有精神疾病，其中 52.0%或 2420 万人是 18-49 岁的女性。围产期抑郁和焦虑与妊娠不良结局、产妇功能和儿童健康发育有关。
本横断面研究使用 2014 年卫生中心患者调查（HCPS），旨在评估育龄女性患者自我报告的心理健康状况的流行率，并研究抑郁与身体健康之间的关系。感兴趣的身体健康状况包括自我评估的健康状况、肥胖、高血压、吸烟和糖尿病，所有这些都与潜在的妊娠并发症和胎儿健康有关。研究发现，40.8%的患者报告患有抑郁症；28.8%报告患有广泛性焦虑症；15.2%的患者在 Kessler 6 量表上符合严重心理困扰的标准。此外，患有抑郁症的患者同时患有两种或三种身体疾病的可能性要高出两到三倍。
本研究扩展了关于产妇心理健康的讨论，涵盖了孕前、产后和孕期护理期间，以提高对可能影响妊娠结局和生命轨迹的身体和心理健康问题的相互关联的理解。从 2014 年到 2018 年，卫生资源和服务管理局（HRSA）已支持近 7.5 亿美元的投资，以改善和扩大获得预防、治疗、健康教育和意识的精神健康和物质使用障碍服务，通过综合初级保健一体化。展望未来，HRSA 将实施战略培训和技术援助（T/TA）框架，旨在通过在初级保健中采用以科学为驱动的解决方案来加速治疗同时患有慢性疾病的患者的抑郁症，以推进积极的产妇结局。
