Department of Public Health, Shenzhen Kangning Hospital, Shenzhen, Guangdong Province, China.
Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA.
Epidemiol Psychiatr Sci. 2020 Jun 2;29:e133. doi: 10.1017/S2045796020000463.
Abstract.
Intimate partner violence (IPV) is an important risk factor for perinatal depression (PND). But IPV's impact on the natural prognosis of PND symptoms is not well understood. We tested two hypotheses: (1) pregnant women with IPV experiences will exhibit more severe PND symptoms than women without IPV experience; (2) IPV experience will impede the recovery prognosis of PND. We also explored the contribution of IPV to PND comparing with other risk factors.
The sample is comprised of 813 pregnant women followed through perinatal period in Hunan, China. We assessed IPV experience using items from the Short Form of the Revised Conflict Tactics Scale (CTS2S), and PND symptoms via the Edinburgh Postnatal Depression Scale (EPSD). We conducted Linear Mixed-effects Model to compare the trajectories of PND symptoms between victims and non-victims and a multistage Generalised Estimating Equations Model to explore salient factors on the trajectory of PND symptoms.
There were 90 participants (11.07%) who reported IPV experience in the past 12 months. With respect to physical, psychological and sexual violence, the prevalence was 4.55% (37/813), 9.23% (75/813) and 2.34% (19/813). Victims reported more severe PND symptoms (t = 5.30, p < 0.01) and slower decreasing slope of trajectories (t = 28.89, p < 0.01). The PND trajectory was associated with IPV experience (OR = 3.78; 95% CI 1.39-10.26), social support (OR = 0.93; 95% CI 0.88-0.97), positive coping strategies (OR = 0.85; 95% CI 0.80-0.91), negative coping strategies (OR = 1.25; 95% CI 1.14-1.37) and monthly income of $0.15-$298.36 (compared to no income, OR = 0.0075; 95% CI 0.00052-0.11).
The findings suggest the reported prevalence of IPV is lower in Hunan than most of the previous studies during perinatal period in other provinces of China, and IPV victimisation is associated with increased severity and slowed prognosis of PND symptoms. Future studies that screen for victimisation and establish its explicit mechanism to the poorer prognosis of PND symptoms would benefit the prevention and treatment of PND.
摘要。
亲密伴侣暴力（IPV）是围产期抑郁（PND）的一个重要危险因素。但是，IPV 对 PND 症状自然预后的影响尚不清楚。我们检验了两个假设：（1）有 IPV 经历的孕妇会表现出比没有 IPV 经历的孕妇更严重的 PND 症状；（2）IPV 经历会阻碍 PND 的恢复预后。我们还比较了 IPV 与其他风险因素对 PND 的贡献。
本研究样本包括 813 名在湖南进行围产期随访的孕妇。我们使用修订后的冲突策略量表（CTS2S）短表中的项目评估 IPV 经历，使用爱丁堡产后抑郁量表（EPSD）评估 PND 症状。我们采用线性混合效应模型比较了受害者和非受害者之间 PND 症状的轨迹，采用多阶段广义估计方程模型探索 PND 症状轨迹的显著因素。
在过去 12 个月内，有 90 名参与者（11.07%）报告有 IPV 经历。在身体、心理和性暴力方面，其流行率分别为 4.55%（37/813）、9.23%（75/813）和 2.34%（19/813）。受害者报告的 PND 症状更严重（t=5.30，p<0.01），轨迹下降的斜率更慢（t=28.89，p<0.01）。PND 轨迹与 IPV 经历（OR=3.78；95%CI 1.39-10.26）、社会支持（OR=0.93；95%CI 0.88-0.97）、积极应对策略（OR=0.85；95%CI 0.80-0.91）、消极应对策略（OR=1.25；95%CI 1.14-1.37）和月收入 0.15-298.36 美元（与无收入相比，OR=0.0075；95%CI 0.00052-0.11）相关。
研究结果表明，湖南报告的 IPV 流行率低于中国其他省份围产期的大多数先前研究，而 IPV 受害与 PND 症状的严重程度增加和预后缓慢有关。未来的研究应筛查受害者，并明确其对 PND 症状预后较差的机制，这将有助于预防和治疗 PND。
