Kubota Chika, Inada Toshiya, Shiino Tomoko, Ando Masahiko, Sato Maya, Nakamura Yukako, Yamauchi Aya, Morikawa Mako, Okada Takashi, Ohara Masako, Aleksic Branko, Murase Satomi, Goto Setsuko, Kanai Atsuko, Ozaki Norio
Department of Psychiatry, National Center of Neurology and Psychiatry, Kodaira, Japan.
Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Front Psychiatry. 2020 May 15;11:441. doi: 10.3389/fpsyt.2020.00441. eCollection 2020.
The aim of the present study was to elucidate the foreseeable risk factors for suicidal ideation among Japanese perinatal women.
This cohort study was conducted in Nagoya, Japan, from July 2012 to March 2018. The Edinburgh Postnatal Depression Scale (EPDS) questionnaire was conducted at four time points: early pregnancy, late pregnancy, 5 days postpartum, and 1 month postpartum. A total of 430 women completed the questionnaires. A logistic regression analysis was performed using the presence of suicidal ideation on the EPDS as an objective variable. The explanatory variables were age, presence of physical or mental disease, smoking and drinking habits, education, hospital types, EPDS total score in early pregnancy, bonding, and quality and amount of social support, as well as the history of major depressive disorder (MDD).
The rate of participants who were suspected of having suicidal ideation at any of the four time points was 11.6% (n=52), with the highest (n=25, 5.8%) at late pregnancy. For suicidal ideation, education level (OR: 1.19; 95% CI: 1.00-1.41; p=0.047), EPDS total points in the pregnancy period (OR: 1.25; 95% CI: 1.16-1.34; p < 0.000), a history of MDD (OR: 2.16; 95% CI: 1.00-4.79; p=0.049), and presence of mental disease (OR: 2.39; 95% CI: 1.00-5.70; p=0.049) were found to be risk factors for suicidal ideation. Age [odds ratio (OR): 0.88; 95% confidence interval (CI): 0.80-0.95; p=.002] and quality of social support (OR: 0.77; 95% CI: 0.60-0.99; p=.041) were found to be protective factors.
Based on these results, effective preventive interventions, such as increasing the quality of social support and confirming the history of depression, should be carried out in pregnant depressive women at the early stage of the perinatal period.
本研究旨在阐明日本围产期女性自杀意念的可预见风险因素。
本队列研究于2012年7月至2018年3月在日本名古屋进行。在四个时间点进行爱丁堡产后抑郁量表(EPDS)问卷调查:孕早期、孕晚期、产后5天和产后1个月。共有430名女性完成了问卷调查。以EPDS上存在自杀意念作为客观变量进行逻辑回归分析。解释变量包括年龄、身体或精神疾病史、吸烟和饮酒习惯、教育程度、医院类型、孕早期EPDS总分、母婴联结、社会支持的质量和数量,以及重度抑郁症(MDD)病史。
在四个时间点中任何一个时间点被怀疑有自杀意念的参与者比例为11.6%(n = 52),其中孕晚期最高(n = 25,5.8%)。对于自杀意念,发现教育程度(比值比[OR]:1.19;95%置信区间[CI]:1.00 - 1.41;p = 0.047)、孕期EPDS总分(OR:1.25;95% CI:1.16 - 1.34;p < 0.000)、MDD病史(OR:2.16;95% CI:1.00 - 4.79;p = 0.049)和精神疾病史(OR:2.39;95% CI:1.00 - 5.70;p = 0.049)是自杀意念的风险因素。年龄[比值比(OR):0.88;95%置信区间(CI):0.80 - 0.95;p = 0.002]和社会支持质量(OR:0.77;95% CI:0.60 - 0.99;p = 0.041)是保护因素。
基于这些结果,应在围产期早期对抑郁的孕妇采取有效的预防干预措施,如提高社会支持质量和确认抑郁病史。