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现场围产期情绪障碍诊所对围产期情绪障碍的诊断和管理的影响。

Impact of an on-site perinatal mood disorders clinic in the diagnosis and management of perinatal mood disorders.

机构信息

Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainesville, FL, USA.

Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA.

出版信息

J Perinat Med. 2020 Oct 25;48(8):837-843. doi: 10.1515/jpm-2020-0036.

Abstract

Objectives To assess change in Edinburgh Postnatal Depression Scale (EPDS) scores in women treated at the Perinatal Mood Disorders Clinic (PMDC) as a measure of improvement in perinatal mood disorders (primary outcome), and treatment disposition at final visit. Methods Chart review was performed for all PMDC patients between March 1, 2017 and June 1, 2018 (n=120), as a self-controlled case series design. Two-tailed t-tests compared initial and final EPDS scores for all patients with >1 visit (n=64), where EPDS score of ≥13 indicated a positive screen for depression. A multivariable linear regression model with robust standard errors estimated the relationship between patient characteristics and final EPDS scores. Results Of 120 patients, n=56 had one visit and n=64 had >1 visit. Of these 64, mean final score (11.04) was lower than mean initial score (16.54; p<0.001). Additionally, certain patient characteristics were associated with higher final EPDS score, including history of mood disorder and treatment with both pharmacotherapy and psychotherapy. Conclusions Women treated at the PMDC showed improved EPDS scores when receiving at least two separate care visits. Therefore, the clinic may be filling a gap in access to timely care for women with perinatal mood disorders.

摘要

目的

评估在围产期情绪障碍诊所 (PMDC) 接受治疗的女性的爱丁堡产后抑郁量表 (EPDS) 评分变化,以衡量围产期情绪障碍的改善情况(主要结局),以及最终就诊时的治疗处置情况。

方法

对 2017 年 3 月 1 日至 2018 年 6 月 1 日期间所有 PMDC 患者(n=120)进行图表回顾,采用自身对照病例系列设计。对所有就诊次数大于 1 次的患者(n=64)进行双侧 t 检验,比较初始和最终 EPDS 评分,其中 EPDS 评分≥13 表示抑郁筛查阳性。采用稳健标准误差的多变量线性回归模型估计患者特征与最终 EPDS 评分之间的关系。

结果

在 120 名患者中,n=56 次就诊,n=64 次就诊次数大于 1 次。在这 64 名患者中,最终评分(11.04)低于初始评分(16.54;p<0.001)。此外,某些患者特征与最终 EPDS 评分较高相关,包括心境障碍史和药物治疗与心理治疗联合应用。

结论

在 PMDC 接受治疗的女性在接受至少两次单独的护理就诊后,EPDS 评分有所改善。因此,该诊所可能填补了及时为围产期情绪障碍女性提供治疗的空白。

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