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产后女性的自杀风险与心境障碍:一项纵向研究。

Suicide Risk and Mood Disorders in Women in the Postpartum Period: a Longitudinal Study.

机构信息

Postgraduate Program in Health and Behavior, Catholic University of Pelotas (UCPel), Gonçalves Chaves, 377 - 411 C, Pelotas, RS, 96015-560, Brazil.

Faculty of Medicine, Federal University of Pelotas (UFPel), Pelotas, RS, Brazil.

出版信息

Psychiatr Q. 2021 Jun;92(2):513-522. doi: 10.1007/s11126-020-09823-5.

Abstract

Suicide associated with severe psychiatric illnesses is considered the leading cause of maternal deaths. We aimed to assess the suicide risk in women who experienced depressive or mixed episodes of mood change during the postpartum period and to determine which disorder is more related to suicide risk in the same period. We conducted a longitudinal study with 706 women whose children were born from April 2007 to May 2008 in a southern city in Brazil, and received prenatal care by the Brazilian National System of Public Health. The first assessment occurred during the prenatal period and the second within 30 to 60 days postpartum. The incidence of suicide risk was 10.9%. The odds of postpartum suicide risk were 6.50 (95% CI: 2.73; 15.48) higher in mothers with postpartum depression and 41.50 (95% CI: 12.11; 142.16) higher in those with mixed episodes than those who did not suffer from any mood disorder. Women with chronic episodes (who had depressive or mixed episodes during pregnancy and postpartum) were at increased odds of 4.94 (95% CI: 1.46; 16.69) of a postpartum suicide risk. The postpartum seems to be a critical period in the women's mental health. The impact of mental disorders in this period, especially mixed episodes, can increase the odds of a suicide risk onset. A good psychiatric evaluation and support during the prenatal and postpartum care may prevent the subsequent risk of suicide.

摘要

与严重精神疾病相关的自杀被认为是导致产妇死亡的主要原因。我们旨在评估在产后期间经历过抑郁或混合情绪变化的女性的自杀风险,并确定哪种障碍在同一时期与自杀风险更相关。我们进行了一项纵向研究,共纳入了 706 名于 2007 年 4 月至 2008 年 5 月在巴西南部某城市分娩的女性,她们都接受了巴西国家公共卫生系统的产前保健。第一次评估是在产前进行的,第二次是在产后 30 至 60 天内进行的。自杀风险的发生率为 10.9%。产后抑郁症母亲产后自杀风险的比值比(OR)为 6.50(95%CI:2.73;15.48),混合发作母亲的 OR 为 41.50(95%CI:12.11;142.16),均高于无任何情绪障碍的母亲。患有慢性发作(在怀孕期间和产后都经历过抑郁或混合发作)的女性产后自杀风险的比值比(OR)为 4.94(95%CI:1.46;16.69)。产后似乎是女性心理健康的一个关键时期。该时期精神障碍的影响,尤其是混合发作,可能会增加自杀风险的发生几率。在产前和产后护理期间进行良好的精神科评估和支持,可能会预防随后的自杀风险。

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