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印度南部一家三级医院的产前抑郁和广泛性焦虑障碍

Antenatal Depression and Generalized Anxiety Disorder in a Tertiary Hospital in South India.

作者信息

Jyothi Kantipudi Suvarna, Kannan G K, Viswanathan Sushma, Ranganathan Sumathi, Menon Jayakumar, Ramanathan Sathianathan

机构信息

Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, India.

Mind Space Clinic, Chennai, Tamil Nadu, India.

出版信息

Indian J Psychol Med. 2020 Aug 11;42(6):513-518. doi: 10.1177/0253717620928440. eCollection 2020 Nov.

Abstract

BACKGROUND

Antenatal depression is associated with several adverse maternal outcomes, perinatal outcomes, lower academic achievements in adolescence, and future mental health problems for the mothers. Early identification and effective treatment of depression in antenatal women can also improve perinatal outcomes.

AIM

This study aims to understand the prevalence of antenatal depression and anxiety disorder, along with associated factors, among antenatal women attending the outpatient clinic of the obstetrics department in a tertiary care hospital.

METHODS

A cross-sectional design was employed for determining the prevalence, while a case-control framework was used for analysis of the associated factors. Semi-structured sociodemographic pro forma, Patient Health Questionnaire (PHQ-9) Tamil version, and Generalised Anxiety Disorder (GAD-7) Tamil version were administered to antenatal women after obtaining informed consent. Those who scored above 10 points on the PHQ-9 or above 9 points on the GAD-7 were interviewed using the Mini-International Neuropsychiatric Interview (MINI) diagnostic interview schedule, by a psychiatrist, for confirming the diagnosis.

RESULTS

In our sample, 22% of the participants were diagnosed with depression, and 23% with generalized anxiety disorder (GAD). Twenty-eight participants (13.4%) had both depression and GAD. Antenatal depression was associated with alcohol use in the spouse (P < 0.015), physical violence (P < 0.026), low perceived social support from the in-laws (P < 0.039), and pressure to have a male child (0.001). Antenatal GAD was associated with low perceived social support from the in-laws (P < 0.039) and pressure to have a male child (P < 0.041).

CONCLUSION

The occurrence of depression and generalized anxiety disorder is high in antenatal women. Our study identified relevant psychosocial factors that may be potential targets to develop effective interventions.

摘要

背景

产前抑郁症与多种不良孕产妇结局、围产期结局、青少年学业成绩较低以及母亲未来的心理健康问题相关。早期识别并有效治疗产前女性的抑郁症也可改善围产期结局。

目的

本研究旨在了解在一家三级护理医院产科门诊就诊的产前女性中,产前抑郁症和焦虑症的患病率及其相关因素。

方法

采用横断面设计来确定患病率,同时使用病例对照框架分析相关因素。在获得知情同意后,对产前女性发放半结构化社会人口学表格、泰米尔语版患者健康问卷(PHQ-9)和泰米尔语版广泛性焦虑障碍量表(GAD-7)。PHQ-9得分高于10分或GAD-7得分高于9分的患者,由精神科医生使用迷你国际神经精神访谈(MINI)诊断访谈表进行访谈,以确诊病情。

结果

在我们的样本中,22%的参与者被诊断为抑郁症,23%被诊断为广泛性焦虑障碍(GAD)。28名参与者(13.4%)同时患有抑郁症和GAD。产前抑郁症与配偶饮酒(P < 0.015)、身体暴力(P < 0.026)、来自公婆的社会支持感较低(P < 0.039)以及生男孩的压力(P < 0.001)相关。产前GAD与来自公婆的社会支持感较低(P < 0.039)以及生男孩的压力(P < 0.041)相关。

结论

产前女性中抑郁症和广泛性焦虑障碍的发生率较高。我们的研究确定了相关的社会心理因素,这些因素可能是制定有效干预措施的潜在目标。

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