Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany.
Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
Transl Psychiatry. 2021 Feb 11;11(1):121. doi: 10.1038/s41398-021-01245-6.
Postpartum depression (PPD) and adjustment disorder (AD) affect up to 25% of women after childbirth. However, there are no accurate screening tools for either disorder to identify at-risk mothers and enable them to benefit from early intervention. Combinations of anamnestic, clinical, and remote assessments were evaluated for an early and accurate identification of PPD and AD. Two cohorts of mothers giving birth were included in the study (N = 308 and N = 193). At baseline, participants underwent a detailed sociodemographic-anamnestic and clinical interview. Remote assessments were collected over 12 weeks comprising mood and stress levels as well as depression and attachment scores. At 12 weeks postpartum, an experienced clinician assigned the participants to three distinct groups: women with PPD, women with AD, and healthy controls (HC). Combinations of these assessments were assessed for an early an accurate detection of PPD and AD in the first cohort and, after pre-registration, validated in a prospective second cohort. Combinations of postnatal depression, attachment (for AD) and mood scores at week 3 achieved balanced accuracies of 93 and 79% for differentiation of PPD and AD from HC in the validation cohort and balanced accuracies of 87 and 91% in the first cohort. Differentiation between AD and PPD, with a balanced accuracy of 73% was possible at week 6 based on mood levels only with a balanced accuracy of 73% in the validation cohort and a balanced accuracy of 76% in the first cohort. Combinations of in clinic and remote self-assessments allow for early and accurate detection of PPD and AD as early as three weeks postpartum, enabling early intervention to the benefit of both mothers and children.
产后抑郁症（PPD）和适应障碍（AD）影响高达 25%的产后妇女。然而，目前没有针对这两种疾病的准确筛查工具来识别高危产妇，使她们能够受益于早期干预。本研究评估了病史、临床和远程评估的组合，以早期、准确地识别 PPD 和 AD。研究纳入了两个产妇队列（N=308 和 N=193）。在基线时，参与者接受了详细的社会人口统计学病史和临床访谈。在 12 周内进行了远程评估，包括情绪和压力水平以及抑郁和依恋评分。在产后 12 周时，一位经验丰富的临床医生将参与者分为三组：患有 PPD 的女性、患有 AD 的女性和健康对照组（HC）。评估了这些评估的组合，以在第一个队列中早期、准确地检测 PPD 和 AD，并在预注册后在前瞻性的第二个队列中进行验证。产后抑郁、依恋（AD）和第 3 周情绪评分的组合在验证队列中区分 PPD 和 AD 与 HC 的平衡准确率为 93%和 79%，在第一个队列中的平衡准确率为 87%和 91%。仅基于情绪水平，在第 6 周区分 AD 和 PPD 的平衡准确率为 73%，在验证队列中的平衡准确率为 73%，在第一个队列中的平衡准确率为 76%。在诊所和远程自我评估的组合可以早期、准确地检测产后 3 周内的 PPD 和 AD，从而进行早期干预，使母亲和孩子受益。
