Disciple of Psychology, College of Science, Health, Education and Engineering, Murdoch University, Murdoch, WA, Australia.
School of Medicine, The University of Notre Dame Australia, Fremantle, WA, Australia.
Aust N Z J Psychiatry. 2021 Nov;55(11):1079-1088. doi: 10.1177/0004867421998796. Epub 2021 Mar 16.
Poorer mother-infant interaction quality has been identified among women with major depression; however, there is a dearth of research examining the impact of bipolar disorder. This study sought to compare mother-infant emotional availability at 6 months postpartum among women with perinatal major depressive disorder, bipolar disorder and no disorder (control).
Data were obtained for 127 mother-infant dyads from an Australian pregnancy cohort. The Structured Clinical Interview for the -5 was used to diagnose major depressive disorder ( = 60) and bipolar disorder ( = 12) in early pregnancy (less than 20 weeks) and review diagnosis at 6 months postpartum. Prenatal and postnatal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale, along with self-report psychotropic medication use. Mother and infant's interaction quality was measured using the Emotional Availability Scales when infants reached 6 months of age. Multivariate analyses of covariance examining the effects of major depressive disorder and bipolar disorder on maternal emotional availability (sensitivity, structuring, non-intrusiveness, non-hostility) and child emotional availability (responsiveness, involvement) were conducted.
After controlling for maternal age and postpartum depressive symptoms, perinatal disorder (major depressive disorder, bipolar disorder) accounted for 17% of the variance in maternal and child emotional availability combined. Compared to women with major depressive disorder and their infants, women with bipolar disorder and their infants displayed lower ratings across all maternal and child emotional availability qualities, with the greatest mean difference seen in non-intrusiveness scores.
Findings suggest that perinatal bipolar disorder may be associated with additional risk, beyond major depressive disorder alone, to a mother and her offspring's emotional availability at 6 months postpartum, particularly in maternal intrusiveness.
已有研究表明，患有重性抑郁症的女性其母婴互动质量较差；然而，目前鲜有研究探讨双相情感障碍对母婴互动的影响。本研究旨在比较产后 6 个月时患有围产期重性抑郁障碍、双相情感障碍和无障碍的女性（对照组）的母婴情绪可获得性。
本研究的数据来自澳大利亚妊娠队列中的 127 对母婴。在妊娠早期（<20 周）使用结构临床访谈 -5 对主要抑郁障碍（n=60）和双相情感障碍（n=12）进行诊断，并在产后 6 个月时对诊断进行复查。使用爱丁堡产后抑郁量表测量产前和产后的抑郁症状，同时还测量了自我报告的精神药物使用情况。当婴儿达到 6 个月大时，使用情绪可获得量表测量母亲和婴儿的互动质量。使用协方差分析的多变量分析，检验重性抑郁障碍和双相情感障碍对母亲情绪可获得性（敏感性、结构化、非侵入性、非敌意）和儿童情绪可获得性（反应性、参与性）的影响。
在控制了母亲年龄和产后抑郁症状后，围产期障碍（重性抑郁障碍、双相情感障碍）解释了母亲和儿童情绪可获得性综合的 17%的方差。与患有重性抑郁障碍及其婴儿的女性相比，患有双相情感障碍及其婴儿的女性在所有母婴情绪可获得性质量方面的评分较低，其中非侵入性评分的平均差异最大。
研究结果表明，与单纯重性抑郁障碍相比，围产期双相情感障碍可能会使母亲及其后代在产后 6 个月时的情绪可获得性进一步下降，尤其是在母亲的侵入性方面。
