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比较互动研究方案:围产期产妇合并抑郁和焦虑障碍对儿童发育的影响。

Study protocol of the COMPARE-Interaction study: the impact of maternal comorbid depression and anxiety disorders in the peripartum period on child development.

机构信息

Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany

Department of Psychology, Clinical Psychology of Children and Adolescents, Ludwig-Maximilians-University Munich, Munich, Germany.

出版信息

BMJ Open. 2022 Jan 20;12(1):e050437. doi: 10.1136/bmjopen-2021-050437.

Abstract

INTRODUCTION

To date, there are only few studies that compare the consequences of peripartum maternal depressive disorders (PD) versus depressive with comorbid anxiety disorders (PDCA) for infant and child development. As comorbidity is associated with greater impairment and symptom severity related to the primary diagnosis, comorbidity in mothers might raise their offspring's risk of developing internalising or externalising disorders even more than has been noted in conjunction with PD alone.

METHODS AND ANALYSIS

This study aims to analyse the impact of parental psychopathology, particularly peripartum depression in mothers with and without comorbid anxiety disorders according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) on child cognitive and socioemotional development. Maternal/paternal psychopathology, mother-infant/father-infant interaction and child development are assessed at four measurement points over the first 2 years (T1: 3-4 months postpartum, T2: 12 months postpartum, T3: 18 months postpartum and T4: 24 months postpartum). The mediating role of mother-infant/father-infant interaction and infant stress reactivity in the relationship between PD/PDCA and infant cognitive and socioemotional development will be analysed. In the ongoing study, 174 families (n=58 mothers with PD, n=58 mothers with PDCA and n=58 healthy controls) will be recruited in inpatient and outpatient centres as well as maternity hospitals in Munich and Heidelberg.

ETHICS AND DISSEMINATION

This study is implemented in accordance with the current guidelines of the World Medical Association (revised Declaration of Helsinki) and the General Data Protection Regulation of the European Union. The study procedures were approved by the independent ethics committees of the Department of Psychology, Ludwig-Maximilians-University Munich (74_Reck_b) and of the Medical Faculty, University Heidelberg (S-446/2017). Participation is voluntary. A signed written informed consent form must be obtained from each study subject prior to any study-specific procedure. Participants can withdraw from the study at any point in time without giving a reason or being subjected to any future disadvantages. In case of withdrawal from the study, the subject's data and material will be kept unless the participant asks for data removal. Results will be published and disseminated to further the discussion on the effects of maternal PD and PDCA on parent-infant interaction, infant stress reactivity and child development. Furthermore, study results will be presented at international congresses and expert conferences.

摘要

引言

迄今为止,仅有少数研究比较了围产期产妇抑郁障碍(PD)与伴发焦虑障碍的产妇抑郁障碍(PDCA)对婴儿和儿童发育的影响。由于共病与原发性诊断相关的损害和症状严重程度更大,因此母亲的共病可能会使她们的后代患内化或外化障碍的风险进一步增加,而不仅仅是与 PD 相关。

方法和分析

本研究旨在根据《精神障碍诊断与统计手册》第 5 版(DSM-5)分析父母精神病理学,特别是伴发或不伴发焦虑障碍的围产期母亲的抑郁对儿童认知和社会情感发展的影响。在最初的 2 年内,通过四个时间点评估产妇/父亲精神病理学、母婴/父子互动和儿童发育(T1:产后 3-4 个月,T2:产后 12 个月,T3:产后 18 个月,T4:产后 24 个月)。将分析母婴/父子互动和婴儿应激反应在 PD/PDCA 与婴儿认知和社会情感发展之间关系中的中介作用。在正在进行的研究中,将在慕尼黑和海德堡的住院和门诊中心以及妇产医院招募 174 个家庭(n=58 例 PD 母亲,n=58 例 PDCA 母亲和 n=58 例健康对照组)。

伦理和传播

本研究符合世界医学协会(赫尔辛基宣言修订版)和欧盟一般数据保护条例的现行指南。研究程序已获得慕尼黑路德维希-马克西米利安大学心理学系(74_Reck_b)和海德堡大学医学系(S-446/2017)的独立伦理委员会的批准。参与是自愿的。在进行任何特定于研究的程序之前,必须从每个研究对象获得签署的书面知情同意书。参与者可以随时退出研究,无需给出理由或面临任何未来的不利。如果参与者退出研究,则会保留参与者的数据和材料,除非参与者要求删除数据。研究结果将发表并传播,以进一步讨论母亲 PD 和 PDCA 对母婴互动、婴儿应激反应和儿童发育的影响。此外,研究结果将在国际大会和专家会议上展示。

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