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昆士兰州围产期心理健康转介和精神科入院的趋势。

Trends of perinatal mental health referrals and psychiatric admissions in Queensland.

机构信息

Institute for Social Science Research (ISSR), The University of Queensland, Brisbane, QLD, Australia.

School of Medicine, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, QLD, Australia.

出版信息

Aust N Z J Psychiatry. 2023 Mar;57(3):401-410. doi: 10.1177/00048674221080405. Epub 2022 Mar 1.

Abstract

BACKGROUND

Perinatal depression is often underdiagnosed; consequently, many women suffer perinatal depression without follow-up care. Screening for depressive symptoms during the perinatal period has been recommended in Australia to increase detection and follow-up of women suffering from depressive symptoms. Screening rates have gradually increased over the last decades in Australia.

OBJECTIVE

To explore trends in referrals of women to community mental health services during the perinatal period, and prenatal and postnatal admissions to psychiatric units, among those who gave birth in Queensland between 2009 and 2015.

METHOD

Retrospective analyses of data from three linked state-wide administrative data collections. Trend analyses using adjusted Poisson regression models examined 426,242 births. Outcome variables included referrals to specialised mental health services; women admitted with a mood disorder during the second half of their pregnancy and during the first 3 months of the postnatal period; and women admitted with non-affective psychosis disorders during the second half of their pregnancy and during the first 3 months of the postnatal period.

RESULTS

We found an increase in mental health referrals during the perinatal period over time (adjusted incidence rate ratio, 1.07; 95% confidence interval, [1.06, 1.08]) and a decrease in admissions with mood disorders during the first 3 months of the postnatal period (adjusted incidence rate ratio, 0.95; 95% confidence interval, [0.94, 0.98]). We did not find any changes in rates of admission for other outcomes.

CONCLUSION

Since the introduction of universal screening in Queensland, referrals for mental health care during the perinatal period have increased, while admissions for mood disorders in the first 3 months after delivery decreased.

摘要

背景

围产期抑郁症常常被漏诊;因此,许多患有围产期抑郁症的女性得不到后续治疗。澳大利亚建议在围产期期间筛查抑郁症状,以提高对患有抑郁症状的女性的检测和后续治疗率。在过去几十年中,澳大利亚的筛查率逐渐提高。

目的

探讨 2009 年至 2015 年间昆士兰州分娩的女性在围产期期间转介至社区心理健康服务机构的情况,以及产前和产后精神科住院治疗的趋势。

方法

对三个全州范围的行政数据集合进行回顾性数据分析。采用调整后的泊松回归模型进行趋势分析,共纳入 426242 名分娩女性。主要结局变量包括转介至专门的精神卫生服务机构;在妊娠后半期和产后头 3 个月因心境障碍住院的女性;以及在妊娠后半期和产后头 3 个月因非情感性精神病住院的女性。

结果

我们发现,随着时间的推移,围产期心理健康转介率呈上升趋势(调整后的发病率比,1.07;95%置信区间,[1.06,1.08]),产后头 3 个月因心境障碍住院的人数减少(调整后的发病率比,0.95;95%置信区间,[0.94,0.98])。我们未发现其他结局的入院率有变化。

结论

自昆士兰州开展普遍筛查以来,围产期心理健康治疗的转介率有所增加,而产后头 3 个月内心境障碍的入院率有所下降。

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