Chechko Natalia, Stickel Susanne, Losse Elena, Shymanskaya Aliaksandra, Habel Ute
Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany.
Institute of Neuroscience and Medicine, JARA-Institute Brain Structure Function Relationship (INM-10), Research Center Jülich, 52428 Jülich, Germany.
J Pers Med. 2022 Mar 28;12(4):538. doi: 10.3390/jpm12040538.
The inhomogeneity of postpartum mood and mother-child attachment was estimated from immediately after childbirth to 12 weeks postpartum in a cohort of 598 young mothers. At 3-week intervals, depressed mood and mother-child attachment were assessed using the EPDS and the MPAS, respectively. The diagnosis was based on clinical interviews at the end of the 12-week follow-up. The latent class mixed model estimated multiple distinct patterns in depressed mood and mother-child attachment. The baseline EPDS cluster contained 72% of the study population and showed low EPDS values during the follow-up period, while the five remaining clusters showed either deterioration or improvement of the EPDS levels. The majority of women with postpartum depression showed deteriorating, and the majority of adjustment disorder cases improving, behavior. While the cases with more pronounced EPDS values were found to constitute more homogeneous clusters in terms of diagnosis, subclinical or only temporarily increased EPDS levels represented less homogeneous clusters. Higher EPDS levels correlated with the higher risk factor profiles. The four MPAS/EPDS clusters demonstrated that higher EPDS lead to lower mother-child attachment, and vice versa.
在一个由598名年轻母亲组成的队列中，评估了产后情绪和母婴依恋的不均匀性，时间跨度从分娩后即刻至产后12周。每隔3周，分别使用爱丁堡产后抑郁量表（EPDS）和母婴依恋量表（MPAS）对抑郁情绪和母婴依恋进行评估。诊断基于12周随访结束时的临床访谈。潜在类别混合模型估计了抑郁情绪和母婴依恋中的多种不同模式。基线EPDS类别包含72%的研究人群，且在随访期间EPDS值较低，而其余五个类别则显示出EPDS水平的恶化或改善。大多数产后抑郁症患者表现出恶化的行为，而大多数适应障碍病例表现出改善的行为。虽然发现EPDS值较高的病例在诊断方面构成更同质的类别，但亚临床或仅暂时升高的EPDS水平代表的类别不太同质。较高的EPDS水平与较高的风险因素特征相关。四个MPAS/EPDS类别表明，较高的EPDS会导致较低的母婴依恋，反之亦然。
