School of Behavioural, Social and Legal Sciences, Orebro University, Orebro, Sweden.
School of Medical Sciences, Orebro University, Orebro, Sweden.
J Affect Disord. 2023 Mar 15;325:817-823. doi: 10.1016/j.jad.2023.01.069. Epub 2023 Jan 18.
Attention deficit hyperactivity disorder (ADHD) is associated with an increased risk of poor mental health. However, the understanding of ADHD-related burden and impairments in women during the postpartum period is limited. The aim with the present study was to examine the risk of depression and anxiety disorders during the postpartum period among women with and without an ADHD diagnosis.
We used register-based data to identify women who gave birth to their first and/or second child between 2005 and 2013 in Sweden (n = 773,047), of which 0.5 % (n = 3515) had a diagnosis of ADHD prior to pregnancy. Diagnoses of depression and anxiety disorders up to one year after delivery were collected from the national patient register.
A total of 16.76 % of the women with an ADHD diagnosis were also diagnosed with depression disorders in the postpartum period, prevalence ratio (PR) 5.09 (95 % confidence interval (CI), 4.68-5.54). A total of 24.92 % of the women with an ADHD diagnosis were also diagnosed with anxiety disorders in the postpartum period, PR 5.41 (5.06-5.78). Stratified results revealed that having a diagnosis of ADHD increased the risk for both depression and anxiety disorders postpartum, beyond other well-known risk factors.
There is a potential risk of surveillance bias as women diagnosed with ADHD are more likely to have repeated visits to psychiatric care and might have an enhanced likelihood of also being diagnosed with depression and anxiety disorders postpartum, compared to women without ADHD.
ADHD is an important risk factor for both depression and anxiety disorders postpartum. Therefore, ADHD needs to be considered in the maternal care, regardless of sociodemographic factors and the presence of other psychiatric disorders.
注意力缺陷多动障碍（ADHD）与心理健康状况不佳的风险增加有关。然而，对于产后女性的 ADHD 相关负担和损伤的理解有限。本研究旨在调查患有和不患有 ADHD 的女性在产后期间患抑郁和焦虑障碍的风险。
我们使用基于登记的资料，在瑞典（n=773047）中识别 2005 年至 2013 年期间首次和/或第二次分娩的女性，其中 0.5%（n=3515）在怀孕前被诊断为 ADHD。产后一年时从国家患者登记处收集了抑郁和焦虑障碍的诊断。
共有 16.76%被诊断为 ADHD 的女性在产后期间还被诊断为抑郁障碍，患病率比（PR）为 5.09（95%置信区间（CI），4.68-5.54）。共有 24.92%被诊断为 ADHD 的女性在产后期间还被诊断为焦虑障碍，PR 为 5.41（5.06-5.78）。分层结果表明，与其他已知的危险因素相比，患有 ADHD 诊断会增加产后患抑郁和焦虑障碍的风险。
由于 ADHD 患者更有可能多次就诊于精神科护理，因此存在监测偏倚的风险，并且他们在产后更有可能被诊断出抑郁和焦虑障碍，而不是没有 ADHD 的女性。
ADHD 是产后抑郁和焦虑障碍的一个重要危险因素。因此，无论社会人口因素和其他精神障碍的存在与否，都需要在产妇护理中考虑 ADHD。
