Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland.
Psychological Methods, Evaluation and Statistics, University of Zurich, Zurich, Switzerland.
Womens Health (Lond). 2023 Jan-Dec;19:17455057221147391. doi: 10.1177/17455057221147391.
Depressive symptoms are common in the peripartum period and pose a great risk to the well-being of the mother, the infant, and the entire family. Evidence from longitudinal studies suggests that affected women do not constitute one homogeneous group in terms of severity, chronicity, and onset of symptoms. To account for individual differences regarding the longitudinal course of depressive symptoms from pregnancy to the postpartum period, growth mixture models have proven to be useful.
We conducted a group-based trajectory modeling analysis to identify perinatal depressive symptom trajectories in a Swiss sample ( = 151). Depressive symptoms were assessed six times, covering nearly 6 months from the third trimester of pregnancy to 3 months postpartum. In addition to determining perinatal depressive symptom trajectories, we aimed to examine whether these trajectories are linked to psychopathological risk factors such as a history of premenstrual syndrome (PMS), anxiety, prenatal stress, and somatic symptoms after delivery that are associated with hormonal fluctuations.
The findings revealed three trajectories of perinatal depressive symptoms that were relatively stable over time and differed in symptom load (low, medium, high), as well as one trajectory of decreasing symptoms, with a significant symptom reduction after giving birth. Women with a higher depressive symptom load experienced a greater degree of prior premenstrual symptoms, prenatal anxiety, and birth anxiety, as well as somatic symptoms after delivery.
Further research is needed to account for the distinct trajectories of perinatal depressive symptoms in order to provide appropriate care for affected women. A focus on somatic symptoms after delivery and their association with depressive mood is essential to better understand the potential shared etiopathology of reproductive transition phase mood disorders.
围产期抑郁症状很常见,对母亲、婴儿和整个家庭的幸福构成了极大的威胁。来自纵向研究的证据表明,受影响的女性在严重程度、持续性和症状发作方面并非构成一个同质群体。为了说明从怀孕到产后期间抑郁症状的纵向变化过程中的个体差异,增长混合模型已被证明是有用的。
我们对瑞士样本( = 151)进行了基于群组的轨迹建模分析,以确定围产期抑郁症状轨迹。使用六次评估来测量抑郁症状,涵盖了从妊娠第三个月到产后三个月近 6 个月的时间。除了确定围产期抑郁症状轨迹外,我们还旨在检查这些轨迹是否与心理病理风险因素相关联,例如经前期综合征(PMS)、焦虑、产前压力和产后躯体症状,这些因素与荷尔蒙波动有关。
研究结果显示,有三种相对稳定的围产期抑郁症状轨迹,在症状负荷(低、中、高)方面存在差异,还有一种症状减轻的轨迹,产后症状显著减轻。具有较高抑郁症状负荷的女性经历了更多的经前期症状、产前焦虑和分娩焦虑,以及产后躯体症状。
需要进一步研究围产期抑郁症状的不同轨迹,以便为受影响的女性提供适当的护理。关注产后躯体症状及其与抑郁情绪的关系,对于更好地理解生殖过渡期情绪障碍的潜在共同发病机制至关重要。