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退伍女兵产后情绪和焦虑障碍的发病率及风险因素

Incidence and risk factors for postpartum mood and anxiety disorders among women veterans.

作者信息

Pratt Alessandra A, Sadler Anne G, Thomas Emily B K, Syrop Craig H, Ryan Ginny L, Mengeling Michelle A

机构信息

Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, 601 Highway 6 West, Building 42, Iowa City, IA 52246, USA.

Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, 601 Highway 6 West, Building 42, Iowa City, IA 52246, USA; VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Iowa City (VRHRC-IC), Iowa City VA Health Care System, 601 Highway 6 West, Iowa City, IA 52246, USA; Department of Psychiatry, University of Iowa Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA 52242, USA.

出版信息

Gen Hosp Psychiatry. 2023 Sep-Oct;84:112-124. doi: 10.1016/j.genhosppsych.2023.06.013. Epub 2023 Jun 25.

Abstract

BACKGROUND

Our aim was to determine rates of postpartum mood and anxiety disorders (PMADs) among U.S. women Veterans and the overlap among PMADs. We further sought to identify PMAD risk factors, including those unique to military service.

METHODS

A national sample of women Veterans completed a computer-assisted telephone interview (N = 1414). Eligible participants were aged 20-45 and had separated from service within the last 10 years. Self-report measures included demographics, general health, reproductive health, military exposures, sexual assault, childhood trauma, and posttraumatic stress disorder (PTSD). The PMADs of interest were postpartum depression (PPD), postpartum anxiety (PPA) and postpartum PTSD (PPPTSD). This analysis included 1039 women Veterans who had ever been pregnant and who answered questions about PPMDs related to their most recent pregnancy.

RESULTS

A third (340/1039, 32.7%) of participants were diagnosed with at least one PMAD and one-fifth (215/1039, 20.7%) with two or more. Risk factors common for developing a PMAD included: a mental health diagnosis prior to pregnancy, a self-report of ever having had a traumatic birth experience, and most recent pregnancy occurring during military service. Additional risk factors were found for PPD and PPPTSD.

CONCLUSION

Women Veterans may be at an increased risk for developing PMADs due to high rates of lifetime sexual assault, mental health disorders, and military-specific factors including giving birth during military service and military combat deployment exposures.

摘要

背景

我们的目的是确定美国女性退伍军人产后情绪和焦虑障碍(PMADs)的发生率以及这些障碍之间的重叠情况。我们还试图确定PMADs的风险因素,包括那些军事服务特有的因素。

方法

一项全国性的女性退伍军人样本完成了一次计算机辅助电话访谈(N = 1414)。符合条件的参与者年龄在20至45岁之间,并且在过去10年内已退伍。自我报告的测量内容包括人口统计学、总体健康状况、生殖健康、军事暴露、性侵犯、童年创伤以及创伤后应激障碍(PTSD)。感兴趣的PMADs包括产后抑郁症(PPD)、产后焦虑症(PPA)和产后创伤后应激障碍(PPPTSD)。该分析纳入了1039名曾经怀孕且回答了与她们最近一次怀孕相关的PPMDs问题的女性退伍军人。

结果

三分之一(340/1039,32.7%)的参与者被诊断患有至少一种PMAD,五分之一(215/1039,20.7%)被诊断患有两种或更多种。发生PMAD的常见风险因素包括:怀孕前的心理健康诊断、曾有过创伤性分娩经历的自我报告以及最近一次怀孕发生在服役期间。还发现了PPD和PPPTSD的其他风险因素。

结论

由于终身性侵犯、心理健康障碍的高发生率以及包括在服役期间分娩和军事战斗部署暴露等军事特定因素,女性退伍军人患PMADs的风险可能会增加。

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