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妊娠合并胎儿异常时的心理健康:单一胎儿护理中心的抑郁筛查与转诊

Mental health in pregnancy complicated by fetal anomaly: depression screening and referrals in a single fetal care center.

作者信息

Hansen Kara, Kukora Stephanie K, Sherman Ashley, Feldman Keith

机构信息

Fetal Health Center, Children's Mercy Kansas City, Kansas City, MO, USA.

Bioethics Center and Division of Neonatology, Children's Mercy Kansas City, Kansas City MO; University of Missouri-Kansas City (UMKC) School of Medicine, Kansas City, MO, USA.

出版信息

J Perinatol. 2024 Sep 17. doi: 10.1038/s41372-024-02118-8.

Abstract

To quantify depression screening rates in a fetal care center, identify characteristics associated with screenings and identify mental health referral uptake rates STUDY DESIGN: This retrospective cohort study of 166 patients in a single fetal care center investigated patients screened during pregnancy with the Edinburgh Postnatal Depression Scale RESULTS: Patients screened positive for depression at a rate of 31.9% using 10 as the cut-off score at their first mental health consult following diagnosis. Patients with a prior mental health diagnosis and lacked insurance or had state insurance were more likely to screen positive. Additionally, patients were more likely to screen positive with a severe fetal diagnosis or uncertain fetal prognosis. Patients were likely to accept a referral for therapy; fewer accepted a referral for pharmacotherapy CONCLUSION: Fetal care center patients are at risk of depressed mood and may be identified through universal screening. Particular attention should be provided to patients with an uncertain fetal prognosis and other identified characteristics.

摘要

为了量化胎儿护理中心的抑郁症筛查率,确定与筛查相关的特征,并确定心理健康转诊接受率。研究设计:这项对单一胎儿护理中心的166名患者进行的回顾性队列研究,调查了孕期使用爱丁堡产后抑郁量表进行筛查的患者。结果:以10分为诊断后首次心理健康咨询时的临界值,抑郁症筛查呈阳性的患者比例为31.9%。既往有心理健康诊断且没有保险或有国家保险的患者更有可能筛查呈阳性。此外,患有严重胎儿诊断或胎儿预后不确定的患者更有可能筛查呈阳性。患者有可能接受治疗转诊;接受药物治疗转诊的较少。结论:胎儿护理中心的患者有情绪低落的风险,可通过普遍筛查来识别。应特别关注胎儿预后不确定的患者和其他已确定的特征患者。

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