Northwestern University Feinberg School of Medicine, Asher Center for the Study and Treatment of Depressive Disorders, Chicago, Illinois.
University of Toronto, Women's College Hospital, Toronto, Ontario, Canada.
J Clin Psychiatry. 2024 Nov 20;85(4):23m15023. doi: 10.4088/JCP.23m15023.
Little is known about differences between Black and White women with respect to the prevalence of postpartum mood disorders or symptom presentations. To determine the prevalence and characteristics of postpartum major mood disorders in Black and White women at 4-6 weeks after birth. This is a secondary analysis of a large-scale study designed to screen women for postpartum depression with the Edinburgh Postnatal Depression Scale (EPDS) and collect symptom data. Data were collected at an urban maternity hospital in an academic setting in Pittsburgh, Pennsylvania. Of the 2,019 women who screened positive and accepted a psychiatric diagnostic interview, 163 and 85 Black women had major depressive and bipolar disorders, respectively, and 508 and 177 White women had major depressive and bipolar disorders, respectively. Those with an EPDS score greater than or equal to 10 were offered a psychiatric assessment (in-person at home or by telephone) with the Structured Clinical Interview for using the Structured Interview Guide for the Hamilton Rating Scale for Depression, Atypical Depression Version symptom inventory, a questionnaire related to childhood and adulthood physical and sexual abuse, and the Short Form Survey 12. Participants who self-identified as Black or White were included in this analysis. Among screen-positive participants, no significant difference in the rate of major depressive disorder (40% Black and 35% White) was observed. However, bipolar disorder significantly differed between Black (19.2%) and White (11.5%) women. Additionally, symptom profiles differed between Black and White participants with major depressive disorder, and a high rate of traumatic experiences was reported by participants with major depression and bipolar disorder in both racial groups. An understanding of the different presentations of postpartum mood disorders between Black and White women, as well as trauma-informed care, can optimize postpartum health care through supporting advocacy efforts for resource allocation and health care delivery. Dataset from study at ClinicalTrials.gov identifier: NCT00282776.
目前对于黑人和白人女性在产后情绪障碍的患病率或症状表现方面的差异知之甚少。本研究旨在确定产后 4-6 周黑人及白人女性产后主要心境障碍的患病率和特征。这是一项大规模研究的二次分析,该研究旨在使用爱丁堡产后抑郁量表(EPDS)对女性进行产后抑郁筛查,并收集症状数据。数据来自宾夕法尼亚州匹兹堡市一家城市妇产医院的学术环境。在 2019 名筛查阳性并接受精神病学诊断访谈的女性中,分别有 163 名和 85 名黑人女性患有重度抑郁症和双相情感障碍,分别有 508 名和 177 名白人女性患有重度抑郁症和双相情感障碍。EPDS 评分≥10 分的患者接受了精神病评估(在家中进行面对面评估或通过电话进行),使用《汉密尔顿抑郁量表》的结构化临床访谈,《非典型性抑郁症状清单》、一份与儿童期和成年期身体和性虐待有关的问卷以及《简短健康调查问卷 12 版》。本分析纳入了自我认定为黑人或白人的参与者。在筛查阳性的参与者中,重度抑郁症的发生率没有显著差异(黑人 40%,白人 35%)。然而,黑人(19.2%)和白人(11.5%)女性的双相情感障碍发生率存在显著差异。此外,黑人及白人重度抑郁症患者的症状特征存在差异,两组重度抑郁症和双相情感障碍患者均报告了较高的创伤经历发生率。了解黑人和白人女性产后情绪障碍的不同表现形式以及基于创伤的护理方法可以通过支持资源分配和医疗保健提供的宣传工作,优化产后保健。本研究数据来自于 ClinicalTrials.gov 注册号:NCT00282776。