Li Yijia, Gao Mengyu Miranda, Liu Sihan, Yang Li, Zheng Ruimin
Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, PR China.
Key Laboratory of Adolescent Cyberpsychology and Behavior (Ministry of Education), Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, PR China.
J Affect Disord. 2025 Jun 15;379:109-117. doi: 10.1016/j.jad.2025.03.016. Epub 2025 Mar 4.
Perinatal depression is a major global public health problem, but the onset and progression of symptoms that give rise to perinatal depression are less clear in the scientific literature.
This study followed 1210 Chinese pregnant women who completed the Edinburgh Postnatal Depression Scale at five time points: 13, 24, and 37 weeks of gestation (G13, G24, G37), and 1 and 6 weeks postpartum (W1, W6). Cross-lagged panel networks were used to analyze and compare networks from first to second trimester (G13 → G24), second to third trimester (G24 → G37), and one week to six weeks postpartum (W1 → W6).
Results showed that network structure did not differ significantly between the three networks, demonstrating continuity of depressive symptoms over the course of pregnancy and postpartum. Across the three periods, self-reported panic was identified as the symptom that had the largest influence on other symptoms at a following assessment, and self-reported worry was the symptom that was most strongly influenced by depressive symptoms at previous timepoints. Moreover, thoughts of self-harm showed a distinct feature where it could only trigger other symptoms in the postnatal, but not prenatal period.
Self-reported questionnaires used in this study may be susceptible to bias. Items of perinatal depressive symptoms included in the network analysis are also not exhaustive.
Findings from this symptom-oriented psychopathology network shed light upon the developmental course of perinatal depressive symptoms, providing insights for tailored preventative intervention programs.
围产期抑郁症是一个重大的全球公共卫生问题，但引发围产期抑郁症的症状的发作和进展在科学文献中尚不清楚。
本研究跟踪了1210名中国孕妇，她们在五个时间点完成了爱丁堡产后抑郁量表：妊娠13周、24周和37周（G13、G24、G37），以及产后1周和6周（W1、W6）。采用交叉滞后面板网络分析和比较妊娠早期至中期（G13→G24）、中期至晚期（G24→G37）以及产后1周和6周（W1→W6）的网络。
结果显示，三个网络的结构没有显著差异，表明抑郁症状在妊娠和产后过程中具有连续性。在这三个时期中，自我报告的恐慌被确定为在后续评估中对其他症状影响最大的症状，而自我报告的担忧是在先前时间点受抑郁症状影响最强的症状。此外，自我伤害的想法表现出一个独特的特征，即它只能在产后而非产前触发其他症状。
本研究中使用的自我报告问卷可能容易产生偏差。纳入网络分析的围产期抑郁症状项目也不详尽。
这个以症状为导向的精神病理学网络的研究结果揭示了围产期抑郁症状的发展过程，为量身定制的预防干预项目提供了见解。
