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生育期退伍军人的产后抑郁症状严重程度:探究环境指标的作用。

Postpartum depressive symptom severity among child-bearing Veterans: Examining contributions of environmental indices.

作者信息

Nettleton Stephanie, Diesel Sara, Alexander Bruce, O'Hara Michael W, Vander Weg Mark, Thomas Emily B K

机构信息

VHA Office of Rural Health (ORH), Veterans Rural Health Resource Center - Iowa City (VRHRC-IC), Iowa City VA Healthcare System, Iowa City, IA, USA.

Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA.

出版信息

Rural Ment Health. 2025;1. doi: 10.1037/rmh0000312.

Abstract

Veterans are at increased risk of experiencing postpartum depression yet are understudied. Environmental factors like rurality and resource richness are associated with various health outcomes, although environmental relations to mental health outcomes, such as postpartum depression (PPD), have not been explored thoroughly. The current study aimed to examine the relation between living environment utilizing two indices (Area Deprivation Index and Rural Urban Commuting Area) and postpartum depressive symptom severity in postpartum Veterans. The study sample included postpartum Veterans that were recruited for an online CBT intervention. We utilized screening data from this recruitment effort. Depressive symptom severity was measured via the Patient Health Questionnaire-9. Individual Veteran-level administrative data included age, race, ethnicity, and residential address. Linear regression was used to determine whether resource richness and rurality were associated with depressive symptom severity when adjusting for race. Black Veterans had greater depressive symptom severity than White Veterans (β = 0.12, = 3.39 < .001). Rural-dwelling Veterans had lower depressive symptom severity than non-rural dwelling Veterans. Resource richness was not significantly associated with depressive symptom severity. There was not a significant interaction between race and rurality. The results of this study indicate that Black postpartum Veterans enrolled in VA care experienced greater depressive symptom severity. Additionally, rural-dwelling postpartum Veterans reported lower depressive symptom severity. Many postpartum Veterans in this sample were experiencing high symptom burden. Screenings for depressive symptom severity in the postpartum period should be provided to all childbearing individuals, but among Veterans, this may be particularly important.

摘要

退伍军人患产后抑郁症的风险增加,但相关研究不足。农村地区和资源丰富程度等环境因素与各种健康结果相关,尽管环境与心理健康结果(如产后抑郁症(PPD))之间的关系尚未得到充分探讨。本研究旨在利用两个指标(地区贫困指数和城乡通勤区)来检验生活环境与产后退伍军人产后抑郁症状严重程度之间的关系。研究样本包括为在线认知行为疗法干预招募的产后退伍军人。我们利用了此次招募工作的筛查数据。通过患者健康问卷-9来测量抑郁症状严重程度。退伍军人个人层面的行政数据包括年龄、种族、民族和居住地址。在对种族进行调整后,使用线性回归来确定资源丰富程度和农村地区与抑郁症状严重程度是否相关。黑人退伍军人的抑郁症状严重程度高于白人退伍军人(β = 0.12, = 3.39 <.001)。居住在农村的退伍军人的抑郁症状严重程度低于非农村地区的退伍军人。资源丰富程度与抑郁症状严重程度没有显著关联。种族和农村地区之间没有显著的交互作用。本研究结果表明,接受退伍军人事务部护理的黑人产后退伍军人抑郁症状严重程度更高。此外,居住在农村的产后退伍军人报告的抑郁症状严重程度较低。该样本中的许多产后退伍军人症状负担较重。应向所有育龄人群提供产后抑郁症状严重程度筛查,但在退伍军人中,这可能尤为重要。

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