从青春期和受孕前 (VIHCS) 预测围产期抑郁症:20年前性队列研究
George C Patton1, Helena Romaniuk2, Elizabeth Spry1
1Centre for Adolescent Health, Murdoch Childrens Research Institute, University of Melbourne, Royal Children's Hospital Melbourne, Parkville, VIC, Australia.
Lancet (London, England)
|June 15, 2015
概括
围产期抑郁症通常是早期心理健康问题的后果. 在怀孕前识别有心理健康问题史的女性是早期干预和支持的关键.
科学领域:
- 生殖健康 生殖健康
- 心理健康 心理健康
- 围产阶段精神病学 围产阶段精神病学
背景情况:
- 在高收入国家,围产期抑郁影响了10-15%的妇女,而在低收入国家,情况更糟.
- 儿童的结果包括认知,行为和情绪困难;低收入环境中的衰老和身体疾病.
- 孕前心理健康史对于了解围产期抑郁风险至关重要.
研究的目的:
- 为了评估患有围产期抑郁症状的妇女怀孕前精神健康问题的患病率.
- 为了确定怀孕前精神健康问题的历史是否预测围产期抑郁症.
主要方法:
- 利用了来自维多利亚青少年健康队列研究 (VAHCS) 和其后续,维多利亚代际健康队列研究 (VIHCS) 的数据.
- 使用经过验证的仪器评估抑郁症状 (经过修订的临床面试时间表,一般健康问卷,综合国际诊断面试,爱丁堡产后抑郁量表).
- 从怀孕32周到产后12个月,追踪怀孕和评估围产期抑郁症状 (EPDS分数≥10).
主要成果:
- 66%的女性 (253/384) 在受孕前有心理健康问题.
- 在青春期和青春期患有精神健康问题的女性,患上围产期抑郁症状的比率显著更高 (34%对8%).
- 在85%的怀孕中,报告了怀孕前心理健康问题的病史,并出现围产期抑郁症状.
结论:
- 围产期抑郁症状往往先于从青春期或年轻成人开始的心理健康问题.
- 在怀孕前有持续常见精神障碍史的女性代表了可识别的高风险群体.
- 对围产期抑郁症的预防性干预应考虑怀孕前的时期.
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