围产期抑郁症和自杀行为风险
Hang Yu1, Qing Shen2,3, Emma Bränn1
1Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
JAMA network open
|January 9, 2024
概括
患有围产期抑郁症 (PND) 的女性面临着明显更高的自杀行为风险,特别是在诊断后的第一年. 这种高风险持续长达18年,需要对这种脆弱人群进行持续的临床治疗.
科学领域:
- 生殖医学 生殖医学
- 精神病学是一个精神病学.
- 流行病学 流行病学
背景情况:
- 围产期抑郁症 (PND) 影响了许多女性,但关于自杀行为风险的长期数据很少.
- 了解与PND相关的长期风险对于有效的孕产妇心理健康护理至关重要.
研究的目的:
- 调查PND与短期和长期自杀行为风险之间的关联.
- 量化PND妇女自杀企图和完成自杀的风险.
主要方法:
- 在瑞典 (2001-2017) 进行的一项全国性人口匹配队列研究,包括超过86,000名患有PND的妇女和匹配的对照.
- 兄弟姐妹的比较被用来控制家族因素.
- 时间与事件分析估计了自杀行为的危险比率 (HR).
主要成果:
- 与未受影响的女性相比,患有PND的女性表现出自杀行为风险增加了3.15倍 (HR 3.15).
- 在诊断后的第一年 (HR 7.20) 风险显著增加,但直到18岁 (HR 2.34) 风险仍然显著.
- 这种关联在产后抑郁症和没有先前精神病史的妇女中更为强烈.
结论:
- 围产期抑郁症显著增加了自杀行为风险.
- 增加的风险在诊断后的早期是最明显的,但长期持续存在.
- 警的临床监测对于患有PND的女性是必不可少的,因为持续的自杀行为风险.
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