在流产后的6个月内出现严重抑郁症
R Neugebauer1, J Kline, P Shrout
1Epidemiology of Developmental Brain Disorders Department, New York State Psychiatric Institute, New York, NY 10032, USA.
JAMA
|February 5, 1997
概括
流产的女性在六个月内面临更高的重大抑郁症 (MDD) 风险,特别是如果没有孩子. 早期监测和支持对于这些妇女在流产后至关重要.
科学领域:
- 生殖健康 生殖健康
- 心理健康 心理健康
- 精神病学是一个精神病学.
背景情况:
- 失去怀孕,包括流产,是一个重要的事件,可以影响妇女的心理健康.
- 以前的研究表明,不良生殖事件和随后的情绪障碍之间存在联系,但具体的风险因素需要进一步阐明.
研究的目的:
- 为了调查在流产后的六个月内发展重大抑郁症 (MDD) 的风险.
- 确定经历流产的妇女的特定子组,这些妇女有更高的MDD风险,包括没有孩子的妇女,以前有生殖能力丧失的妇女和老年妇女.
- 探索MDD的风险是否随着流产时的妊娠年龄或女性对怀孕的态度而变化.
主要方法:
- 采用了一个队列研究设计,将经历流产的女性 (n=229) 与社区对照组 (n=230) 进行比较.
- 用诊断面试时间表来评估主要抑郁症.
- 参与者是参加自发堕胎医疗中心的妇女和匹配的社区样本.
主要成果:
- 与对照组相比,流产妇女患MDD的风险明显高 (10.9%) (4.3%),整体相对风险 (RR) 为2.5.5.
- 与有孩子的妇女相比,没有孩子的妇女的风险明显增加 (RR=5.0) (RR=1.3).
- 在流产组中,大多数MDD病例始于流产后的第一个月内,54%有MDD病史的人出现了复发. 风险因先前的生殖能力丧失,母亲的年龄,妊娠时间或对怀孕的态度而没有显著变化.
结论:
- 经历流产的女性患重度抑郁症的风险增加,特别是在流产后的最初几周.
- 没有孩子的妇女和有重大抑郁症史的人被确定为需要密切监测的高风险群体.
- 医疗保健提供者应考虑为流产妇女提供支持性咨询或精神药物治疗,特别是那些属于确定的高风险类别的妇女.
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