产后忧郁和抑郁症的发生和预防

阐述了产后忧郁和抑郁症的临床表现和关系，介绍了引起产后忧郁和产后抑郁症的生物因素、心理因素、社会因素以及预防措施。     

产后抑郁症相关因素的探讨

目的:了解产后3 d产后忧郁的发生及产后42 d产后抑郁症的发生率及其相关的发病因素。方法:采用产后忧郁症评估表——贝氏量表(BDI)、焦虑自评量表、产褥期抑郁症诊断标准和产妇一般情况调查表,对192例产妇进行产后忧郁和产后抑郁症及其相关因素的调查。结果:产后3 d产后忧郁发生率20.8%(40/192),产后抑郁症发生率5.2%(10/192)。孕期夫妻关系,丈夫企盼生男孩的程度,家庭支持等心理因素及经前期综合征等生物学因素和产后抑郁情况密切相关。结论:产后忧郁在围生期妇女中具有较高的发生率,是产妇常见的精神及心理障碍。产后焦虑和忧郁情绪是发生产后抑郁症的最主要因素。调节好家庭成员的关系,加强孕产妇心理保健及分娩知识的宣传教育,及早发现和治疗。     

产后忧郁及其护理

一般认为产后忧郁是生物、心理、社会等诸因素相互作用的结果 ,目前诊断尚无客观指标。简要介绍了产后忧郁的病因 ,并从心理学角度提出了预防和护理措施。     

产后忧郁及其护理

一般认为产后忧郁是生物、心理、社会等诸因素相互作用的结果，目前诊断尚无客观指标.简要介绍了产后忧郁的病因，并从心理学角度提出了预防和护理措施。     

影响产妇心身健康因素的研究

目的:探讨影响产妇心理健康的有关因素,为预防产后抑郁提供依据。方法:对220名产妇应用艾森克人格问卷(EPQ)、社会支持量表(SSRS)、生活事件量表(LES)、抑郁自评量表(SDS)、焦虑自评量表(SAS)及心理健康自评量表(SCL-90)进行评定,分析产妇心身健康的影响因素。结果:与常模相比EPQ显示低E分和高N分(P<0.05);SCL-90的躯体化、忧郁、焦虑因子分及SAS总分、SDS总分在产后均显著高于产前(P<0.05);SSRS总分则显著低于产前(P<0.01);神经质倾向、主观支持不足、产前忧郁、SDS总分高和负性生活事件是产后心身健康的主要影响因素(P<0.05)。结论:产后抑郁是多种因素共同作用的结果,需采取综合措施以预防产后抑郁症的发生。     

产后心理障碍原因分析和心理护理

2008年我院产科分娩11093例，其中发生产后抑郁53例，年龄22～41（平均27．4）岁，剖腹产31例，生理产22例。这些产妇都不同程度的出现表情冷淡、压抑、易激惹、失眠、精神忧郁，或出现焦虑、孤独感、思维过程异常、认知不良、偏执、甚至躁狂等表现。最早出现情绪改变的在产时，最晚出现在产后10d。笔者对产后心理障碍原因和心理护理总结如下。     

产妇产后抑郁因素及护理对策

产后抑郁症是指产妇分娩早期出现的以哭泣、忧郁、疲乏、易怒、焦虑、沮丧、悲哀等一系列症状为特征的心理障碍,一般发生在产后6周内.不仅对产妇的自身健康、婚姻和家庭有不良的影响,而且还会对哺乳和母婴关系产生影响,更甚者会引起产妇杀婴和自杀的行为,危害极大,国内外不乏此类报道.笔者对产妇产后抑郁因素及护理对策总结如下.     

惠州市产后抑郁症发病情况及相关因素分析

目的：调查惠州市产后抑郁症的发病情况并探讨其相关影响因素。方法采用整群随机抽样方法，以2013年1～5月全市5所医院产后42 d妇女为调查对象，采用自行设计的一般资料调查表及爱丁堡产后忧郁调查量表（EPDS）进行问卷调查，对产后抑郁症可能的影响因素进行Logistic多因素回归分析。结果1806例产妇中，发生产后抑郁症209例，发病率为11．6％。Logistic多因素回归分析结果显示，新生儿性别为男孩、顺产、有人帮忙带小孩、上孕妇学校次数等于或大于2次为产后抑郁症的保护因素（P＜0．05）；担心分娩影响体型、家庭不和睦、对居住环境不满意为产后抑郁症的危险因素（P＜0．05）。结论产后抑郁症是多种因素共同作用的结果，有针对性地对产后妇女采取干预措施，才能有效保护产后妇女的心理健康。     

优质护理服务降低产后忧郁症发病率的效果研究

目的：探讨优质护理服务对产后忧郁症的影响,客观评价优质护理服务在降低产后忧郁发病率的实践效果。方法2010年1～12月在我院住院分娩的产妇观察组采用优质护理服务（48例）和对照组采用常规护理服务（52例）,调查实施优质护理服务一年后两组产妇产后忧郁症发病率,正确评价优质护理服务在产科护理工作中的实施效果。结果观察组的产后抑郁症发病率显著低于对照组,差异有统计学意义（P＜0．01）。结论优质护理服务是提高护理工作水平、加强服务意识的重要保障,可有效降低产后忧郁发病率。     

产后抑郁症的诱因分析及护理措施研究

针对产妇存在的产后忧郁问题,通过对发病率、发病原因、病情危害等方面的分析,从护理心理学角度提出了预防措施,对产后抑郁症的防治具有积极作用。     

Paternal postpartum depression, its relationship to maternal postpartum depression, and implications for family health

BACKGROUND: Much attention has been paid to the problem of postpartum depression in women. However, there is some indication that men also experience depression after the birth of a child, and that paternal depression is linked to maternal depression. AIMS: The purpose of this integrative review was to examine current knowledge about postpartum depression in fathers. Specific aims were (1) to examine the incidence of paternal depression in the first year after the birth of a child, (2) to identify the characteristics and predictors of paternal postpartum depression, (3) to describe the relationship between maternal and paternal postpartum depression, and (4) to discuss the influence of paternal depression on the family and infant. METHODS: A literature search from 1980 to 2002 was carried out using the CINAHL, PsychInfo, and Medline electronic databases. Twenty research studies were identified that included incidence rates of paternal depression during the first year postpartum. These were further examined and synthesized regarding onset, severity, duration, and predictors of paternal depressive symptoms, and for information about the relationship between maternal and paternal depression. FINDINGS: During the first postpartum year, the incidence of paternal depression ranged from 1.2% to 25.5% in community samples, and from 24% to 50% among men whose partners were experiencing postpartum depression. Maternal depression was identified as the strongest predictor of paternal depression during the postpartum period. The implications of parental depression for family health were discussed. CONCLUSIONS: Postpartum depression in men is a significant problem. The strong correlation of paternal postpartum depression with maternal postpartum depression has important implications for family health and well-being. Consideration of postpartum depression in fathers as well as mothers, and consideration of co-occurrence of depression in couples, is an important next step in research and practice involving childbearing families.     

The epidemiology and pathogenesis of postpartum depression

Mood disorders--maternity blues, depression and bipolar disorders with psychotic features--are common and increased in rate during the postpartum period as compared to the non-postpartum period. Several authors showed a frequent recurrence of postpartum depression in women with a history of postpartum depression. Bloch, et al: (2000) showed that 5 of 8 women(62.5%) with a history of postpartum depression and none of the 8 control women developed significant mood symptoms during the withdrawal from high serum levels of progesterone and estradiol. These findings indicate that a history of postpartum depression produces hypersensitivity or reverse tolerance to subsequent exposure to an acute decrease of gonadal steroids at least for a subgroup of women with a past postpartum depression.     

初产妇社会支持与产后抑郁关系的探讨

目的探究目前初产妇社会支持与产后抑郁的关系.方法通过对200例初产妇进行问卷调查,应用SPSS进行相关分析.结果初产妇社会支持与产后抑郁呈中度负相关的关系(r=-0.44,P＜0.01).在社会支持的4种类型中,情感支持与产后抑郁的关系为轻度负相关(r=-0.16,P＜0.01),物质支持、信息支持和评价支持分别与产后抑郁呈中度负相关关系(r分别为-0.31,-0.35,-0.45,P＜0.05).结论增强初产妇的社会支持,尤其是信息支持和评价支持,可以防止或减少产后抑郁的发生.     

Social support and postpartum depression

Discrepancies between prenatal social support expectations and subsequent perceptions of support actually received were examined in relation to postpartum depression. Low-risk primiparous women (N = 105) were surveyed 1 month before and 1 month after delivery. Almost half of the women prenatally and one third postpartally had depression scores which would lead them to be classified as possibly depressed (CES-D scores of 16 or greater). In multiple regression, two social support discrepancy measures, prenatal depression and postpartal closeness to husband, correlated with postpartal depression and accounted for nearly 40% of its variance. The generalizability of the findings should be further explored, but the findings suggest the need for attention to prenatal expectations of postpartum support as a way to influence the incidence of postpartum depression. In addition, continued efforts to identify causes of postpartum closeness with the spouse are needed.     

产后抑郁及其相关心理社会因素调查

目的探讨产后抑郁的发生率及其相关的心理社会因素,为早期心理卫生干预提供依据。方法采用爱丁堡抑郁量表及自拟的心理社会因素调查表对350例初产妇产后6w的抑郁状况进行测评分析。结果产后抑郁的发生率为22%,其中轻度占90.6%,中度占9.4%。产妇的年龄、学历、婴儿性别、分娩过程、婆媳关系不同,对产后抑郁的影响有显著性差异（P〈0.05）;夫妻关系、产后护理、居住条件、产后睡眠状况不同,对产后抑郁影响有极显著性差异（P〈0.01）;而产妇的职业、家庭收入、喂养方式不同,对产后抑郁影响无显著性差异（P〉0.05）。结论初产妇产后抑郁发生率较高,心理社会因素对产后抑郁的影响不容忽视。我们应做好孕产妇在围产期中的心理卫生保健工作,使产妇愉快地度过情感危险期,从而降低产褥期抑郁的发生。     

Prediction of postpartum depression

This article briefly reviews definitions, etiology, and cultural aspects of postpartum depression. Studies attempting to predict postpartum depression are examined, and a summary of risk factors is given. The importance of educating all pregnant women about postpartum depression is stressed, and sample patient education information is presented.     

产妇产后抑郁症相关因素的调查分析

目的了解影响产妇产后抑郁症的相关因素,并提出相对应的护理干预措施。方法采用抑郁自评量表（sDs）和自行设计的调查问卷对I100例产妇产后的抑郁心理状态和影响产后抑郁症的相关因素进行调查结果产妇产后抑郁症的发病率为7．4％。影响产妇产后抑郁症发生的相关因素分别为：家庭关系（56．4％）、产妇问题（27．1％）和小儿问题（16．5％）。结论有效的产前健康教育、产时心理护理和社区护理干预可减轻产妇产后抑郁症的发生。     

产后抑郁相关影响因素调查及社区医疗对策

目的探讨社区产妇产后抑郁症患者的相关影响因素及对策。方法使用爱登堡产后抑郁量表(EPDS)对2008~2010年69例社区产后抑郁症患者资料进行总结与分析。结果社区中产妇产后抑郁的发生率为17.7%,产后抑郁的发生与产妇文化程度以及分娩方式等有关(P<0.01);与产妇年龄、婴儿性别无关。结论产妇回到家庭后发生产后抑郁的影响因素较多,社区医务人员需注意观察产妇的心理变化,早期发现和及时治疗产后抑郁症。     

Theoretical perspectives of postpartum depression and their treatment implications

Approximately 13% of new mothers experience postpartum depression. This crippling mood disorder wreaks havoc not only on the mothers themselves but also on their entire families. Between 25% and 50% of mothers with postpartum depression have episodes lasting 6 months or longer. The most significant factor in the duration of the postpartum depression is the length of delay to adequate treatment. The purpose of this article is to describe five different theoretical perspectives of postpartum depression and the interventions for treatment derived from each: the medical model, feminist theory, attachment theory, interpersonal theory, and self-labeling theory. Crucial to clinicians' choice of treatment of postpartum depression is the theoretical lens they use to view this devastating mood disorder. Nursing implications derived from these theoretical perspectives are addressed.     

产后早期母婴连结与产后抑郁状况及其相关性分析

目的探讨产妇产后早期母婴连结及产后抑郁现状及其相关性。方法采用便利抽样法,选取2018年8月—10月在本市某三级甲等综合医院门诊进行产后复查的413例产妇为研究对象,采用一般资料调查表、产后连结问卷(postpartum bonding questionnaire,PBQ)、爱丁堡抑郁量表(Edinburgh postnatal depression scale,EPDS)进行调查。结果产妇母婴连结总分的中位数为12.0(6.0,19.0)分,均数(13.8±9.6)分,处于低水平,其中正常母婴连结者80.9%,轻度连结异常者17.4%,潜在拒绝者1.5%,明确拒绝者0.2%;产后抑郁得分为(7.2±4.6)分,处于低水平,产后抑郁发生率31.0%;产后抑郁与母婴连结得分呈正相关(r=0.419,P<0.001);多重线性回归分析显示,在控制一般资料后产后抑郁是母婴连结的风险因素(P<0.05)。结论母婴连结障碍及其产后抑郁发生率不容忽视,产后抑郁是影响母婴连结的危险因素。应注意早期发现产后母婴连结障碍和产后抑郁,采取针对性的干预策略,促进母婴健康。