广东省翁源县妇女孕期抑郁水平及影响因素的调查分析

目的调查广东省翁源县妇女孕期抑郁的水平并分析其影响因素,为孕期心理保健提供重要依据。方法采用单纯随机抽样的方法,抽取在广东省翁源县妇幼保健院住院分娩的产妇进行问卷调查。结果 206名调查对象中,抑郁量表平均得分为（40.75±9.42）分,孕期抑郁症的患病率为14.56%。多因素分析表明,年龄≥35岁、家庭人均收入〈2000元/月、主观支持得分低的孕妇孕期抑郁水平高。结论年龄、家庭经济状况、主观支持情况对妇女孕期抑郁水平有影响,应有针对性地开展心理卫生健康教育和心理咨询工作。     

沈阳地区孕妇产前情绪状态的调查研究

目的了解孕妇产前的情绪波动状况,为其心理辅导、实施精神助产提供科学依据。方法应用焦虑自评量表(SAS)和抑郁自评量表(SDS),对我院2006年上半年来院就诊的孕35周以上的产前孕妇随机抽取220名进行测试,收回有效问卷216份。量表均值用t检验与全国普通人口常规检测的标准数据(常模)进行组间比较。结果孕妇总体产前的SAS与全国正常群体模型(全国常模)相比无显著性差异,但SDS总粗分明显低于全国常模(P<0.01),同时出现抑郁症状的产妇其SDS总粗分明显高于全国常模(P<0.01);在焦虑患者中,轻度患者占91.67%,中度者为8.34%,无重度焦虑的患者;在抑郁患者中,轻度和中度患者各占50%,无重度抑郁患者。结论在调查的产妇中,焦虑的出现率未见增加,但出现抑郁症状的产妇明显多于正常人。     

产妇产后抑郁情况临床分析

产妇抑郁属一种良性精神障碍．因个体素质差异(文化程度、性格、经济状况、环境等)、产前宣教程度和产式不同而异。为了确保产妇的身心健康．防止产后抑郁症的发生，提出有效的预防措施．对我院186例产妇进行了抑郁心理咨询调查。     

产后抑郁症的护理

目的 探讨产后抑郁症护理预防的疗效.方法 随机抽取我科产妇100例,分为观察组和对照组各50例.对观察组进行护理预防,对照组不进行任何干预.产后8天采用爱丁堡产后抑郁量表(Edinburgh postnatal depression scale.EPDS)对其抑郁程度进行评分,EPDS≥13分且符合DSM-IV产后抑郁...     

十堰地区孕妇抑郁症状调查及相关风险因素

目的:调查分析十堰地区孕妇抑郁症状及影响的相关因素,为该地区孕产妇的心理保健提供依据。方法:采用流行病学研究中心抑郁量表(CES-D)对十堰地区妊娠期女性进行为期5年的调查与评价,分析十堰市妊娠期女性的心理健康异常的相关影响因素。结果:共380例产妇进行了心理健康状况调查分析,所有孕妇可能存在抑郁症状的共有84人,总阳性率为22.1%,其中健康组的稳定职业、家庭人均收入≥3000、医保或公费支付、产次≥1次和孕前保健的比例显著高于抑郁组(P0.05),而抑郁组孕妇的有流产经历比例显著高于健康组(P0.05),其中家庭人均收入(OR:3.234,95%CI:1.422~4.245)、产次(OR:2.134,95%CI:1.022~3.523)、流产经历(OR:2.342,95%CI:1.677~4.231)、孕前保健(OR:4.562,95%CI:1.345~7.234)均为孕妇合并抑郁症状的显著影响因素。结论:十堰地区的孕妇普遍存在抑郁情绪的症状,不同孕妇的家庭人均收入、产次、流产经历、孕前保健是影响孕妇合并抑郁症状的主要因素。     

简易精神症状自陈量表对强制隔离戒毒所疑似精神障碍个体的甄别

目的:探讨《简易精神症状自陈量表》甄别强制戒毒人群中诈病以及伪装的有效性和特异性,为强制隔离戒毒所判别疑似精神障碍病例的真伪提供参考。方法:选取强制隔离戒毒机构内疑似精神障碍(A组)的个体,正常强制戒毒人员(B组)各100例、正常人(C组)98例为研究对象,采用《简易精神症状自陈量表》(self-report scale ofbrief psychopathological symptoms,SBPS)、艾森克个性问卷(EPQ)对三组的精神障碍状况、心理健康状况和人格特征进行测试。结果:疑似精神障碍组中有19例SBPS评分≥13分,占≥13分总人数的67.85%。疑似精神障碍组中SBPS评分≥13分者,EPQ的掩饰分量表(L)的标准得分在倾向掩饰或典型掩饰的比值达68.42%。结论:采用《简易精神症状自陈量表》结合EPQ的掩饰分量表对强制隔离戒毒人员中疑似精神障碍进行甄别,可以在一定程度上区分出伪装、诈病的病例,但特异性仍有待修订提高。     

高龄孕妇妊娠期抑郁症对体质量增长和妊娠结局的影响

目的:探讨高龄孕妇妊娠期抑郁症对体质量增长和妊娠结局的影响。方法:回顾性分析154例高龄产妇的临床资料,根据抑郁自评量表(SDS)评分为观察组(SDS≥53分)和对照组(SDS53分),其中观察组69例,对照组85例,观察比较两组孕妇孕期体质量增长、妊娠期并发症、分娩方式、新生儿结局。结果:观察组孕妇在兴趣减退、失眠乏力、能力减退、食欲减退、决断困难、思考困难、感觉无用等抑郁症状及抑郁总分显著高于对照组,差异具有统计学意义(t=7.204,5.017,5.070,7.468,6.761,4.716,4.908,11.157;P0.05)。观察组孕妇体质量增长、顺产显著低于对照组(t=6.828,P0.05;χ~2=11.169,P0.05),而剖宫产率显著低高于对照组(χ~2=4.589,P0.05)。观察组孕妇在妊娠呕吐、羊水量异常、胎膜早破、产后出血及产后血压升高等并发症显著高于对照组(P0.05)。观察组在早产儿、新生儿低体重、新生儿低血糖、新生儿窒息的发生率显著高于对照组(P0.05)。结论:妊娠期高龄孕妇抑郁情绪,能够降低产妇体质量增长,使产妇剖宫产率、分娩并发症及不良妊娠结局发生率显著增高。     

城镇女性乳腺癌病人术后心理焦虑和抑郁原因分析

目的 分析城镇女性乳腺癌病人术后心理抑郁、焦虑原因.方法 采用焦虑自评量表(self-rating anxietyscale,SAS)、抑郁自评量表(sel-rating depression scale,SDS)对97例乳腺癌手术后病人调查,分析其评分情况以及焦虑、抑郁发生率.结果 SAS≥50分61例(占62.89%),SDS≥53分67例(占69.07%).SAS≥50分且SDS≥53分45例(占46.39%).文化程较高、经济状况差、婚姻满意度高患者抑郁、焦虑发生率高;化疗、放疗患者抑郁、焦虑发生率无差剐;青年患者抑郁发生率高、焦虑发生率低.结论 分析产生抑郁、焦虑的原因加强健康教育提高乳腺癌的治疗效果.     

未特定抑郁障碍转归的4年随访

目的:了解社区未特定抑郁障碍患者转归，探索远期生活质量影响因素。方法:基于天津市心理健康调查随访研究，选取2011年基线时符合未特定抑郁障碍终生患诊断者为病例组，基线和2015-2016年随访时均无任何精神障碍诊断者为对照组，于随访时进行精神障碍现患诊断和生命质量评估。结果:共完成102例病例组和291例对照组随访。其中病例组中符合未特定抑郁障碍现患诊断者占8.9%,转为其他精神障碍者占26.5%,其余64.6%不符合任一现患精神障碍诊断。多因素分析显示，病例组生理职能(β=-15.39)、一般健康状况(β=-6.90)和心理健康(β=-3.75)下降高于对照组。结论:部分未特定抑郁障碍患者会转为其他精神障碍，且远期生活质量低于正常人群，因此需要重视该类患者的治疗和干预。     

沈阳地区产妇产前产后情绪状态变化的研究

目的了解产妇产前产后的情绪变化情况,为其心理辅导、实施精神助产提供科学依据。方法应用焦虑自评量表（SA S）和抑郁自评量表（SDS）对我院2006年上半年来院就诊的孕35周以上的产前孕妇随机抽取220名、产后产妇220名进行测试,收回有效问卷434份（产前216份,产后218份）。量表均值用t检验与全国普通人口常规检测的标准数据（常模）进行组间比较,其他项目用χ2检验对产前产后的数据进行了比较。结果孕妇总体产前产后的SA S总粗分与全国正常群体模型（全国常模）相比无显著性差异,但产后明显少于产前（χ2=0.003,P〈0.01）。产前产后的SDS总粗分均明显低于全国常模（P〈0.01）,而产后的产妇SDS总粗分又稍低于产前。结论在调查的产妇中,产后焦虑和抑郁的出现情况明显低于产前,说明产妇分娩后多数人都处于情绪比较稳定的状态。     

Depression and anxiety in perinatal period: prevalence and risk factors in an Italian sample

Accumulating evidence suggests that pregnancy does not protect women from mental illness. The aim of this study was to assess the prevalence, sociodemographic correlates, and the risks factors for perinatal depression and anxiety. Five hundred ninety women between 28th and the 32nd gestational weeks were recruited and submitted to a sociodemographic, obstetric, and psychological interview. The Edinburgh Postnatal Depression Scale (EPDS) and the state-trait anxiety inventory (STAI-Y) were also administered in antenatal period and 3?months postnatally. The Structured Clinical Interview for DSM-IV (SCID-I) was used to diagnose mood and anxiety disorders. Three months after delivery, EPDS was administered by telephone interview. Women with an EPDS score ≥10 were 129 in antenatal period (21.9%) and 78 in postnatal period (13.2%). During pregnancy 121 women (20.5%) were positive for STAI-Y state and 149 women (25.3%) for STAI-Y trait. The most important risk factors for antenatal depression are: foreign nationality, conflictual relationship with family and partner, and lifetime psychiatric disorders. The principal risk factors for postnatal depression are: psychiatric disorders during pregnancy and artificial reproductive techniques. Psychiatric disorders, during and preceding pregnancy, are the strongest risk factors for antenatal state and trait anxiety. Antenatal depressive and anxiety symptoms appear to be as common as postnatal symptoms. These results provide clinical direction suggesting that early identification and treatment of perinatal affective disorders is particularly relevant to avoid more serious consequences for mothers and child.     

Antenatal risk factors for postnatal depression: a large prospective study

BACKGROUND: This study measured antenatal risk factors for postnatal depression in the Australian population, both singly and in combination. Risk factor data were gathered antenatally and depressive symptoms measured via the beyondblue National Postnatal Depression Program, a large prospective cohort study into perinatal mental health, conducted in all six states of Australia, and in the Australian Capital Territory, between 2002 and 2005. METHODS: Pregnant women were screened for symptoms of postnatal depression at antenatal clinics in maternity services around Australia using the Edinburgh Postnatal Depression Scale (EPDS) and a psychosocial risk factor questionnaire that covered key demographic and psychosocial information. RESULTS: From a total of 40,333 participants, we collected antenatal EPDS data from 35,374 women and 3144 of these had a score >12 (8.9%). Subsequently, efforts were made to follow-up 22,968 women with a postnatal EPDS. Of 12,361 women who completed postnatal EPDS forms, 925 (7.5%) had an EPDS score >12. Antenatal depression together with a prior history of depression and a low level of partner support were the strongest independent antenatal predictors of a postnatal EPDS score >12. LIMITATIONS: The two main limitations of the study were the use of the EPDS (a self-report screening tool) as the measure of depressive symptoms rather than a clinical diagnosis, and the rate of attrition between antenatal screening and the collection of postnatal follow-up data. CONCLUSIONS: Antenatal depressive symptoms appear to be as common as postnatal depressive symptoms. Previous depression, current depression/anxiety, and low partner support are found to be key antenatal risk factors for postnatal depression in this large prospective cohort, consistent with existing meta-analytic surveys. Current depression/anxiety (and to some extent social support) may be amenable to change and can therefore be targeted for intervention.     

Do changes in subjective sleep and biological rhythms predict worsening in postpartum depressive symptoms? A prospective study across the perinatal period

Abnormalities of sleep and biological rhythms have been widely implicated in the pathophysiology of major depressive disorder (MDD) and bipolar disorder (BD). However, less is known about the influence of biological rhythm disruptions across the perinatal period on postpartum depression (PPD). The objective of this study was to prospectively evaluate the relationship between subjective changes in both sleep and biological rhythms and worsening of depressive symptoms from pregnancy to the postpartum period in women with and without mood disorders. Eighty-three participants (38 euthymic women with a history of a mood disorder and 45 healthy controls) were studied. Participants completed subjective assessments of sleep (Pittsburgh Sleep Quality Index), biological rhythm disturbances (Biological Rhythms Interview of Assessment in Neuropsychiatry), and depressive symptoms (Edinburgh Postnatal Depression Scale) prospectively at two time points: third trimester of pregnancy and at 6–12 weeks postpartum. Multivariate regression analyses showed that changes in biological rhythms across the perinatal period predicted worsening of depressive symptoms in both groups. Moreover, women with a history of a mood disorder showed higher levels of sleep and biological rhythm disruption during both pregnancy and the postpartum period. These findings suggest that disruptions in biological rhythms during the perinatal period increase the risk for postpartum mood worsening in healthy pregnant as well as in pregnant women with a history of mood disorders.     

Screening for postnatal depression. Validation of the Norwegian version of the Edinburgh Postnatal Depression Scale,and assessment of risk factors for postnatal depression

OBJECTIVE: The Edinburgh Postnatal Depression Scale (EPDS) is a self-rating scale developed to screen for postnatal depression. The aim of this study was to validate a Norwegian translation of the EPDS, study its psychometric properties, and identify risk factors for postnatal depression. METHOD: EPDS was filled in by 411 women at 6-12 weeks postpartum. Of these, 100 were interviewed using the Mini International Neuropsychiatric Interview for DSM-IV major and minor depressive disorders. RESULTS: When using a cut-off of 11 on the EPDS, 26 of 27 women with major depression were identified (sensitivity 96%, specificity 78%). An aggregate point prevalence of 10.0% of major and minor depression was found. A one-factor model accounted for 46.6% of the variance. Strongest risk factors for postpartum depression were previous depression, depression in current pregnancy, and current somatic illness. LIMITATIONS: Women screened using the EPDS who had a score above threshold, yet did not attend the diagnostic interview could cause the point prevalence of depression to be higher than indicated here. CONCLUSION: The Norwegian translation of EPDS functions equally well as other translations as a screening tool for postnatal depression. The risk factors that were found are compatible with other studies.     

Depressive and anxiety disorders in the postpartum period: how prevalent are they and can we improve their detection?

The objectives of this study were: (1) to examine Composite International Diagnostic Interview (CIDI) period prevalence and comorbidity for depression and anxiety disorder in a cohort of women assessed during the first 6–8 months postpartum and (2) to examine the benefits of combining the Edinburgh Postnatal Depression Scale (EPDS) with a simple “interval symptom” question to optimize screening postpartum. Women aged over 18 (N = 1,549) were assessed during late pregnancy and reviewed at approximately 2, 4, and 6–8 months postpartum using the EPDS and an “interval symptom” question. The latter asked about any depressive symptoms in the interval since the last EPDS. Women who scored >12 on the EPDS and/or positive on the “interval symptom” question were then administered the CIDI. A further 65 randomly selected women that screened negative were also administered the CIDI. Loss to postnatal follow-up was very significant, and returns rates were inconsistent across the three postnatal time points. Almost 25% of those who screened positive did not complete a CIDI. For screen-positive status, a total of 314 (24.4%) of those that returned questionnaires (N = 1,289) screened positive at least once across the 6- to 8-month interval. Of these, 79 were lost to follow-up; thus, 235 (74.8%) completed a CIDI. In this group, 34.7% had been positive both on the EPDS and the “interval” question, 15.9% on the EPDS alone, and 49.4% on the “interval” question alone. For the CIDI diagnosis and estimated 6- to 8-month period CIDI prevalence, among those 235 women who screened positive and completed a CIDI, 67.2% met the criteria for a CIDI diagnosis, as did 16.9% of those who screened negative. The breakdown in CIDI diagnoses in the 235 women was 32.8% major depression (± anxiety disorder); 26.4% minor depression alone; and 8.1% with a primary anxiety disorder (approximately half with minor depression). Put another way, 20.4% of these women had an anxiety disorder (approximately two thirds with comorbid depression) and 37.7% of women with a major depressive episode (MDE) had a comorbid anxiety disorder. The estimated 6- to 8-month prevalence rate for a CIDI diagnosis of anxiety or depression (major or minor) was 29.2% (95% CI 26.7%–31.7%). The use of the “interval symptom” question alone was 1.7 times more likely to identify positive CIDI cases than the EPDS alone. Almost 40% of postnatal women with a diagnosis of MDE have a comorbid diagnosis of anxiety disorder. The estimated 6- to 8-month period prevalence for CIDI cases of anxiety and depression was 29.2%. Screening for anxiety and depression using the EPDS alone was associated with a lesser capacity to identify CIDI caseness than a simple “interval symptom” question (for the 2 months prior) which almost doubled the yield. This paper demonstrates that combining the EPDS with the “interval symptom” question improves detection of CIDI caseness.     

Prevalence of paternal perinatal depressiveness and its link to partnership satisfaction and birth concerns

Depressive disorders have shown an increasing prevalence over the past decades. Growing evidence suggests that pregnancy and childbirth trigger depressive symptoms not only in women but likewise in men. This study estimates the prevalence of paternal perinatal depressiveness in a German community sample and explores its link to partnership satisfaction as well as birth-related concerns and concerns about the future. Data was gathered in a longitudinal study over the second and third trimester of their partner’s pregnancy up to 6 weeks postpartum. In a two-stage screening procedure, 102 expectant fathers were assessed for symptoms of depression, anxiety, and partnership satisfaction using the Edinburgh Postnatal depression Scale (EPDS), the State/Trait Anxiety Inventory, a self-constructed questionnaire for birth concerns and the Questionnaire of Partnership. The prevalence of elevated depressive symptoms among expectant fathers was 9.8 % prenatally and 7.8 % postnatally. Prenatal relationship quality, prenatal EPDS scores, and birth concerns were significantly associated with and explained 47 % of the variance in paternal postnatal depressive symptoms. The prevalence of paternal depressive symptoms is a significant concern. Our findings point out the need for implementing awareness and screening for depressiveness in fathers in clinical routine in Germany as well as the necessity of developing a screening instrument for paternal birth-related anxiety.     

The Edinburgh Postnatal Depression Scale (EPDS) and the detection of major depressive disorders in early postpartum: some concerns about false negatives

This paper presents a phenomenological study of three false negative cases according to the Edinburgh Postnatal Depression Scale (EPDS) of major depressive disorder identified by a semi-structured clinical interview. In a study of 87 unselected women with 23 of them suffering from a major depressive disorder (according to the Research Diagnostic Criteria), three cases of major depressive disorders were not identified as potential cases by the EPDS. The symptomatology of these three false negative cases was also assessed by a semi-structured interview (Present State Examination). Comparisons between EPDS scores and the scores of two other self report questionnaires (the General Health Questionnaire-28 and the Center for Epidemiologic Studies-Depression Scale) suggest that EPDS is better at identifying depressed postnatal women with anhedonic and anxious symptomatology rather than those whose depression presents mainly with psychomotor retardation.     

Tailoring screening protocols for perinatal depression: prevalence of high risk across obstetric services in Western Australia

Given what appears to be an ever-increasing list of concerning consequences of perinatal depression, longitudinal studies have much to offer when considering the timing and efficacy of prevention and intervention strategies. The course of depressive symptomatology across the perinatal period at four obstetric services was investigated utilising Western Australian data collected as part of the beyondblue National Postnatal Depression Program. Pregnant women completed one or two Edinburgh Postnatal Depression Scale (EPDS) assessments during pregnancy and a demographic and psychosocial risk factors questionnaire. One or two EPDS assessments were administered within 12 months postpartum. Prevalence of high risk scores across gestational ages ranged from 14% to 5% during pregnancy and 6% to 9% in the postnatal period. For women who were screened twice, the prevalence of high risk scores appeared earlier and decreased with advancing gestation (p = 0.026). The prevalence of postnatal high risk increased after 12 weeks postpartum (p = 0.029). Screening protocols for depressive symptomatology during pregnancy may need to be fine-tuned across individual hospitals, and take into account gestational ages, in order to be most effective. As depressive symptomatology persists postnatally, screening protocols may need to extend beyond 12 weeks postpartum.     

Depression during pregnancy and the postpartum period in adolescent and adult Portuguese mothers

Summary Objective: To study prevalence as well as risk factors for pregnancy and postpartum depression in a sample of adolescent and adult Portuguese mothers. Methods: The Edinburgh Postnatal Depression Scale (EPDS) was administered to 108 (54 adult and 54 adolescent) Portuguese women at 24–36 weeks of pregnancy and at 2–3 months postpartum. Results: Rates for EPDS > 12 are high during the 3^rd trimester of pregnancy (18.5%) and at 2–3 months postpartum (17.6%), and not significantly different between these two periods; more than 1/4 of the sample (27.8%) had an EPDS > 12 before or after delivery. Adolescent mothers presented more depressive symptoms as well as more EPDS > 12 than adult mothers, both in pregnancy (25.9% versus 11.1%) and at 2–3 months postpartum (25.9% versus 9.3%); moreover, when considering other socio-demographics, adolescent mothers were still at risk for depressive symptoms during pregnancy as well as for postpartum depression. Women depressed in pregnancy, and ones who are under 18 years old and who live with the partner, were at risk for postpartum EPDS > 12. Conclusion: Adolescent mothers seem particularly at risk for depression during pregnancy and the postpartum period, therefore, just like the women who are depressed during pregnancy, they should be better targeted in preventive and intervention measures.     

Identification of women at risk of depression in pregnancy: using women’s accounts to understand the poor specificity of the Whooley and Arroll case finding questions in clinical practice

Antenatal mental health assessment is increasingly common in high-income countries. Despite lacking evidence on validation or acceptability, the Whooley questions (modified PHQ-2) and Arroll ‘help’ question are used in the UK at booking (the first formal antenatal appointment) to identify possible cases of depression. This study investigated validation of the questions and women’s views on assessment. Women (n?=?191) booking at an inner-city hospital completed the Whooley and Arroll questions as part of their routine clinical care then completed a research questionnaire containing the Edinburgh postnatal depression scale (EPDS). A purposive subsample (n?=?22) were subsequently interviewed. The Whooley questions ‘missed’ half the possible cases identified using the EPDS (EPDS threshold ≥10: sensitivity 45.7 %, specificity 92.1 %; ≥13: sensitivity 47.8 %, specificity 86.1 %), worsening to nine in ten when adopting the Arroll item (EPDS ≥10: sensitivity 9.1 %, specificity 98.2 %; ≥13: sensitivity 9.5 %, specificity 97.1 %). Women’s accounts indicated that under-disclosure relates to the context of assessment and perceived relevance of depression to maternity services. Depression symptoms are under-identified in current local practice. While validated tools are needed that can be readily applied in routine maternity care, psychometric properties will be influenced by the context of disclosure when implemented in practice.