孕晚期抑郁对新生儿神经行为的影响

目的探讨孕晚期抑郁情绪对新生儿神经行为的影响。方法以2015-09—2017-06在我院进行产检,妊娠周期≥28周的276例妊娠期妇女为研究对象,采用爱丁堡抑郁自评量表(EPDS)和负性认知加工偏向量表对妊娠晚期妇女进行调查,婴儿神经国际量表(INFANIB)对新生儿神经行为进行评估,观察妊娠晚期抑郁情绪下负性认知的情况以及对新生儿神经行为的影响。结果 276例孕晚期妊娠妇女中抑郁情绪阳性33例,阴性243例,其中抑郁阳性妊娠妇女负性认知加工偏向负性记忆偏向、负性解释偏向、负性沉思偏向及总分均明显高于抑郁阴性妊娠妇女(P0.05);276例新生儿中INFANIB评分显示临界值108例,正常168例,神经行为异常临界值以上发生率39.13%,妊娠晚期妇女负性注意力偏向和负性沉思偏向与INFANIB临界值新生儿呈负相关(P0.05),与EPDS无明显相关性(P0.05)。结论孕晚期妊娠妇女抑郁发生率较高,其在负性认知加工偏向中的表现特点与新生儿神经行为异常有显著的相关性。     

心理健康教育干预对孕期焦虑抑郁及产后抑郁的作用分析

目的探讨心理健康教育干预对孕期焦虑抑郁及产后抑郁的作用。方法选取我院516名孕产妇为研究对象,按入院时间顺序分为对照组252名和实验组264名,对照组接受常规综合护理,实验组在此基础上接受心理健康教育干预,比较分析两组孕产妇妊娠期间焦虑抑郁情况及产后抑郁情况。结果两组孕产妇妊娠24~26、30~32、38~40周SAS、SDS评分均显著低于同组干预前(P0.05);实验组孕产妇妊娠24~26、30~32、38~40周SAS、SDS评分均显著低于对照组(P0.05);实验组孕产妇妊娠24~40周焦虑、抑郁发生率均显著低于对照组(P0.05),妊娠期焦虑抑郁主要发生在妊娠38~40周;实验组孕产妇产后1周、1个月及3个月EPDS评分均显著低于对照组(P0.05);实验组孕产妇产后抑郁发生率显著低于对照组(P0.05),产后抑郁主要发生在产后1周。结论对孕产妇实施心理健康教育干预能够有效减少孕期焦虑抑郁及产后抑郁的发生,促进围产期身心健康。     

母亲产后抑郁对喂养方式及子代体重增加量影响的队列研究

目的比较产后抑郁母亲与正常对照组对子代喂养方式的差异,明确产后抑郁是否对子代的体重增加有所影响。方法分别在西南医科大学附属医院、泸州市中医院、泸州市江阳区妇幼保健院和泸州市妇女儿童医院对住院待产的产妇进行筛查,对符合入组标准的48例产妇在产后第4、8、12周,使用爱丁堡产后抑郁量表(EPDS)和婴幼儿喂养方式及体重增加量调查表进行评定,将在首次评定时EPDS评分≥13分的被试归入产后抑郁组(n=14),将EPDS评分13分者归入对照组(n=34),比较两组人口学资料、EPDS评分、喂养方式及其婴儿体重增加量等方面的差异。结果产后第12周,产后抑郁组婴儿体重增加量高于对照组(Z=-2.612,P=0.009)。各随访时间点,产后抑郁组平均每日非母乳喂养的比例均高于对照组(Z_(4周)=-2.652,Z_(8周)=-3.591,Z_(12周)=-2.822,P均0.05)。产后抑郁组平均每日非母乳喂养的次数(Z_(4周)=-2.403,Z_(8周)=-3.666,Z_(12周)=-2.834,P均0.05)和非母乳喂养量(Z_(4周)=-2.289,Z_(8周)=-3.347,Z_(12周)=-2.609)均高于对照组。产后抑郁组当月用于婴儿食品等消耗品的支出均高于对照组(Z_(4周)=-3.404,Z_(8周)=-4.130,Z_(12周)=-3.859,P均0.05)。结论截止产后第12周,产后抑郁母亲的子代较少接受母乳喂养,但喂养方式的差异并未影响子代体重的增加。     

产后抑郁症患者HPA轴激素、甲状腺功能及性激素的水平分析

目的探讨产后抑郁患者下丘脑-垂体-肾上腺(HPA)轴激素、甲状腺功能及性激素的水平及其意义。方法选取产后6～7周经我院精神科门诊检测评估为产后抑郁的产妇100例作为抑郁组、100例同期产后未发生抑郁的产妇作为对照组;检测对比两组的HPA激素、甲状腺激素、性激素水平;并分析抑郁组患者各项激素水平与爱丁堡产后抑郁量表(EPDS)评分的关系。结果抑郁组患者的CHR、ACTH水平高于对照组(P0.05),抑郁组患者的CORT水平低于对照组(P0.05);抑郁组患者的TSH水平低于对照组(P0.05),抑郁组患者的TG-Ab、TPO-Ab、FT3、FT4水平与对照组比较,无统计学意义的差异(P0.05);抑郁组患者的E2水平低于对照组(P0.05),抑郁组患者的PRL、P值高于对照组(P0.05);抑郁组患者的E2、TSH、CORT水平与EPDS评分负相关(P0.05),抑郁组患者的PRL、CHR、ACTH测定值与EPDS评分正相关(P0.05)。结论产后抑郁患者自身激素水平异于正常产妇,调节产后激素水平可能有利于改善产后抑郁。     

基于微信公众平台的围产期认知干预对产妇的妊娠期抑郁症状及睡眠质量的作用

目的观察基于微信公众平台的围产期认知干预对改善妊娠期抑郁症状及睡眠质量的作用。方法选取在我院接受产检的妊娠期抑郁症产妇118例作为研究对象,按照随机数字表法分为观察组和对照组,各59例,其中对照组采用常规干预,观察组采用基于微信公众平台的围产期认知干预。观察对比两组抑郁状况、睡眠质量、护理满意度。结果干预前两组产妇的抑郁自评量表(SDS)和爱丁堡产后抑郁量表(EPDS),匹兹堡睡眠指数量表(PSQI)评分,组间无明显差异(P0.05);干预后两组SDS、EPDS评分显著低于干预前(P0.05),且观察组显著低于对照组(P0.05);干预后两组PSQI评分显著低于干预前,且观察组显著低于对照组(P0.05);观察组护理满意度评分显著高于对照组(P0.05)。结论相较于常规干预方式,基于微信公众平台的围产期认知干预能够更有效减轻妊娠期产妇抑郁症状,提高睡眠质量和护理满意度。     

苏州市某社区产后抑郁流行病学调查及相关危险因素

目的调查苏州市某社区产后抑郁的检出率及相关危险因素,为产后抑郁的防治提供参考。方法选取苏州市某社区88例产妇,采用爱丁堡产后抑郁量表(EPDS)评定其产后抑郁情况,采用艾森克人格问卷(EPQ)和社会支持评定量表(SSRS)评定产妇的个性特征及社会支持情况。以EPDS评分9分为界将产妇分为产后抑郁组和正常组,分析影响产后抑郁的相关因素。结果苏州市某社区产后抑郁检出率为21.6%;产后抑郁组EPQ神经质(N)维度评分高于正常组,差异有统计学意义[(88.45±8.07)分vs.(37.16±8.22)分,t=2.625,P0.05]。产后抑郁组与正常组SSRS总评分与各维度评分比较差异均无统计学意义(t=-1.411~-0.590,P均0.05)。产后抑郁组SSRS客观支持及主观支持评分与EPDS评分均呈负相关(r=-0.471、-0.459,P均0.05)。结论苏州市某社区产后抑郁的检出率较高,产妇的神经质人格特质与产后抑郁有关。     

血清孤啡肽、瘦素水平与产后抑郁的相关性研究

目的研究血清孤啡肽(NC)、瘦素(LP)水平与产后抑郁的相关性。方法选择2017年12月～2019年12月我院收治的220例产妇作为研究对象,按照爱丁堡产后抑郁量表(EPDS)评分分组,≥10分为抑郁组,10者为无抑郁组。比较两组的年龄、产次、分娩方式、体重、孕周、新生儿体重、新生儿性别和NC、LP,并用Pearson直线相关法分析NC、LP与产后抑郁的相关性,用多因素Logistic回归分析产后抑郁的危险因素。结果 220例产妇中,98例EPDS≥10分,122例EPDS10分。两组的产次、分娩方式、孕周、新生儿体重、新生儿性别比较均无统计学差异(P0.05);抑郁组的年龄、体重显著高于无抑郁组(P0.05)。抑郁组的NC显著高于无抑郁组,LP显著低于无抑郁组(P0.05);经Pearson相关分析发现NC与产后抑郁呈正相关,LP与产后抑郁呈负相关(P0.05);多因素Logistic回归分析发现年龄、体重、NC、LP均是产后抑郁发生的独立危险因素。结论 NC与产后抑郁呈正相关,LP与产后抑郁呈负相关,这提示监测NC、LP水平,可有助于防治产后抑郁。     

音乐治疗合并心理干预对高危孕妇孕期和产后焦虑抑郁情绪的影响

目的:探索音乐治疗合并心理干预对高危孕妇孕期和产后焦虑抑郁情绪的影响。方法:将195位孕16~20周的高危孕妇随机分为干预组(98例)和对照组(97例);孕24周时对干预组进行1次音乐治疗培训,之后在家中30 min/d的聆听音乐直到分娩;孕25~29周每周1次团体心理治疗。对照组按常规产科流程产前检查。入组时及孕6~9个月每月1次综合性医院焦虑/抑郁量表(HAD)评估;产后3~7 d、42 d及3个月时分别进行爱丁堡产后抑郁调查表(EPDS)评估。结果:孕7及8个月干预组HAD评分显著高于对照组(P均0.05);分娩前干预组HAD评分较基线显著下降(P0.05),但两组间差异无统计学意义。产后各时点EPDS评分干预组显著低于对照组(P0.05或P0.01)。结论:音乐治疗结合团体心理干预能减轻高危妊娠孕妇分娩前的焦虑、抑郁情绪及产后的抑郁症状。     

血清甲状腺激素、肾上腺皮质激素水平变化与产后抑郁的关系研究

目的探讨分娩前后一周血清甲状腺激素及肾上腺皮质激素水平变化对产后抑郁的影响。方法选取2012年3月-2012年9月在贵阳医学院附属医院就诊的395例孕产妇为研究对象,采用爱丁堡产后抑郁量表(EPDS)对其产后抑郁状况进行评定,并用采用生物素双抗体夹心酶联免疫吸附法(ELISA)测定产妇血清皮质醇(Cor)、三碘甲状腺原氨酸(T3)、四碘甲状腺原氨酸(T4)、促甲状腺激素(TSH)、五羟色胺(5-HT)水平。结果 1产后一周抑郁症状检出人数为48例,检出率为12.15%。2抑郁组与非抑郁组COR均高于正常值,抑郁组产后COR稍高于非抑郁组,两两间差异均无统计学意义(P0.05)。3抑郁组产后血清TSH水平低于非抑郁组,差异有统计学意义(P0.05)。4相关分析显示:产后EPDS得分与产后血清皮质醇水平呈正相关、与产后5-HT、T3及TSH水平呈负相关(P0.05)。5逐步线性回归分析显示:甲状腺激素水平及肾上腺皮质醇水平对产后抑郁的直接预测效应无显著意义(P0.05),对5-HT水平有显著预测效应,预测变异量为65.6%(P0.05)。结论 5-HT及其受体功能对产后抑郁的发病起重要作用,产后血清甲状腺激素水平及肾上腺皮质醇水平对的产后抑郁没有直接作用,但通过作用于5-羟色胺水平影响产后抑郁症状的发生。     

心理护理干预对孕产妇的妊娠结局及产后抑郁状况的影响

目的研究孕产妇实施心理护理干预对其妊娠结局及产后抑郁状况的影响。方法以2012年3月~2013年12月期间在我院妇产科分娩的70例孕产妇为对照组。选取2014年1月~2016年2月期间于我院妇产科分娩的100例孕产妇为观察组研究对象。对照组实施常规护理干预,观察组在对照组基础护理干预的基础上实施心理护理干预。对比分析两组的妊娠结局、产后5天与3周后的爱丁堡产后抑郁量表(EPDS)评分情况。结果观察组患者的自然分娩率显著高于对照组,而产后出血率与剖宫产率显著低于对照组;产后5天以及产后3周,观察组患者的EPDS评分显著低于对照组,且产后抑郁的发生率显著低于对照组,差异均具有统计学意义(P0.05)。结论为孕产妇实施心理护理干预能有效改善孕产妇的妊娠结局,降低产后抑郁的发生率,是临床效果显著的护理方式。     

伴有抑郁的老年冠心病患者自主神经功能的改变

目的:探讨伴有抑郁老年冠心病患者自主神经功能的改变。方法:根据汉密尔顿抑郁量表(HAMD)、Zung氏抑郁自评量表(SDS)、以及冠状动脉造影结果,将163例住院患者及健康体检者分为冠心病伴抑郁组(48例)、冠心病组(65例)、正常对照组(50例);并行24 h动态心电图检查,分析心率变异各项指标及其与抑郁程度的相关性。结果:与正常对照组相比,冠心病伴抑郁组与单纯冠心病组,时域指标均下降,频域指标中低频功率(LF)、LF/高频功率(HF)值上升。冠心病伴抑郁组的抑郁严重度与24 h正常RR间期标准差(SDNN)呈负相关,与LF/HF之间呈正相关(r=-0.967,r=0.971,P均0.05)。结论:伴有抑郁症状老年冠心病患者自主神经功能改变更明显,并与抑郁程度相关。     

A study of the Edinburgh Postnatal Depression Scale (EPDS) on 859 mothers: detection of mothers at risk for postpartum depression

The postpartum is a high-risk period for the occurrence of anxious and depressive episodes. Indeed, during the first few days after delivery, mothers can present postpartum blues symptomatology: fatigue, anxiety, disordered sleeping and a changing mood. Postpartum depression is characterised by a changing mood, anxiety, irritability, depression, panic and obsessional phenomena. It occurs in approximately 10 to 20% mothers. The exact prevalence depending on the criteria used for detection. The first symptoms usually appear between the fourth and sixth week postpartum. However, postpartum depression can start from the moment of birth, or may result from depression evolving continuously since pregnancy. We can add that the intensity of postpartum blues is a risk factor that can perturb maternal development. So it is important for health professionals to dispose of predictive tools. This study is a validation of the French version of the EPDS. The aims of the study were to evaluate the postpartum depression predictive value at 3 days postpartum and to determine a cut-off score for major depression. Subjects participating in this study were met in 3 obstetrical clinics in, or in the vicinity of, Toulouse. Mothers with psychological problems, under treatment for psychological problems or mothers whose babies present serious health problems were excluded from the study. The EPDS was presented to 859 mothers (mean age=30.3; SD=4.5) met at one of the clinics at 3 days postpartum (period 1). They had an EPDS mean score of 6.4 (SD=4.6); 258 (30%) mothers had an EPDS score 9. 82.6% of these mothers experienced a natural childbirth and 17.3% a caesarean section; 51.5% gave birth to their first child, 36.2% to their second child and 12.3% to their third or more. All subjects were given a second EPDS with written instructions to complete the scale during the period 4 to 6 weeks postpartum and return it for analysis (period 2). Between the 4 to 6 weeks postpartum period, 722 mothers replied again to the EPDS. 131 mothers had an EPDS score 11 (mean age=30.3; SD=4.8). They had an EPDS mean score of 13.6 (SD=3.3). Mothers with probable depression were interviewed and assessed, using the Mini (Mini Neuropsychiatric Interview, Lecrubier et al. 1997), the SIGH-D (Structured Interview Guide for the Hamilton Depression Scale) and the BDI (Beck Depression Inventory) in order to diagnose a major depressive episode. They had a HDRS mean score of 13.7 (SD=5.1) and a BDI mean score of 13.6 (SD=5). At 3 days postpartum, we observed that 258 mothers (30%) had an EPDS scores 9 and 164 mothers (19%) had an EPDS scores 11. Between 4 and 6 weeks postpartum, we observed 18.1% of postpartum depression (EPDS 11) and 16.8% (EPDS 12) of major postpartum depression. The analysis of the sensitivity and the specificity at 3 days postpartum provides a cut-off score of 9 (Sensibility: 0.88) (Specificity: 0.50) as predictive of postpartum depression, for this cut-off score, the type I error is low (5.8%) but the type II error is more higher (18.9%). The analysis of the sensitivity and the specificity between 4 and 6 weeks postpartum provides a cut-off score of 12 (Sensibility: 0.91) (Sensibility: 0.74) for the detection of major postpartum depression. Factor analysis shows at 3 days postpartum that the internal structure of the scale is composed of two subscales. The first factor F1 "anxiety" accounts 28% of the variance and the second factor F2 "depression" accounts 20% of the variance. Between 4 and 6 weeks postpartum, factor analysis suggests an unidimensional model in the evaluation of postpartum depression which is better than a two factor model. This factor accounts 40% of the variance. The scale has a good predictive value, and we can observe a significant correlation with the EPDS periods 1 and 2 (r=0.56; p<0.05). This result shows that the depressive mothers mood intensity predicts a future depressive risk. Furthermore, correlations between EPDS and BDI (r=0.68; p<0.05) and EPDS and HDRS (r=0.67; p<0.05) show a good convergent validity. The reliability study confirms the good internal consistency of the EPDS, at 3 days postpartum and in the postpartum depression -symptomatology evaluation (Cronbach's Alpha>0.80). In conclusion, this scale demonstrates good validity and is fast and easy use in obstetrical services, allowing early detection of women who risk to develop postpartum depression and, in the first week of postpartum, of mothers who suffer from a major postpartum depression. The use of the EPDS for an early screening of the risk of postnatal depression which is essential considering the consequences that postnatal depression can have on the development of the infant, on the quality of the relationship within the couple and on other social relationships. Mothers at risk for postnatal depression should be controlled and surveyed by the health professionals in obstetrical clinics.     

共情能力与产后抑郁症状的相关性研究

目的:探讨共情能力与产后抑郁症状的相关性.方法:对1366例符合入组标准的产后42 d回院进行产后保健的产妇,按照自愿原则进行一般人口学资料的收集,并进行爱丁堡产后抑郁量表(EPDS)、人际反应指针问卷(IRI-C)自评;以EPDS≥9分为划界值将入组者分组及组间比较;分析EPDS评分与IRI-C评分间的关系.结果:共...     

抑郁症焦虑症患者心率变异性特点的对比研究

目的探讨抑郁症、焦虑症患者自主神经功能的特点。方法随机选择42例抑郁症患者,10例焦虑症患者和17例健康对照者分别接受短时心率变异性分析,记录相关考察指标,进行统计学分析。结果心率变异性分析的各项考察指标中,各观察组均有一项或多项低于正常对照组（P〈0．05）;且各组之间互相对比分析P〈0．05。结论抑郁症、焦虑症患者均存在心率变异性的降低,其自主神经功能活性降低。抑郁症患者因伴或不伴有焦虑症状,其心率变异指标不同,可以指导治疗。     

产后抑郁症与社会心理因素

目的：经前不适、社会支持和心理应激对产后抑郁症发生的影响。方法：对88例产妇评定Edinburgh产后抑郁量表（EPDS）、社会支持评定量表（SSRS）、艾森克人格问卷（EPQ）。结果：产后抑郁症发生率为17％；产后抑郁症的既往经前不适率比正常对照组的明显为高；EPDS总分与SSRS的客观支持呈显著负相关性；产后抑郁症的住房拥挤率比正常对照组明显为低。结论：有经前不适史的产妇易感产后抑郁症；产后抑郁症病人感到客观支持减少是抑郁的结果；产妇在小家庭受到的照顾不如大家庭周到。     

孕期家庭亲密度适应性对产妇产后抑郁的影响

目的分析孕期家庭亲密度适应性对产妇产后抑郁的影响。方法选取2013-03-2014-03我院收治的晚期妊娠孕妇160例为研究对象,分别于产前和产后6周采用爱丁堡产后抑郁量表和家庭亲密度适应性量表对其进行调查。结果观察组和对照组实际适应性和适应性不满意程度评分相比,差异具有统计学意义(t=-3.509,2.657;P均0.05)。观察组和对照组实际亲密度和亲密度不满意程度评分相比,差异具有统计学意义(t=-2.472,3.005;均P0.05)。实际适应性、适应性不满意程度、实际亲密度和亲密度不满意程度是产后抑郁的影响因素。结果孕期家庭亲密度适应性差会导致产妇产后抑郁,护理人员要重视对家庭亲密度重要性的宣传,降低产妇产后抑郁发生率。     

Screening and intervention for depressive mothers of new-born infants]

BACKGROUND AND THE AIM OF THE STUDY: Postnatal depression is a key concept for mother-infant mental health. Evidence of its impact on mother-infant relationship has been increasingly demonstrated in recent years. Therefore optimal intervention is important for women and their babies' mental health. Identifying risk factors of postnatal depression and developing screening system are needed. Study I Hospital-based prospective study--onset and course of Postnatal depression and developing screening system. SAMPLING AND METHOD: One hundred and one consecutive admitted women on maternity ward in our university hospital were invited to the study and 88 mothers participated. Present psychiatric status was assessed by telephone interview at three weeks and three months postnatally, using the Schedule for Affective Disorders and Schizophrenia and diagnosis was made based on Research Diagnostic Criteria. The Maternity Blues Scale and Edinburgh Postnatal Depression Scale (EPDS) were also administered at the 5th day, one and three months postnatally. RESULTS AND DISCUSSION: At 3 weeks, 21 of the 88 mothers (24%) were categorized as having had Maternity blues, and twelve (14%) were diagnosed as depression cases. At 3 months postpartum overall 15 of 88 mothers (17%) were categorized as depression cases. Ten out of total 15 mothers had their onset of depression within the first week. There were no differences in age, parity, educational level, social class compared to non-depressed mothers. The scores of the Blues and the EPDS were always significantly higher in depressed mothers. The Blues scale score was significantly higher in the depressed mothers compared to the control mothers at any timing of investigation. Even at the fifth postnatal day, 11 of 15 mothers who subsequently became clinical depression had already scored 9 or more, which is indicative of postnatal depression, this means postnatal depression could be detected from the very early postpartum period. As for the validity test of the EPDS, having set a cut-off point being 9 or more, the sensitivity was 82% and the specificity were 95% respectively. This score is the same as Okano reported in Japan and lower than many studies in Western countries. Study II Multi-centre prospective study of early postpartum mood states. SAMPLING AND METHODS: Fourteen obstetric wards in teaching hospitals participated in the study, and there, recruitment in each ward continued until 20 post-natal women had agreed to participate. Two hundred twenty six patients (89.7%) completed the study. During the first 5 days Maternity blues scale, and the EPDS on the 5th postnatal day, and one month postnatally the EPDS again were given to the mothers. The EPDS score of 9 or more was regarded as a probable case of postnatal depression. RESULTS AND DISCUSSION: Seventy-nine out of the 226 patients (35%) had maternity blues. Forty six out of the 226 patients (20%) had postnatal depression (EPDS being 9 or more) at one month postnatally. There was a significant correlation between the EPDS scores on the 5th postnatal day and those at one month. Having maternity blues and higher than 9 or more of the EPDS score were significantly related to the EPDS scores of 9 or more at one month postnatally. (odds's ratio = 4.4 and 13 respectively). Dysphoria on 5 day was significantly related to history of pregnancy loss, Caesarean section, Maternal and neonatal complications and Maternity blues. Dysphoria on one month was only related to Maternal complication. CONCLUSIONS: The onset of postnatal depression can be within the first week after delivery. The use of the EPDS during the first week is a simple and useful screening for early onset case. Maternal complications and related medical factors might be the risk factors of mood disturbance during early postnatal period.     

Affective (depressive) morbidity in puerperal Nigerian women: validation of the Edinburgh Postnatal Depression Scale

OBJECTIVE: To determine the rate of depression in a group of postpartum Nigerian women and to validate the Edinburgh Postnatal Depression Scale (EPDS) in this group. METHOD: Between April and August 2000, all postpartum women who remained in the maternity ward for up to 7 days, and those who attended the postnatal clinics of Nnamdi Azikiwe University Teaching Hospital were recruited. Translated local language versions of the EPDS and the Zung Self-Rating Depression Scale were used to screen the subjects. A structured interview schedule was adapted from the depression section of the Composite International Diagnostic Interview and affective module of the ICD-10 Symptom Check List to assess screened subjects. RESULTS: The total rejection rate was 23%, with 225 women participating in the study. Twenty-four subjects (10.7%) had depression. At the optimal cut-off score of 9, the EPDS had a sensitivity of 0.75, and specificity of 0.97. CONCLUSION: The EPDS clearly distinguished between depressed and non-depressed postpartum mothers (t = 7.63, P < 0.001, df = 222). Because of its brevity and acceptability, it is recommended that the EPDS be used in routine postnatal screening.     

产后抑郁症全程综合性社区干预探讨

目的:探讨产后抑郁症全程综合性社区干预的效果。方法:采用自编一般情况和相关因素问卷、综合性医院所用焦虑抑郁量表(HAD)和总甲状腺素(TT4)、游离甲状腺素(FT4)测定孕晚期386例孕妇,筛查出产后抑郁症的高危孕妇122例,按随机自愿的原则分为干预组和对照组各61例;干预组给予全程综合性社区干预。2组均在产后1周、4周、8周、12周采用HAD、爱丁堡产后抑郁量表(EPDS)及美国精神障碍分类与诊断手册第4版-修订版轴Ⅰ障碍用临床定式检查(SCID)分别进行评估。结果:①产后4周、8周、12周HAD、EPDS评分,干预组比对照组明显降低,差异有统计学意义(P均0.05);②孕晚期、产后1周、4周、8周、12周干预组HAD、EPDS评分逐渐降低,差异有统计学意义(P0.01);③产后4个时点抑郁发生率:干预组分别为50%、29.09%、16.36%和9.09%,对照组分别为66.67%、57.89%、44.64%和23.21%。产后4周、8周、12周两组抑郁症发生率比较差异有统计学意义(P均0.05)。结论:全程综合性社区干预能显著降低产后抑郁症的发生率。