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1.
OBJECTIVE: To provide a profile of women suffering from major postpartum depression as assessed by the Postpartum Depression Screening Scale (PDSS). DESIGN: A secondary analysis conducted on a portion of the data collected from an earlier psychometric testing of the PDSS. SETTING: Private practice in the San Francisco Bay Area of a marriage and family therapist specializing in perinatal mood disorders. PARTICIPANTS: One hundred thirty-three women who were diagnosed with major postpartum depression. INTERVENTION: Each mother completed the PDSS followed by a Diagnostic and Statistical Manual of Mental Disorders (4th ed.) diagnostic interview. MAIN OUTCOME MEASURE: Seven dimensions of postpartum depression: sleeping/eating disturbances, anxiety/insecurity, emotional lability, mental confusion, loss of self, guilt/shame, and suicidal thoughts as measured by the PDSS. RESULTS: Scores on all seven dimensions of the PDSS were elevated. The three top dimensions were emotional lability, mental confusion, and anxiety/insecurity. The mean total PDSS score of 120 was well beyond the recommended cutoff score of 80 for a positive screen for major postpartum depression. CONCLUSION: Clinicians who come in contact with new mothers need to be alert to the range of possible symptoms that postpartum depressed mothers may experience so that these women are not left to suffer in silence. 相似文献
2.
目的 探讨产后抑郁症的发生率及其影响因素,方法 随机抽取在本院产前门诊初诊并决定在本院分娩的1052例孕妇进行医院焦虑及抑郁情绪自评量表调查,其中以艾迪产后抑郁量表(EPDS)跟踪调查至产后7天内共866例。结果 EPDS阳性率为15.01%(130/866),并用单因素和多元逐步回归分析了产后抑郁症的影响因素,发现孕妇健康状况,孕期夫妻关系,分娩时医务人员的态度,丈夫企盼生男孩的程度及孕妇孕期听 相似文献
3.
Objective: The present study established severity cut-off scores for the Edinburgh Postnatal Depression Scale (EPDS) based on a widely used depression symptom severity measure, the Beck Depression Inventory (BDI). Background: The EPDS is a widely used screening tool to identify clinically significant levels of depression in postpartum women. Traditionally, an EPDS cut-off score is used to identify probable depression. This dichotomisation of postpartum women into depressed vs. non-depressed groups fails to account for valuable information regarding the variability in symptom severity among those in the depressed group. The identification of depression severity ranges (e.g. mild, moderate or severe) for the EPDS would provide incremental information regarding level of depression, which in turn, could inform treatment referrals. Methods: A sample of 1516 postpartum women completed the EPDS and the BDI. Equipercentile linking was used to develop concordance between EPDS and BDI scores, and severity ranges were established by identifying EPDS scores that corresponded to established severity ranges on the BDI. Results: The following severity ranges were established for the EPDS: none or minimal depression (0–6), mild depression (7–13), moderate depression (14–19), and severe depression (19–30). Conclusion: Postpartum women experience a wide range of depression severity. The establishment of severity ranges for EPDS scores may guide treatment referrals. Although the study sample size was large, only a limited number of women scored in the severe range of depression symptoms. Replication in a larger sample of depressed women is an important direction for future research. 相似文献
7.
OBJECTIVE: To review the literature concerning maternal postpartum depression beyond the early postpartum period. DATA SOURCES: A literature search was conducted using Cinahl, Medline, and PsychInfo electronic databases. Keywords included postpartum depression, postpartum depressive symptoms, course, prevalence, incidence, and remission. STUDY SELECTION: Studies selected included incidence of maternal depression or depressive symptoms, existing in the early postpartum period, and measured again at postpartum points from 6 months through 2 1/2 years after delivery. Only studies published in English were included. Twenty-three articles were located, and a recent relevant study conducted by the current author also was included. DATA EXTRACTION: Studies were reviewed and data organized according to year, sample characteristics, time of depression assessment, instrument used, cutoff score, rate of depression, and factors associated with depression at later postpartum time points. DATA SYNTHESIS: For a significant percentage of women, postpartum depressive symptoms continue for months or even years after giving birth. Factors associated with postpartum depression at later time points are identified. CONCLUSIONS: Continued evaluation of women with elevated depression levels at initial screening, and treatment for women whose depression does not remit spontaneously within the first few weeks or months postpartum is recommended. Further research is needed to understand the phenomenon of persistent postpartum depression. 相似文献
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Postpartum depression has been described as a thief that steals motherhood. Early recognition is one of the major challenges with this devastating mood disorder. This article describes a revised version of the Postpartum Depression Predictors Inventory (PDPI) based on the results of an updated meta-analysis. This revised inventory consists of 13 risk factors related to postpartum depression. Guide questions for each of the 13 predictors that clinicians can use during an interview process also are included. Included among these 13 predictors in the PDPI-Revised are four new risk factors: self-esteem, marital status, socioeconomic status, and unplanned/unwanted pregnancy. Ideally, this checklist should be completed each trimester to update a pregnant woman's risk status. After a woman gives birth, the PDPI-Revised should be used to continue to monitor her risk status because she can develop postpartum depression at any time during the 1st year after childbirth. 相似文献
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目的:系统评价心理治疗对产后抑郁症(PPD)的干预效果.方法:通过计算机和手工检索1968年1月到2012年10月国内外心理治疗PPD的随机对照试验(RCT),根据既定的纳入和排除标准筛选文献,质量评价后进行Meta分析.结果:本研究共纳入9篇RCT,合计1003例.Meta分析结果显示,心理干预结束时(SMD=-0.23,95%CI为-0.44 ~-0.01,P<0.05)、结束后3个月(SMD=-1.13,95% CI为-1.52 ~-0.74,P<0.05)和6个月(SMD=-0.39,95%CI为-0.57 ~-0.21,P<0.05),干预组与对照组的EP-DS评分均有显著差异;心理干预结束后≥2年,干预组与对照组的EPDS评分无显著差异(SMD=-0.14,95%CI为-0.47 ~0.19,P>0.05).心理治疗疗程≥8周,干预组与对照组的EPDS评分有显著差异(SMD=-0.41,95%CI为-0.65 ~-0.16,P<0.05);疗程<8周,两组则无显著差异(SMD=0.01,95%CI为-0.17 ~0.19,P>0.05).采用团体心理治疗,干预组与对照组的EPDS评分有显著差异(SMD=-0.50,95%CI为-0.91 ~-0.09,P<0.05);采用个体心理治疗,两组则无显著差异(SMD=-0.17,95%CI为-0.41 ~0.08,P>0.05).结论:心理治疗PPD的近期效果较好,治疗时应注意治疗周期、干预形式等,以增强心理治疗的效果. 相似文献
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ObjectiveTo determine the relationship between the traditional Chinese practice of postpartum care, known as zuoyuezi, and postpartum depression (PPD) in China. MethodsA total of 342 Chinese women were surveyed 6- to 8-weeks post partum using the Edinburgh Postnatal Depression Scale (EPDS) and items assessing sociodemographics, health history, peripartum experiences, zuoyuezi, and social support. ResultsPrevalence of PPD was 15.5% (EPDS cutoff ≥ 13). PPD was associated with lower income, difficult pregnancy experience, poor infant health status, not attending childbirth classes, and low spousal involvement before and after delivery. Among the 96% of women who practiced zuoyuezi, those for whom the caregiver was her mother-in-law or who perceived zuoyuezi as unhelpful had twice the odds of PPD. ConclusionThese data highlight the importance of the peripartum experience in assessing PPD risk. Zuoyuezi is still commonly practiced in urban China, and further research is needed to explore its role in the potential prevention of PPD. 相似文献
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ObjectiveTo assess the feasibility of using community health workers to administer short or ultra-short screening instruments during routine community-based prenatal outreach for detecting probable depression at 12 weeks postpartum. MethodsDuring pregnancy and at 12 weeks postpartum, the 10-item Edinburgh Postnatal Depression Scale (EPDS-10) was administered to 249 Xhosa-speaking black African women living in Khayelitsha, South Africa. We compared the operating characteristics of the prenatal EPDS-10, as well as 4 short and ultra-short subscales, with the criterion standard of probable postpartum depression. ResultsSeventy-nine (31.7%) women were assessed as having probable postpartum depression. A prenatal EPDS-10 score of 13 or higher had 0.67 sensitivity and 0.67 specificity for detecting probable postpartum depression. Briefer subscales performed similarly. ConclusionCommunity health workers successfully conducted community-based screening for depression in a resource-limited setting using short or ultra-short screening instruments. However, overall feasibility was limited because prenatal screening failed to accurately predict probable depression during the postpartum period. 相似文献
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Objective.?To determine the timing of screening for postpartum depression that optimizes access to psychiatric care. Methods.?Cross-sectional evaluation of women receiving obstetric care in a community-based medical center clinic from March to July 2006, who were screened for depression at 36 weeks gestation, delivery, and 6 weeks postpartum using the Edinburgh Postnatal Depression Scale. Positive screens generated referrals for psychiatric evaluation. The rate of positive screens for depression and psychiatric follow-up at each time point was evaluated. Results.?Of the 293 patients evaluated, the distribution of the first screen which occurred during the study period was 21% at 36 weeks, 31% at delivery, and 48% at 6 weeks postpartum. The incidence of a positive screen was 5% at 36 weeks, 16% at delivery and 14% at 6 weeks postpartum. Access to psychiatric care occurred in 33% at 36 weeks, 15% at 6 weeks postpartum and 100% at delivery ( p?=?0.001). Conclusion.?Screening for depression in the hospital after delivery improves access to psychiatric care. 相似文献
14.
Backgroundthe purpose of the study was to assess the validity of the 10-item Edinburgh Postnatal Depression Scale (EPDS) in screening for postnatal depression (PND) in Hungary. Methodsbetween July 2010 and March 2011, a sample of 266 women attending a routine check-up at six weeks post partum completed the newly translated Hungarian version of the EPDS at the Department of Obstetrics and Gynecology, University of Szeged, Hungary, and underwent clinical assessments based on the Structured Clinical Interview for DSM-IV disorders (SCID-I). Findingseight (3.0%) of the mothers were diagnosed with major postnatal depression, and 36 (13.5%) with minor depression on the basis of the SCID. Internal consistency of the Hungarian version of the EPDS was satisfactory (Cronbach α coefficients ≥0.727). The best cut-off for major depression was 12/13, with a sensitivity of 100.0%, and a specificity of 97.7%. The area under the ROC curve was found significant for combined (major+minor) depression as well and at a cut-off of 7/8 indicated a sensitivity of 72.7% and a specificity of 86.0%. A factor analysis suggested multidimensionality with two factors (anxiety and depression). Conclusionsthe EPDS showed good validity in the postnatal period in a clinical sample in Hungary. 相似文献
15.
OBJECTIVE: To assess and characterize health education regarding postpartum depression (PPD) received by recently delivered women during their postpartum hospital stay. DESIGN: Mailed, self-administered survey. SETTING: All 121 hospitals in Ohio that provide obstetric and postpartum care. PARTICIPANTS: Nurse managers for obstetric services, 90 (74%) of whom returned surveys. MAIN OUTCOME MEASURES: Types of postpartum education provided, format of postpartum depression education delivery, attitudes regarding postpartum depression education. RESULTS: Most hospitals (89.7%) educate newly delivered women about PPD, most often by passive methods. Specific educational programs were offered by only 14% of hospitals. Most PPD education was provided during hospitalization after delivery; however, 50% of respondents felt that it should be provided at every possible opportunity. CONCLUSION: PPD education is one of several topics covered during hospitalization for newly delivered mothers. Health providers of all disciplines should be involved in educating a new mother about PPD. 相似文献
16.
目的 探讨产后抑郁症、焦虑症发病原因和防治对策。方法 用抑郁自评量表 (SDS)和焦虑自评量表 (SAS)对 1 5 0 0例围产期产妇评定 ,并与我国常模对照。结果 产妇中 1 2 1 % (1 81 1 5 0 0 )有抑郁情绪 ,1 0 6 % (1 5 9 1 5 0 0 )有焦虑情绪 ,抑郁、焦虑评分显著高于我国常模水平 ,差异有极显著性 (P <0 0 1 ) ;多因素分析显示产后抑郁症、焦虑症与家庭类型、经济收入、年龄、受教育程度、性格、分娩方式及医务人员态度有相关性。结论 产后抑郁症、焦虑症的发生主要与社会因素 (家庭类型、经济收入、年龄、受教育程度 )、心理因素 (性格、分娩方式及医务人员态度 )有关。提示在产后焦虑症、抑郁症的治疗上 ,应从药物、心理和社会因素多方面综合性治疗。 相似文献
17.
OBJECTIVES: To describe the newly developed item coding and computation of the total score for the Postpartum Depression Predictors Inventory-Revised along with recommended cutoff points. DESIGN: Methodologic research. SETTING: Obstetrician and gynecologist offices in the Pacific Northwest. PARTICIPANTS: This longitudinal study included 139 women; the study began in the participant's third trimester of pregnancy and ended at 8 months after childbirth. METHODS: The participants completed the Postpartum Depression Predictors Inventory-Revised in their third trimester of pregnancy and again at 2 and 6 months after childbirth. Postpartum depression symptoms were measured by the Edinburgh Postnatal Depression Scale and psychiatric nurse practitioner interview at 2 and 6 months after childbirth. MAIN OUTCOME MEASURES: Sensitivity and specificity of the Postpartum Depression Predictors Inventory-Revised at three points: prenatal and 2 and 6 months after childbirth. RESULTS: The receiver operating characteristic curve analysis indicated that the Prenatal Postpartum Depression Predictors Inventory-Revised performed well and explained 67% of the variance of postpartum depressive symptomatology as measured by Edinburgh Postnatal Depression Scale scores. The Prenatal Postpartum Depression Predictors Inventory-Revised yielded a sensitivity of .76 and a specificity of .54 at a cutoff score of 10.5. CONCLUSIONS: A cutoff score of 10.5 is recommended when using the Postpartum Depression Predictors Inventory-Revised during pregnancy. Further research needs to be conducted on recommended cutoff scores for use of the Postpartum Depression Predictors Inventory-Revised during the postpartum period. 相似文献
18.
Purpose: To evaluate the association between postpartum hormonal contraceptive use and postpartum depression. Materials and methods: We searched the literature through March 2018 on the association between postpartum hormonal contraception use and incident postpartum depression. We used the United States Preventive Services Task Force framework to assess study quality. Results: Of 167 articles identified, four met inclusion criteria. Two studies found no differences in rates of postpartum depression between women using postpartum depot medroxyprogesterone and those not using hormonal contraception; however, a study of women receiving injectable norethisterone enanthate immediately postpartum found a 2–3-fold increased risk of depression at 6 weeks, though not at 3 months. One study compared combined hormonal contraception, progestin-only pills (POPs), etonogestrel implants and levonorgestrel intrauterine devices (LNG-IUDs) with no hormonal contraception, and found a 35–44% decreased risk of postpartum depression with POPs and LNG-IUDs, a small increased risk of postpartum antidepressant use among women using the etonogestrel implant and vaginal ring, and a decreased risk of antidepressant use with POPs. Conclusions: Limited evidence found no consistent associations between hormonal contraceptive use and incidence of postpartum depression. Future research would be strengthened by using validated diagnostic measures, careful consideration of confounders, and ensuring adequate follow-up time. 相似文献
19.
The aims of this study were to evaluate and compare the depression scores of pregnant and non-pregnant women, and to identify the factors associated with depression scores in the two groups. This community-based study was conducted in a primary health care center catchment area in Ankara (population: 17,838) in January 2003. At the beginning of the study, the trimesters of all pregnant women ( n = 66) were determined and as a control group ( n = 138), two non-pregnant women matched for age and parity characteristics living in the same area were selected for each pregnant woman. Each participant completed a questionnaire and the Beck Depression Inventory (BDI). One-way ANOVA, univariate correlation, and multiple linear regression analyses were used in statistical evaluation. Depression scores of pregnant and non-pregnant women, and women at different trimesters of pregnancy were similar. Using a cut-off score ≥ 18 on the BDI, 26.5% of non-pregnant women, 27.3% of pregnant women, 25.0% of pregnant women in their first and second trimester, and 30.0% of third trimester pregnant women were found to be depressive. According to multiple linear regression analysis, age, age at marriage, and the number of people living in the home were associated with depression in both groups. Depression scores were similar in pregnant women and non-pregnant controls. There were different associations between depression score and the study groups' characteristics. 相似文献
20.
Objective: To measure the recurrence rate and precipitating factors of postpartum depression (PPD) following universal screening using the Edinburgh Postnatal Depression Scale (EPDS) in consecutive births. Methods: EPDS questionnaires were administered to all postpartum women at our hospital beginning in June 2008. For this study, perinatal factors were examined in relation to EPDS scores during consecutive births to identify factors in the development of PPD. Outcomes of women previously screening negative and returning for another delivery were analyzed using univariable and multivariable analysis for associations with PPD. Results: Between June 2008 and March 2010, 17 613 women were screened using EPDS questionnaires, and 3842 (22%) women returned and subsequently delivered another infant. A prior negative EPDS score significantly reduced the risk of a subsequent positive EPDS when compared with index testing (3% versus 6%; p?<?0.01). Of those 3631 women previously screening negative and returning for a subsequent delivery, stillbirth and neonatal malformation were both associated with increased risk of PPD, p?=?0.01 and p?=?0.02, respectively. Following logistic regression, stillbirth remained significantly associated with symptoms of PPD (aOR 7.79, 95%CI 1.5–39.5). Conclusions: While prior negative screening portends a reduced risk for PPD, stillbirth in a subsequent pregnancy remains a powerful antecedent for PPD. 相似文献
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