多中心产后门诊妇女抑郁和/或焦虑症状现况研究

目的 了解中国大城市产后妇女中抑郁和／或焦虑症状患病率。方法 采用现况研究方法．于2004年6月1日到9月1日在北京、上海和成都3家医院的产科随访门诊连续收集分娩后妇女317例。由经培训的调查员用统一的调查表进行面对面调查，同时使用综合医院焦虑抑郁量表（HAD）、Hamilton焦虑量表和Hamilton抑郁量表进行心理测评。结果 产后妇女中抑郁自评症状的检出率为3．5％．焦虑自评症状的检出率为4．4％，在具有抑郁和／或焦虑症状（HAD≥9分）的患者中，中重度抑郁症状的检出率为10．0%，中重度焦虑症状的检出率为28．6％。具有抑郁和／或焦虑自评症状者所生育的新生儿的健康状况都良好．统计学检验未提示产妇妊娠合并症、分娩合并症与产妇抑郁和焦虑自评症状检出有显著关系，行剖宫术产妇焦虑自评症状的检出率显著高于顺产产妇。结论 中国大城市产后妇女抑郁、焦虑症状检出率尽管低于发达国家．但鉴于我国每年较大的分娩基数，产后妇女中抑郁和焦虑现象仍应引起卫生管理部门和临床医务人员的关注。

A cross-sectional study on the proportion of depressive and/or anxiety symptoms in postpartum outpatients at obstetrical department of urban China

Purpose To describe the prevalence of depressive and/or anxiety symptoms in postpartum outpatients at obstetrical department in three big cities in China. Methods This was a hospital-based cross-sectional study conducted in three big cities in China in 2004. Three hundred and seventeen eligible subjects were recruited from the outpatient department continually within three months. Face-to-face interview was used in data collection together with the self-completed HAD scale for depressive and/or anxiety symptom screening. Subjects getting a HAD score of 9 or above were further assessed for depressive and/or anxiety symptoms with HAMA scale and HAMD scale by licensed psychologists or psychiatrists. Results The prevalence of self-scaled depressive and anxiety symptoms were 3.5 and 4.4 respectively in the postpartum outpatients. And among self-scaled positive subjects, the proportion with depressive and anxiety symptoms was 10.0 and 28.6 respectively; health status of the newborns, pregnant and delivery complications were not associated with depressive and/or anxiety symptom (P>0.05). Subjects experienced caesarean operation had significantly higher detection rate of anxiety symptoms than that of normal delivery. Conclusions Although the detection rate of postpartum depressive and/or anxiety symptoms was relatively lower in urban China than that in the developed countries, healthcare providers and health policy makers should remain vigilant for these psychic symptoms in postpartum women considering the large population of pregnant women in China.