Abstract.
目的:亲密伴侣暴力(IPV)是围产期抑郁症(PND)的重要危险因素。但IPV对PND症状自然预后的影响尚不清楚。我们测试了两个假设:(1)有IPV经历的孕妇将比没有IPV经历的孕妇表现出更严重的PND症状;(2)IPV经历会阻碍PND的恢复预后。我们还探讨了IPV与其他危险因素相比对PND的贡献。
方法:样本由湖南的813名孕妇组成,中国。我们使用修订后的冲突战术量表(CTS2S)的简短形式评估IPV经验,通过爱丁堡产后抑郁量表(EPSD)和PND症状。我们进行了线性混合效应模型,以比较受害者和非受害者之间的PND症状的轨迹,以及多阶段广义估计方程模型,以探索PND症状轨迹的重要因素。
结果:有90名参与者(11.07%)在过去12个月内报告了IPV经历。关于身体,心理和性暴力,患病率为4.55%(37/813),9.23%(75/813)和2.34%(19/813)。患者报告了更严重的PND症状(t=5.30,p<0.01)和轨迹斜率下降较慢(t=28.89,p<0.01)。PND轨迹与IPV体验相关(OR=3.78;95%CI1.39-10.26),社会支持(OR=0.93;95%CI0.88-0.97),积极应对策略(OR=0.85;95%CI0.80-0.91),消极应对策略(OR=1.25;95%CI1.14-1.37),月收入0.15-298.36美元(与无收入相比,OR=0.0075;95%CI0.00052-0.11)。
结论:研究结果表明,在中国其他省份的围产期,湖南报告的IPV患病率低于大多数以前的研究。IPV受害与PND症状的严重程度增加和预后减慢有关。筛选受害情况并建立其对PND症状预后较差的明确机制的未来研究将有利于PND的预防和治疗。
Abstract.
OBJECTIVE: Intimate partner violence (IPV) is an important risk factor for perinatal depression (PND). But IPV\'s impact on the natural prognosis of PND symptoms is not well understood. We tested two hypotheses: (1) pregnant women with IPV experiences will exhibit more severe PND symptoms than women without IPV experience; (2) IPV experience will impede the recovery prognosis of PND. We also explored the contribution of IPV to PND comparing with other risk factors.
METHODS: The sample is comprised of 813 pregnant women followed through perinatal period in Hunan,
China. We assessed IPV experience using items from the Short Form of the Revised Conflict Tactics Scale (CTS2S), and PND symptoms via the Edinburgh Postnatal Depression Scale (EPSD). We conducted Linear Mixed-effects Model to compare the trajectories of PND symptoms between victims and non-victims and a multistage Generalised Estimating Equations Model to explore salient factors on the trajectory of PND symptoms.
RESULTS: There were 90 participants (11.07%) who reported IPV experience in the past 12 months. With respect to physical, psychological and sexual violence, the prevalence was 4.55% (37/813), 9.23% (75/813) and 2.34% (19/813). Victims reported more severe PND symptoms (t = 5.30, p < 0.01) and slower decreasing slope of trajectories (t = 28.89, p < 0.01). The PND trajectory was associated with IPV experience (OR = 3.78; 95% CI 1.39-10.26), social support (OR = 0.93; 95% CI 0.88-0.97), positive coping strategies (OR = 0.85; 95% CI 0.80-0.91), negative coping strategies (OR = 1.25; 95% CI 1.14-1.37) and monthly income of $0.15-$298.36 (compared to no income, OR = 0.0075; 95% CI 0.00052-0.11).
CONCLUSIONS: The findings suggest the reported prevalence of IPV is lower in Hunan than most of the previous studies during perinatal period in other provinces of
China, and IPV victimisation is associated with increased severity and slowed prognosis of PND symptoms. Future studies that screen for victimisation and establish its explicit mechanism to the poorer prognosis of PND symptoms would benefit the prevention and treatment of PND.