■该研究试图探索与分娩相关的高心理压力水平与产后精神障碍之间的关系。
■从2021年7月到2022年1月,共有284名产妇被纳入研究。通过修订的事件影响量表(IES-R)评估产后1个月的压力水平。IES-R评分≤9分的产妇被纳入低心理压力水平组,IES-R评分>9分的人被纳入高心理压力水平组。爱丁堡产后抑郁量表(EPDS),联盟生理-心理-社会评估问卷(UPPSAQ-70),症状检查表-90(SCL-90)和迷你国际神经精神病学访谈(M.I.N.I.)在产后42±7天进行,以评估产妇的心理健康。EPDS对产妇出生后的心理健康进行了评估,UPPSAQ-70和SCL-90。使用M.I.N.I.在产后42±7天进行半结构化诊断性访谈。
■产后精神障碍的发病率为20.42%(58/284),产后抑郁症的发病率,焦虑症,强迫症和创伤后应激障碍占17.96%(51/284),11.97%(34/284),4.58%(13/284)和1.41%(4/284),分别,合并症发生率为58.62%(34/58)。精神病史和妊娠合并症是产后抑郁症的危险因素(分别为p=0.028,p=0.040);精神病史,缺乏体育锻炼,伴侣暴力和妊娠并发症是产后焦虑症的危险因素(分别为p=0.003,p=0.007,p=0.031,p=0.048);女性婴儿分娩是产后强迫症的危险因素(p=0.022).产后抑郁症的风险,焦虑症和强迫症分别为9.125倍(95%CI=3.900~21.349,p<0.01),与分娩相关的心理应激水平高的产后妇女比心理应激水平低的妇女高7.310倍(95%CI=2.588~20.649,p<0.01)和6.259倍(95%CI=1.347~29.093,p<0.01),分别。
■产后精神障碍的发生率高,与心理压力水平呈正相关。这可能会导致心理压力对产后精神障碍的影响有一个新的视角,并引起除产后抑郁症外的其他精神障碍的更多关注。
UNASSIGNED: The study sought to explore the relationship between high psychological stress levels related to delivery and postpartum mental disorders.
UNASSIGNED: A total of 284 parturients were included in the study from July 2021 to January 2022. The stress level at 1 month postpartum was assessed by the Impact of Event Scale-Revised (IES-R). Parturients with an IES-R score ≤ 9 were included in the low psychological stress level group, and those with an IES-R score > 9 were included in the high psychological stress level group. The Edinburgh Postnatal Depression Scale (EPDS), Union Physio-Psycho-Social Assessment Questionnaire (UPPSAQ-70), Symptom Checklist-90 (SCL-90) and Mini-International Neuropsychiatric Interview (M.I.N.I.) were conducted at 42 ± 7 days postpartum to assess the mental health of parturients.The parturients\' mental health after birth was assessed by the EPDS, UPPSAQ-70, and SCL-90. Semi-structured diagnostic interviews were conducted at 42 ± 7 days postpartum by using the M.I.N.I.
UNASSIGNED: The incidence rate of postpartum mental disorders was 20.42% (58/284), the incidence rates of postpartum depression, anxiety disorders, obsessive-compulsive disorder and posttraumatic stress disorder were 17.96% (51/284), 11.97% (34/284), 4.58% (13/284) and 1.41% (4/284), respectively, and the comorbidity rate was 58.62% (34/58). A history of mental disorders and pregnancy complications were risk factors for postpartum depression (p = 0.028, p = 0.040, respectively); a history of mental disorders, a lack of physical exercise, partner violence and pregnancy complications were risk factors for postpartum anxiety disorders (p = 0.003, p = 0.007, p = 0.031, p = 0.048, respectively); and the delivery of female infants was a risk factor for postpartum obsessive-compulsive disorder (p = 0.022).The risk of postpartum depression, anxiety disorders and obsessive-compulsive disorder was 9.125 times (95% CI = 3.900 ~ 21.349, p < 0.01), 7.310 times (95% CI = 2.588 ~ 20.649, p < 0.01) and 6.259 times (95% CI = 1.347 ~ 29.093, p < 0.01) higher in postpartum women with high psychological stress levels related to delivery than in those with low psychological stress levels, respectively.
UNASSIGNED: The incidence of postpartum mental disorders is high and has a positive correlation with the level of psychological stress. This may lead to a new perspective of the effect of psychological stress on postpartum mental disorders and attract more attention to other mental disorders in addition to postpartum depression.