产后抑郁相关危险因素分析

本文通过分析引发产后抑郁的相关危险因素及其对健康的影响,为探索干预措施提供依据.危险因素重要性的分析显示"夫妻关系不佳"位居危险因素之首;产妇的性格特征和孕期心理状态是产后押郁发生的重要心理影响因素.因此,丈夫角色不容忽视,社会支持系统的建立意义重大,干预效果显著的因素应作为研究重点.     

产后抑郁预防干预方法现状分析

本文通过分析现有产后抑郁预防干预方法,为探索产后抑郁预防干预模式提供依据。研究中提及的产后抑郁预防干预方法众多,但缺乏效果评价,总体干预思路是以早发现为前哨,疏导为重点,建立社会支持系统为支撑,调整生活习惯为保障。集体心理干预值得推广,应加强实施效果评估,并将产后抑郁干预融入孕产妇保健体系。     

产后抑郁预防干预方法现状分析

本文通过分析现有产后抑郁预防干预方法,为探索产后抑郁预防干预模式提供依据.研究中提及的产后抑郁预防干预方法众多,但缺乏效果评价,总体干预思路是以早发现为前哨,疏导为重点,建立社会支持系统为支撑,调整生活习惯为保障.集体心理干预值得推广,应加强实施效果评估,并将产后押郁干预融入孕产妇保健体系.     

我国产后抑郁研究现状分析

本文通过系统分析产后抑郁领域的国内研究现状,为研制针对性的干预策略奠定基础。研究遵循循证医学的理念,运用文献计量分析方法,对国内1998年～2007年间发表的111篇产后抑郁领域的研究文献进行分析。可见研究文献数量呈现逐年上升趋势,但研究范围主要局限于医学中心及区域范畴,研究内容主要涉及产后抑郁的评估与诊断、危险因素研究和预防干预方法的探索,但总体研究设计存在较大缺陷。可见亟需加强社区层面研究,提高研究设计的科学性,并将预防干预方法研究作为重点。     

我国产后抑郁研究现状分析

本文通过系统分析产后抑郁领域的国内研究现状.为研制针对性的干预策略奠定基础.研究遵循循证医学的理念,运用文献计量分析方法,时国内1998年～2007年阃发表的111篇产后抑郁领域的研究文献进行分析.可见研究文献数量呈现逐年上升趋势,但研究范围主要局限于医学中心及区域范畴,研究内容主要涉及产后抑郁的评估与诊断,危险因素研究和预防干预方法的探索,但总体研究设计存在较大缺陷.可见亟需加强社区层面研究,提高研究设计的科学性,并将预防干预方法研究作为重点.     

555例危险行为高危青少年的心理干预：来自个体辅导和团体辅导的效果对照

对有较高风险发展为危险行为青少年的高危群体实施有针对性的心理干预是非常有价值的。本研究对青少年危险行为高危人群进行结构化的个体与团体心理干预,评估两种干预的即时效果和六个月的预后情况。采用《青少年健康相关危险行为问卷》等量表对16所中职院校的学生进行筛查,共555名学生参加本研究,被随机分为个体、团体和对照组并分别进行干预。结果发现：干预后,个体心理干预组被试的危险行为水平、心理健康以及抑郁和焦虑情绪均获得显著改善,并且6个月的预后效果依然明显,而接受团体辅导干预组仅在抑郁指标上有所改善,在危险行为评分、焦虑和心理健康水平上均没有明显的改善。研究认为,对危险行为易感青少年的心理干预应以经过良好设计的个体心理干预为主、团体干预为辅的方式进行。     

冠心病伴焦虑抑郁的临床研究

冠心病是目前公认的心身疾病,心理社会因素与其发生、发展及预后关系密切,其中焦虑、抑郁尤为重要。近年来综合心理干预已引起临床医生重视,本文拟从焦虑、抑郁与冠心病的关系、对其预后的影响以及临床干预治疗现状和水平进行了综述。     

冠心病伴焦虑抑郁的临床研究

冠心病是目前公认的心身疾病,心理社会因素与其发生、发展及预后关系密切,其中焦虑、抑郁尤为重要.近年来综合心理干预已引起临床医生重视,本文拟从焦虑、抑郁与冠心病的关系、对其预后的影响以及临床干预治疗现状和水平进行了综述.     

剖宫产产后抑郁的发生与社会支持、应对方式及防御方式的相关性

了解剖宫产产后抑郁的发生与社会支持、应对方式及防御方式的相关性,对剖宫产患者进行抑郁状况的调查,并对其影响因素进行分析。对抑郁组与非抑郁组的一般情况构成比比较,并采用抑郁自评量表（SDS）、应付方式评定量表（YFFS）、社会支持问卷（ISSI）、防御方式问卷（DSQ）进行测评。社会支持、应对方式及防御方式对产后抑郁的发生均产生一定作用。应付方式、社会支持及防御方式是影响剖宫产患者产后抑郁的重要因素。     

尿毒症血液透析患者抑郁状况的研究

随着透析技术的不断完善,尿毒症患者的生存期明显延长,尿毒症患者的心理障碍问题也日益受到重视,本文通过标准化的心理测量工具,分析不同的自然因素及疾病因素对尿毒症透析患者抑郁的影响,目的在于为寻求有效的综合式生物-心理-社会干预治疗提供有效的临床依据。     

Prospective study of postpartum depression: 4 1/2-year follow-up of women and children

The consequences of maternal postpartum depression for mothers and children were investigated in a 4 1/2-year follow-up study, which included 70 of 99 women who had participated in an earlier study of postpartum depression. Information about maternal adjustment and depression during the follow-up period and child adjustment at age 4 1/2 years was obtained. Women who had experienced a postpartum depression were predicted to be at increased risk for subsequent depression and poor adjustment of their child. Postpartum depression was directly related to subsequent depression but not child problems. Later depression was related to child problems at 4 1/2 years. We concluded that postpartum depression may increase risk for later maternal depression and in turn increases risk for child behavior problems. Intervening with women who have experienced a postpartum depression may reduce likelihood of future depressions and child behavior problems.     

UNDERSTANDING THE CONNECTION BETWEEN ATTACHMENT TRAUMA AND MATERNAL SELF‐EFFICACY IN DEPRESSED MOTHERS

Maternal self‐efficacy predicts sensitive and responsive caregiving. Low maternal self‐efficacy is associated with a higher incidence of postpartum depression. Maternal self‐efficacy and postpartum depression can both be buffered by social support. Maternal self‐efficacy and postpartum depression have both been linked independently, albeit in separate studies, to the experience of violent trauma, childhood maltreatment, and spousal abuse. This study proposed a model in which postpartum depression mediates the relation between attachment trauma and maternal self‐efficacy, with emotional support as a moderator. Participants were 278 first‐time mothers of infants under 14 months. Cross‐sectional data were collected online. Mothers completed questionnaires on attachment trauma, maternal self‐efficacy, postpartum depression, and emotional support. A moderated mediation model was tested in a structural equation modeling framework using Mplus’ estimate of indirect effects. Postpartum depression fully mediated the relation between trauma and maternal self‐efficacy. Emotional support moderated only the pathway between postpartum depression and maternal self‐efficacy. Attachment trauma's implications for maternal self‐efficacy should be understood in the context of overall mental health. Mothers at the greatest risk for low maternal self‐efficacy related to attachment trauma also are those suffering from postpartum depression. Emotional support buffered mothers from postpartum depression, though, which has implications for intervention and future research.     

心理干预对急性冠脉综合征伴抑郁患者应对方式的影响

为了解心理干预对急性冠脉综合征（ACS）伴抑郁患者应对方式的影响,对42名ACS伴抑郁患者随机分为干预组和对照组,在入组时、入组3月后和6月后分别进行HAD（d）、MCMQ测评。结果显示入组3月后和6月后,干预组HAD（d）总分、回避因子分、屈服因子分较对照组降低,面对因子分较对照组升高,与入组时相比干预组HAD（d）...     

Tailoring treatment of depression for women across the reproductive lifecycle: the importance of pregnancy, vasomotor symptoms, and other estrogen-related events in psychopharmacology

Compared with men, women are at increased risk of depression, especially at several reproductive-related lifecycle points. This may be partially due to changing levels of estrogen, a hormone that can affect levels of neurotransmitters and neural proteins. As estrogen levels vary throughout the lifespan, risk of depression in women also varies, and not all treatments are appropriate or effective at all times. In adolescence, onset of depression may be associated with onset of puberty, but treating underage girls with antidepressants can risk suicidality. In females of childbearing age, mood disturbances associated with menstrual cycles signal a risk for later full-blown major depressive disorder. In depressed pregnant and postpartum women, risks of treatment versus risks of nontreatment are intricate and require case-by-case evaluation. In perimenopause, vasomotor symptoms may be harbingers of oncoming depression and also may signal the presence of dysregulated hormones and neurotransmitters. Relieving vasomotor symptoms may be a necessary dimension of treating depression. In postmenopause, response to selected antidepressants may depend on whether the patient is also taking hormone-replacement therapy. To attain optimal outcomes, modern psychopharmacologists must tailor treatment of depression to a woman's reproductive stage of life.     

我国产后抑郁评估与诊断方法应用现状分析

早期评估与诊断是产后抑郁预防干预的第一步,通过分析国内产后抑郁评估与诊断方法的应用现状,为提高评估与诊断结果的科学性提供依据。发现爱丁堡产后抑郁量表为筛查首选量表,分析显示采用同一种量表和不同量表进行评估的检出率均有较大差异。因此,应根据研究特点选择适宜的筛查量表以提高不同研究结果的可比性,同时,需加强量表分界值本土化的研究。     

Stress, psychosocial resources, and depressive symptomatology during pregnancy in low-income, inner-city women.

The authors examined the prospective influence of stress, self-esteem, and social support on the postpartum depressive symptoms of 191 inner-city women (139 European Americans and 52 African Americans) over 3 waves of data collection. Depressive symptomatology was measured by multiple indicators, including self-report and clinical scales. Women became less depressed as they move from prenatal to postpartum stages and adjusted to their pregnancy and its consequences. LISREL and regression analyses indicated that stress was related to increased depression, whereas greater income and social support were related to decreased depression. Self-esteem was related to lower depression at the prenatal and postpartum periods but not to change in depression from the prenatal to the postpartum period. The results also indicated that self-esteem and social support did not have additional stress-buffering effects over and above their direct effects on depression. Finally, African American women did not differ from European American women terms of depression or in terms of how they were impacted by stress or psychosocial resources.     

Do postpartum anxiety and breastfeeding self-efficacy and bonding at early postpartum predict postpartum depression and the breastfeeding method?

We investigated whether postpartum anxiety (PPA) and breastfeeding self-efficacy and bonding at the early postpartum period can be used to predict postpartum depression and the breastfeeding method, and we sought to identify factors related to postpartum depression. Of the 510 eligible women, 185 (36%) returned the questionnaire on all three occasions (1 day, 3 days, and 1 month after childbirth). The mothers' progress on the State-Trait Anxiety Inventory (STAI), Breastfeeding Self-Efficacy Scale Short Form (BFSES-SF), and Postnatal Bonding Questionnaire (PBQ) was observed over three periods. A repeated-measures ANOVA revealed that the mothers at high risk of developing postpartum depression (PPD) were those who did not show an increase in BFSES-SF score at early postpartum, and mothers whose bonding disorders have deteriorated rapidly. The results of the logistic regression analysis revealed a significant difference in employment as a factor related to postpartum depression. Compared to Regular, Part-time status was 4.4 times more likely and Unemployed status was 2.3 times more likely to cause postpartum depression. For the early detection of PPD, it is necessary to identify (1) mothers who do not show an increase in the BFSES-SF score, (2) mothers whose bonding disorders have deteriorated rapidly, and (3) part-time or unemployed mothers as characteristic of postpartum depression.     

Effect of the Healthy MOMs Lifestyle Intervention on Reducing Depressive Symptoms Among Pregnant Latinas

Depression during the prenatal and postpartum periods is associated with poor maternal, perinatal and child outcomes. This study examines the effectiveness of a culturally and linguistically tailored, social support-based, healthy lifestyle intervention led by trained community health workers in reducing depressive symptoms among pregnant and early postpartum Latinas. A sample of 275 pregnant Latinas was randomized to the Healthy MOMs Healthy Lifestyle Intervention (MOMs) or the Healthy Pregnancy Education (control) group. More than one-third of participants were at risk for depression at baseline. MOMs participants were less likely than control group participants to be at risk for depression at follow-up. Between baseline and 6 weeks postpartum, MOMs participants experienced a significant decline in depressive symptoms; control participants experienced a marginally significant decline. For MOMs participants, most of this decline occurred during the pregnancy intervention period, a time when no change occurred for control participants. The change in depressive symptoms during this period was greater among MOMs than control participants (“intervention effect”). From baseline to postpartum, there was a significant intervention effect among non-English-speaking women only. These findings provide evidence that a community-planned, culturally tailored healthy lifestyle intervention led by community health workers can reduce depressive symptoms among pregnant, Spanish-speaking Latinas.