The natural history and NHS service use of women with depression and impact on children in a multi-ethnic inner-city population

多民族内城人口中患有抑郁症的女性的自然史和 NHS 服务使用及其对儿童的影响

基本信息

批准号：
MR/J013501/1
负责人：
Kate Pickett
金额：
$ 22.54万
依托单位：
University of York
依托单位国家：
英国
项目类别：
Research Grant
财政年份：
2012
资助国家：
英国
起止时间：
2012 至无数据
项目状态：
已结题

来源：
https://gtr.ukri.org/projects?ref=MR%2FJ013501%2F1
关键词：
natural history NHS service use

项目摘要

Between 5 to 13 percent of women have symptoms of depression during or after a pregnancy. Some of these women go to their GP with symptoms, are correctly identified as depressed and undergo treatment. However, for various reasons some women who feel depressed do not go to their GP. Some will go to their GP but will fail to be recognised as depressed and so will not be offered treatment. Older research indicates that about half of all women at risk of depression remain undiagnosed (either do not go to the GP or fail to be diagnosed by their GP). This estimate may be out of date. Untreated, in addition to the poor quality of life experienced by the woman, it is well documented that maternal depression can affect some children and families; leading to relationship breakdown, poor child behaviour and emotional well-being and reduced cognitive development. For some children, this translates in later life to difficulties in school, problems with relationships, increased levels of aggression and poor mental health themselves. These potentially preventable disabilities come at great personal cost, as well as high financial costs to the NHS and social care agencies, the criminal justice system, and wider society. Our research involves examining electronic GP records for a large number of mothers (~13,000) who have already elected to participate in a research study. The women live in an ethnically diverse economically deprived city in the UK; factors that make them more at risk for depression than the general UK population. They have consented for us to look at their NHS records. Using record linkage in this way allows us to look at routine NHS data in addition to extensive social, economic data and measures of mental health that have been collected through the research study. This is called an enhanced dataset and will allow us to explore a number of issues that are important to the health of mothers and their families. Using this enhanced dataset we can calculate the number of women who have been identified by the research study as being depressed during their pregnancy but have no GP record of depressive symptoms. We can then provide an updated estimate of the percentage of women whom we already know to be depressed, but who are unidentified to the NHS as depressed. We will then look at the economic and social profiles of three groups of women; those who are unidentified as depressed, those identified as depressed and those who are not depressed. This will enable us to understand in what circumstances unidentified women live and may provide clues about how the NHS can provide services to reach them. One in ten of these women (~1,300) have been followed up with questionnaires about their lifestyle, circumstances and mental health every six months or so since the birth of their child. These children are now around 3-4 years old and their mothers have recently assessed their child's behaviour using a standardised questionnaire. We can combine this assessment of child behaviour with our classification of the mother's mental health (not depressed, treated for depression, not identified as depressed) to estimate any impact on children. This information might help future researchers more accurately predict how much untreated depression costs the NHS. We can also use the enhanced dataset to understand whether the circumstances of some of the women, for example their ethnicity, their marital or economic situation, and their parenting skills protect their children from having behavioural problems. This will help us understand mental health inequality and identify groups of children most at risk of developing behavioural problems so services such as parenting programmes can be targeted.

在怀孕期间或怀孕后，有5％至13％的女性患有抑郁症状。这些妇女中有一些因症状而去做全科医生，被正确识别为抑郁症和接受治疗。但是，由于各种原因，有些感到沮丧的女性不会去参加全科医生。有些人会去他们的全科医生，但不会被认为是沮丧的，因此不会接受治疗。较旧的研究表明，所有有抑郁症风险的女性中约有一半仍未被诊断出来（要么不去GP，要么没有被GP诊断）。此估计可能已过时。未经治疗，除了妇女所经历的生活质量差外，孕产妇抑郁症会影响一些儿童和家庭。导致关系崩溃，儿童行为不良，情绪健康以及认知发展的降低。对于某些儿童而言，这将在以后的生活中转化为学校的困难，人际关系问题，侵略水平的提高和心理健康本身不良。这些潜在的可预防的残疾人以巨大的个人成本以及对NHS和社会护理机构，刑事司法系统和更广泛的社会的高额经济成本。我们的研究涉及检查已经选择参加研究研究的大量母亲（约13,000个）的电子GP记录。这些妇女居住在英国的一个种族多元化的经济贫困城市中；比英国普通人口更容易使他们面临抑郁症的风险。他们同意我们查看他们的NHS记录。通过这种方式使用记录联系，除了通过研究研究收集的广泛的社会，经济数据和精神健康措施外，我们还可以查看常规的NHS数据。这称为增强的数据集，将使我们能够探索许多对母亲及其家人健康至关重要的问题。使用此增强的数据集，我们可以计算出研究期间被研究识别为抑郁症但没有GP记录的抑郁症状记录的女性人数。然后，我们可以提供对我们已经知道要沮丧但对NHS沮丧的妇女百分比的更新估计。然后，我们将研究三组妇女的经济和社会概况。那些被认为是沮丧的人，那些被确定为沮丧的人和那些不沮丧的人。这将使我们能够了解在什么情况下，身份不明的妇女生活，并可能提供有关NHS如何提供服务来达到她们的线索。自孩子出生以来，每六个月左右，就有十分之一的妇女（约1,300名）对她们的生活方式，情况和心理健康的问卷进行了调查。这些孩子现在大约3-4岁，他们的母亲最近使用标准化问卷评估了孩子的行为。我们可以将这种对儿童行为的评估与对母亲心理健康的分类（不抑郁，因抑郁症而不被确定为沮丧），以估计对儿童的任何影响。这些信息可能可以帮助未来的研究人员更准确地预测未经治疗的抑郁症的成本。我们还可以使用增强的数据集来了解某些妇女的情况，例如她们的种族，婚姻或经济状况以及她们的育儿技能保护其子女免于行为问题。这将有助于我们了解心理健康不平等，并确定最面临行为问题风险的儿童群体，因此可以针对育儿计划等服务。

项目成果

期刊论文数量（10）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Using latent class analysis to develop a model of the relationship between socioeconomic position and ethnicity: cross-sectional analyses from a multi-ethnic birth cohort study.

DOI：
10.1186/1471-2458-14-835
发表时间：
2014-08-12
期刊：
BMC public health
影响因子：
4.5
作者：
Fairley L;Cabieses B;Small N;Petherick ES;Lawlor DA;Pickett KE;Wright J
通讯作者：
Wright J

Additional file 1: Table S1. of Variation and ethnic inequalities in treatment of common mental disorders before, during and after pregnancy: combined analysis of routine and research data in the Born in Bradford cohort

附加文件 1：表 S1。

DOI：
10.6084/m9.figshare.c.3627659_d1
发表时间：
2016
期刊：
影响因子：
0
作者：
Prady S
通讯作者：
Prady S

The psychometric properties of the subscales of the GHQ-28 in a multi-ethnic maternal sample: results from the Born in Bradford cohort.

DOI：
10.1186/1471-244x-13-55
发表时间：
2013-02-15
期刊：
BMC psychiatry
影响因子：
4.4
作者：
Prady SL;Miles JN;Pickett KE;Fairley L;Bloor K;Gilbody S;Kiernan K;Mann R;Wright J
通讯作者：
Wright J

Factor structure of parent-reported Strengths and Difficulties Questionnaire in a pre-school age community sample from Born in Bradford

来自出生于布拉德福德的学前年龄社区样本中家长报告的优势和困难问卷的因素结构