Depression in Pregnancy and the Postpartum Period

妊娠期和产后抑郁症

• 批准号: 7099732
• 负责人: KORAY TANFER
• 金额: $ 15.84万
• 依托单位: BATTELLE CENTERS/PUB HLTH RES & EVALUATN
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-01-01 至 2009-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7099732
• 关键词: Depression; Pregnancy; Postpartum; Period

DESCRIPTION (provided by applicant): Perinatal depression is thought to affect a considerable portion of pregnant and postpartum women, creating a public health event with a large population at risk. Untreated, it can have long-term, negative consequences for the woman, her child, and family. Much past research on the prevalence and incidence of perinatal depression and its risk factors has two important limitations: (a) it is largely based on narrowly defined, homogeneous samples; and (b) it has relied on screening tools to assess perinatal depression without confirming the diagnosis. This makes past results vulnerable to dispute. The proposed research provides a cost-effective approach to overcoming the limitations. We will provide more accurate incidence and prevalence estimates than have previously been available for a diverse group of women, better identify risk factors for perinatal depression, and for the first time examine how characteristics of a woman's place of residence are related to her perinatal depression risks. Specifically, we will: (1) Estimate the prevalence and incidence of major and minor depressive episodes at the beginning of the third trimester of pregnancy, and at two weeks and six months postpartum, including estimates by age, race, education, income, marital status, and parity. (2) Estimate, net of other characteristics, the relationships between psychosocial characteristics, including personal and family history of mood disorders and family stressors, and the likelihood of experiencing major and/or minor depression symptoms at each of the three points in time. (3) Estimate, the net effect of pregnancy intention, delivery method and complications on the likelihood of experiencing depression at the three points in time. (4) Estimate the relationships between community characteristics of women's place of residence (e.g., types and availability of health care resources and providers, social, economic, and demographic composition of the community, and the normative environment governing health care seeking behaviors) and the likelihood of experiencing depression at each of the three points in time. We propose to collect data from a larger and more diverse sample of women than in prior U.S. studies of perinatal depression, and to validate a diagnosis of depression at each point in time with the Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID-I) for the women who score above an established level on the Edinburgh Postnatal Depression Scale. We will use these data to estimate incidence and prevalence to address Specific Aim 1 and to estimate multivariate models to address Specific Aims 2-4.

描述（由申请人提供）：围产期抑郁症被认为会影响大部分孕妇和产后妇女，从而创造了一个人口众多的公共卫生事件。未经治疗，它可能会对女人，她的孩子和家人产生长期的负面影响。关于围产期抑郁症及其危险因素的患病率和发生率的过去许多研究具有两个重要的局限性：（a）它主要基于狭义的均匀样本； （b）它依靠筛查工具来评估围产期抑郁症而不证实诊断。这使得过去的结果容易受到争议。拟议的研究为克服局限性提供了一种具有成本效益的方法。我们将提供比以前对各种妇女提供的更准确的发病率和患病率估计值，更好地识别围产期抑郁症的危险因素，并首次研究妇女居住地的特征与她的围产期抑郁症风险如何相关。具体而言，我们将：（1）估计怀孕三个月开始的主要和次要抑郁发作的患病率和发病率，以及产后两个星期零六个月的情况，包括按年龄，种族，教育，收入，婚姻状况和奇偶校验估计。 （2）估计，其他特征的网络，社会心理特征之间的关系，包括情绪障碍和家庭压力源的个人和家族史，以及在这三个时间点中每一个都有重大和/或轻微抑郁症状的可能性。 （3）估计，怀孕意图，分娩方法和并发症的净影响对三个时间点抑郁的可能性。 （4）估计妇女居住地的社区特征（例如，医疗保健资源的类型和可用性和提供者的类型和可用性，社会，经济和人口统计学的组成，社会，经济和人口统计学的组成，以及管理寻求卫生保健行为的规范环境）与在三个点的每个点体验抑郁症的可能性。我们建议比以前在美国围产期抑郁症的研究中收集更大，更多样化的女性样本的数据，并通过对DSM-IV-TR轴I疾病（SCID-I）的结构化临床访谈来验证抑郁症的诊断，以至于在爱丁堡后抑郁症状上得分高于以上水平的女性。我们将使用这些数据来估计发生率和流行率，以解决特定的目标1并估算多元模型以解决特定目标2-4。