產(chǎn)后抑郁癥通常始于產(chǎn)前

Maternal Depression Often Starts Before Giving Birth, Study Says

產(chǎn)后抑郁癥通常始于產(chǎn)前

A large new study has documented unexpected links in the timing and severity of symptoms of maternal depression, which could help mothers and doctors better anticipate and treat the condition.

一項新的大型研究記錄了孕產(chǎn)婦抑郁癥的發(fā)作時間與癥狀嚴重性之間出人意料的聯(lián)系，這能幫助產(chǎn)婦和醫(yī)生更好地預(yù)測和治療這種疾病。

The study of more than 8,200 women from 19 centers in seven countries, published last month in Lancet Psychiatry, found that in those with the severest symptoms — suicidal thoughts, panic, frequent crying — depression most often began during pregnancy, not after giving birth, as is often assumed.

該研究上月發(fā)表在《柳葉刀精神病學(xué)》雜志(Lancet Psychiatry)上，它調(diào)查了七個國家19個中心的8200多名婦女。研究發(fā)現(xiàn)，癥狀最嚴重的抑郁癥——自殺念頭、恐慌、經(jīng)常大哭——最常在懷孕期間開始，而非人們通常認為的分娩之后。

Moderately depressed women often developed their symptoms postpartum, and were more likely than severely depressed women to have experienced complications during pregnancy like pre-eclampsia, gestational diabetes or hypertension.

中度抑郁的孕產(chǎn)婦通常在產(chǎn)后出現(xiàn)癥狀，而且與重度抑郁的孕產(chǎn)婦相比，她們更多地在懷孕期間經(jīng)歷過先兆子癇、孕期糖尿病或高血壓等并發(fā)癥。

Severely depressed women, however, more often reported complications during delivery.

不過，患有重度抑郁癥的產(chǎn)婦更常在分娩時出現(xiàn)并發(fā)癥。

“This is the largest study to date on postpartum depressive symptoms,” said Leah Rubin, an assistant professor in the Women’s Mental Health Research Program at University of Illinois at Chicago, a co-author of a commentary about the study. “This is definitely a first step in the right direction, knowing that depression isn’t one-size-fits-all.”

“這是迄今為止關(guān)于產(chǎn)后抑郁癥狀的最大型研究，”伊利諾伊大學(xué)芝加哥分校女子精神健康研究項目的助理教授利亞·魯賓(Leah Rubin)說，他曾與人合寫了一篇關(guān)于這項報告的評論文章，“知道抑郁癥有多種情況，這無疑是通往正確研究方向的第一步。”

Ten to 20 percent of mothers experience depression, anxiety, bipolar disorder or other symptoms at some point from pregnancy to a year after giving birth. The study could aid efforts to find causes and treatments.

10%至20%的孕產(chǎn)婦在懷孕至產(chǎn)后一年的某個時候出現(xiàn)過抑郁、焦慮、躁郁或其他癥狀。這項研究可以幫助找到原因和治療方法。

The study participants were all mothers. Some had been found to have postpartum depression by clinicians, while others were assessed via a widely used questionnaire. (Some participants fell into both groups.)

這項研究的參與者都是孕產(chǎn)婦。其中一些人的產(chǎn)后抑郁癥是臨床醫(yī)生發(fā)現(xiàn)的，還有一些是通過被普遍采用的問卷調(diào)查評估出來的(有些參與者上述兩種情況兼有)。

Each group could be separated into three subgroups representing women with severe, moderate, and either mild or clinically insignificant depression, said Dr. Samantha Meltzer-Brody, the director of University of North Carolina’s perinatal psychiatry program and the study’s corresponding author.

這項研究的通訊作者、北卡羅來納大學(xué)圍產(chǎn)期精神病研究項目的負責(zé)人薩曼莎·梅爾策-布羅迪博士(Samantha Meltzer-Brody)說，每組可以分成三個小組，分別代表患有重度、中度以及輕度或無臨床癥狀的抑郁癥的孕產(chǎn)婦。

Dr. Meltzer-Brody said the finding that two-thirds of severe depression began during pregnancy raised scientific questions. The biological factors at work could differ from those affecting women with classic postpartum depression, which scientists think may be linked to plummeting hormone levels after delivery.

梅爾策-布羅迪博士說，三分之二的重度抑郁是在懷孕期間開始的，這個發(fā)現(xiàn)引出了一些科學(xué)問題。導(dǎo)致懷孕期間出現(xiàn)抑郁癥的生物因素可能與導(dǎo)致典型產(chǎn)后抑郁癥的生物因素不同，科學(xué)家們認為后者的影響因素可能是分娩后激素水平驟降。

She also wondered whether the finding that 60 percent of moderately depressed women reported issues like diabetes suggested that immune system problems might underlie their symptoms.

她還說，患有中度抑郁癥的產(chǎn)婦60%出現(xiàn)過糖尿病等問題。她想弄清，這一發(fā)現(xiàn)是否說明免疫系統(tǒng)問題是抑郁癥的誘因。

Dr. Meltzer-Brody and her colleagues will begin seeking answers this year by collecting DNA from thousands of women through an international online registry.

梅爾策-布羅迪博士和她的同事們今年將開始尋找這個問題的答案，他們計劃通過國際在線登記收集上萬名婦女的DNA。