Perinatal Symptoms and Treatment Engagement in Female Veterans.
Perinatal Symptoms and Treatment Engagement in Female Veterans.
复制标题
女性退伍军人的围产期症状和治疗参与度。
DOI：
10.1093/milmed/usab278
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发表时间：
2023
影响因子：
1.2
通讯作者：
Shivakumar,Geetha
中科院分区：
文献类型：
--
作者：
Anderson,ElizabethH;Morrow,Carolyn;Mattocks,KristinM;Shivakumar,Geetha
使用退伍军人医疗保健管理局产妇福利的女性退伍军人有很高的精神健康障碍患病率，包括抑郁症，创伤后应激障碍和焦虑。此外，有精神病史的妇女在怀孕和产后经常会出现症状复发或恶化。适当的围产期心理健康护理的参与是至关重要的，以优化结果为母亲和child.Materials和MethodsThis研究评估精神症状的严重程度和预测因子的女性退伍军人的心理健康治疗参与在怀孕期间和产后在弗吉尼亚州北德克萨斯州的医疗保健系统。70名妇女使用退伍军人健康管理局进行了纵向评估，通过图表审查和访谈（包括爱丁堡产后抑郁量表）在怀孕期间和产后。Friedman检验用于评价（1）妊娠前6个月、（2）妊娠和（3）产后期间症状严重程度的变化。多变量逻辑回归被用来确定参加门诊心理健康预约的预测因素。潜在的预测因素包括社会人口因素，抑郁症的症状，军事性侵犯的历史，孕前精神病诊断的存在，并出席心理健康预约pregnancy.ResultsApproximately 40%的参与者在怀孕前表现出至少轻微的精神症状，症状的严重程度在围产期没有显着变化（孕前、孕期和产后）X2（2，n= 70）= 3.56，P = 0.17。妊娠中期或妊娠晚期的抑郁症状是妊娠期（OR = 1.18，95%CI，1.04至1.34）和产后（OR = 1.18，95%CI，1.02至1.36）心理健康预约的重要预测因素。积极的精神病诊断在怀孕前6个月也是一个显着的预测出席分娩后（OR = 14.63，95%CI，1.55至138.51）。ConclusionOur研究结果表明，妇女与以前的历史，心理健康状况将继续有症状，这是一个很好的预测心理健康治疗的参与在围产期。
IntroductionWomen veterans using Veterans Health Care Administration maternity benefits have a high prevalence of mental health disorders, including depression, PTSD, and anxiety. Additionally, women with psychiatric histories often experience a relapse or worsening of symptoms during pregnancy and postpartum. Adequate perinatal mental healthcare engagement is critical to optimizing outcomes for mother and child.Materials and MethodsThis study evaluated psychiatric symptom severity and predictors of women veteran’s mental health treatment engagement during pregnancy and postpartum at the VA North Texas Health Care System. Seventy women using Veterans Health Administration were assessed longitudinally via chart review and interviews (including the Edinburgh Postnatal Depression Scale) during pregnancy and postpartum. A Friedman test was used to evaluate the change in symptom severity during (1) the 6 months before pregnancy, (2) pregnancy, and (3) postpartum. Multivariate logistic regressions were used to determine predictors of attending outpatient mental health appointments. Potential predictors examined included sociodemographic factors, symptoms of depression, history of military sexual assault, presence of a pre-pregnancy psychiatric diagnosis, and attendance of mental health appointments before pregnancy.ResultsApproximately 40% of participants demonstrated at least mild psychiatric symptoms before pregnancy, and symptom severity did not significantly change across the perinatal period (pre-pregnancy, pregnancy, and postpartum)X2(2,n= 70) = 3.56,P= .17. Depressive symptoms during the 2nd or 3rd trimester were a significant predictor for attendance of mental health appointments during both pregnancy (OR = 1.18, 95% CI, 1.04 to 1.34) and postpartum (OR = 1.18, 95% CI, 1.02 to 1.36). An active psychiatric diagnosis during the 6 months before pregnancy was also a significant predictor of attendance following delivery (OR = 14.63, 95% CI, 1.55 to 138.51).ConclusionOur results demonstrate that women with prior histories of mental health conditions will continue to be symptomatic, and this is a good predictor of mental health treatment engagement during the perinatal period.