Predictors of spontaneous remission and recovery among women with untreated perinatal depression in India and Pakistan.
Predictors of spontaneous remission and recovery among women with untreated perinatal depression in India and Pakistan.
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DOI：
10.1017/gmh.2023.26
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Weiss, Helen
中科院分区：
文献类型：
--
作者：
Fuhr, Daniela;Sikander, Siham;Vanobberghen, Fiona;Weobong, Benedict A.;Rahman, Atif;Weiss, Helen
患有围产期抑郁症的母亲可以表现出不同的症状轨迹，并可能自发地从抑郁症中缓解，然而，后者知之甚少。这是第一项研究，试图调查自然缓解和长期恢复未经治疗的妇女围产期抑郁症的预测因素。我们分析了来自印度和巴基斯坦的两项随机对照试验的数据。分析仅限于对照组中未接受积极治疗的女性。广义估计方程和逻辑回归用于估计比值比（OR）和95%置信区间（CI），调整人内相关性。在多变量分析中，缓解与丈夫不工作有关（校正OR，aOR = 2.04，95% CI 1.02-4.11），基线时患者健康问卷-9评分较低（评分≥20 vs. 10-14的aOR = 0.43，95% CI 0.20-0.90）和基线时更好的社会支持（高vs.低社会支持的aOR = 2.37，95% CI 1.32-4.27）。低基线严重程度的妇女可能会从围产期抑郁症缓解与家人和朋友的充分社会支持。这些因素是围产期抑郁症的管理和预防临床恶化的重要因素，在设计低阈值心理干预时应予以考虑。
Mothers with perinatal depression can show different symptom trajectories and may spontaneously remit from depression, however, the latter is poorly understood. This is the first study which sought to investigate predictors of spontaneous remission and longer-term recovery among untreated women with perinatal depression. We analysed data from two randomised controlled trials in women with perinatal depression in India and Pakistan. Analyses were restricted to women in the control groups who did not receive active treatment. Generalised estimating equations and logistic regressions were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for within-person correlation. In multivariable analyses, remission was associated with a husband who is not working (adjusted OR, aOR = 2.04, 95% CI 1.02–4.11), lower Patient Health Questionnaire-9 score at baseline (aOR = 0.43, 95% CI 0.20–0.90 for score of ≥20 vs. 10–14) and better social support at baseline (aOR = 2.37, 95% CI 1.32–4.27 for high vs. low social support). Women with low baseline severity may remit from perinatal depression with adequate social support from family and friends. These factors are important contributors to the management of perinatal depression and the prevention of clinical worsening, and should be considered when designing low-threshold psychological interventions.
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