Generalized anxiety disorder: Course and risk factors in pregnancy
Generalized anxiety disorder: Course and risk factors in pregnancy
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DOI：
10.1016/j.jad.2011.01.003
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发表时间：
2011-06-01
影响因子：
6.6
通讯作者：
Yonkers, Kimberly Ann
中科院分区：
文献类型：
--
作者：
Buist, Anne;Gotman, Nathan;Yonkers, Kimberly Ann
背景：孕期广泛性焦虑障碍（GAD）的研究有限。方法：女性（n = 2793）被纳入耶鲁粉红与蓝色研究，这是一个在过去五年内患有重度抑郁症（MDD）或在过去一年内使用抗抑郁药物的队列。在三个时间点对受试者进行综合国际诊断访谈：两次在怀孕期间，一次在分娩后。我们根据DSM IV定义了广泛性焦虑障碍（GAD）发作，但所需的持续时间减少到一个月或更长。对以下妇女进行病程和相关因素的检查：1)妊娠前6个月或妊娠期间无广泛性焦虑症（A组），2)妊娠前6个月无广泛性焦虑症（B组），3)仅妊娠期有广泛性焦虑症（C组），4)妊娠前6个月和妊娠期间均有广泛性焦虑症（D组）。结果：9.5%的队列在怀孕的某个阶段患有广泛性焦虑症。焦虑症状在妊娠的前三个月最为严重，在整个妊娠期间有所减轻。回归分析显示，广泛性焦虑症的发作史、受教育程度、社会支持和儿童虐待史是四组成员之间的区别。局限性：样本可能不具有代表性，因为它增加了处于危险中的妇女，并且社会经济上处于不利地位的妇女的代表性相对较低。结论：妊娠期焦虑患者的识别可能为那些需要精神治疗的患者提供一个机会。(C) 2011 Elsevier B.V.版权所有
Background: There are limited studies of generalized anxiety disorder (GAD) across pregnancy.Methods: Women (n = 2793) were enrolled in the Yale Pink and Blue study, a cohort enriched with subjects who suffered from major depressive disorder (MDD) within the past five years or used antidepressants in the past year. Subjects were evaluated with the Composite International Diagnostic Interview at three time points: twice in pregnancy and once after delivery. We defined a generalized anxiety disorder (GAD) episode as per DSM IV but with required duration reduced to one month or longer. Course and correlates of GAD were examined in women who had: 1) no GAD during the 6 months prior or in pregnancy (Group A), 2) GAD in the 6 months prior to but not in pregnancy (Group B), 3) GAD in pregnancy only (Group C) and 4) GAD both in the 6 months prior to and during pregnancy (Group D).Results: 9.5% of the cohort suffered from GAD at some point in pregnancy. Anxiety symptoms were highest in the first trimester and decreased across pregnancy. Regression analysis revealed that previous GAD episodes, education, social support and a history of child abuse distinguished between membership in the four groups.Limitations: The sample may not be representational, as it was enhanced with those at risk, and had relatively low representation of socio-economically disadvantaged women.Conclusions: Identification of anxious patients during pregnancy may provide an opportunity to engage those in need of psychiatric treatment. (C) 2011 Elsevier B.V. All rights reserved.