Social support and social conflict as predictors of prenatal depression.
Social support and social conflict as predictors of prenatal depression.
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社会支持和社会冲突是产前抑郁症的预测因素。
DOI：
10.1097/01.aog.0000265352.61822.1b
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发表时间：
2007
影响因子：
7.2
通讯作者：
Ickovics,JeannetteR
中科院分区：
文献类型：
--
作者：
Westdahl,Claire;Milan,Stephanie;Magriples,Urania;Kershaw,TraceS;Rising,SharonSchindler;Ickovics,JeannetteR
目的：估计社会支持和社会冲突如何与产前抑郁症状，并产生一个简短的临床工具，以确定妇女在增加的社会心理风险。方法：这是一项前瞻性研究，1,047名孕妇接受护理的两所大学附属诊所从怀孕早期到产后1年。结构化访谈在怀孕中期进行。分层和Logistic回归被用来检查潜在的直接和交互作用的社会支持和冲突的产前抑郁症状的流行病学研究中心抑郁Scale.RESULTS：百分之三十三的样本报告升高的抑郁症状预测的社会人口因素，社会支持和社会冲突的水平。社会支持和冲突对抑郁症状有独立的影响，尽管社会冲突是一个更强的预测因子。有一个“剂量反应”，人际风险因素的每一次增加都会导致基于症状报告的可能抑郁症的风险（流行病学中心量表大于或等于16）。一个社会支持和三个冲突项目的复合材料被确定为临床医生使用，以确定人际关系的危险因素，抑郁症在怀孕期间。百分之七十六的妇女与三个或三个以上的高风险反应的综合评分报告抑郁symptoms.CONCLUSION：增加评估的社会支持和社会冲突的临床医生在怀孕期间可以确定妇女谁可以受益于团体或个人的干预措施，以提高支持和减少负面的社会interactions.Level的证据：II社会支持和冲突有独立的影响，对抑郁症状的孕妇，一个简短的评估，由临床医生在怀孕期间可以确定妇女的风险。
OBJECTIVE:To estimate how social support and social conflict relate to prenatal depressive symptoms and to generate a brief clinical tool to identify women at increased psychosocial risk.METHODS:This is a prospective study following 1,047 pregnant women receiving care at two university-affiliated clinics from early pregnancy through 1 year postpartum. Structured interviews were conducted in the second trimester of pregnancy. Hierarchical and logistic regressions were used to examine potential direct and interactive effects of social support and conflict on prenatal depressive symptoms measured by the Center for Epidemiologic Studies-Depression Scale.RESULTS:Thirty-three percent of the sample reported elevated levels of depressive symptoms predicted from sociodemographic factors, social support, and social conflict. Social support and conflict had independent effects on depressive symptoms although social conflict was a stronger predictor. There was a “dose–response,” with each increase in interpersonal risk factor resulting in consequent risk for probable depression based on symptom reports (Center for Epidemiologic Studies-Scale greater than or equal to 16). A composite of one social support and three conflict items were identified to be used by clinicians to identify interpersonal risk factors for depression in pregnancy. Seventy-six percent of women with a composite score of three or more high-risk responses reported depressive symptoms.CONCLUSION:Increased assessment of social support and social conflict by clinicians during pregnancy can identify women who could benefit from group or individual interventions to enhance supportive and reduce negative social interactions.LEVEL OF EVIDENCE:IISocial support and conflict have independent effects on depressive symptoms for pregnant women; a brief assessment by clinicians during pregnancy can identify women at risk.