Relapse of major depression during pregnancy in women who maintain or discontinue antidepressant treatment
Relapse of major depression during pregnancy in women who maintain or discontinue antidepressant treatment
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DOI：
10.1001/jama.295.5.499
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发表时间：
2006-02-01
影响因子：
120.7
通讯作者：
Stowe, ZN
中科院分区：
文献类型：
--
作者：
Cohen, LS;Altshuler, LL;Stowe, ZN
历史上，怀孕一直被描述为情绪健康的时期，为防止精神疾病提供“保护”。然而，系统地描述在怀孕期间维持或停止药物治疗的妇女复发的风险是必要的。目的描述怀孕前后停用抗抑郁药物的孕妇与继续使用抗抑郁药物治疗的孕妇的复发风险。设计、环境和患者一项前瞻性自然调查，在怀孕期间每月进行纵向精神病学评估；进行生存分析以确定怀孕期间抑郁症复发的时间。在1999年3月至2003年4月期间，共有201名孕妇从3个在怀孕期间治疗精神疾病方面具有专门知识的中心登记入组。妇女队列的招募来自(1)医院诊所，(2)通过广告和详细介绍研究的社区外展自我推荐，以及(3)社区直接推荐。参与者被认为符合以下条件：1)怀孕前有严重抑郁症史；2)怀孕少于16周；3)在最后一次月经前至少3个月情绪良好；4)目前或最近(
Context Pregnancy has historically been described as a time of emotional well-being, providing "protection" against psychiatric disorder. However, systematic delineation of risk of relapse in women who maintain or discontinue pharmacological treatment during pregnancy is necessary.Objective To describe risk of relapse in pregnant women who discontinued antidepressant medication proximate to conception compared with those who maintained treatment with these medications.Design, Setting, and Patients A prospective naturalistic investigation using longitudinal psychiatric assessments on a monthly basis across pregnancy; a survival analysis was conducted to determine time to relapse of depression during pregnancy. A total of 201 pregnant women were enrolled between March 1999 and April 2003 from 3 centers with specific expertise in the treatment of psychiatric illness during pregnancy. The cohort of women was recruited from (1) within the hospital clinics, (2) self-referral via advertisements and community outreach detailing the study, and (3) direct referrals from the community. Participants were considered eligible if they (1) had a history of major depression prior to pregnancy, (2) were less than 16 weeks' gestation, (3) were euthymic for at least 3 months prior to their last menstrual period, and (4) were currently or recently (