The Epidemiology of Postpartum Depression and Associated Childhood Outcomes.

描述（由申请人提供）：该项目的目的是对NIMH的使命的直接回答，以解决产后抑郁症的流行病学，确定相关的风险因素，并表征与临床显著产后情绪变化相关的儿童发育和心理健康结果。产后抑郁症是最常见的分娩并发症（维斯纳KL，Chambers C，Sit D。产后抑郁症：一个主要的公共卫生问题。JAMA 2006~296：2616-2618），在所有新妈妈中约有11%-19%明显（Evidence Report / Technology Assessment 119. AHRQ出版物05-E006-2）。到目前为止，大多数关于产后抑郁症的研究都依赖于来自诊所或医院的小型便利样本，这些样本无法产生规范性数据，并利用不同的诊断标准，这些标准通常更侧重于抑郁症的诊断，而不是抑郁症的临床诊断。 这项研究建立在瑞典心理健康研究的独特资源基础上。将一系列瑞典登记册联系起来，包括全国病人保健和保健服务利用登记册、全国学校登记册， 通过全国药房登记处、总人口登记处和住房普查，我们将：（a）通过更准确地描述具有临床意义的产后抑郁症（住院和非住院）的程度和模式以及相关风险因素，扩大产后抑郁症流行病学的现有知识基础;（B）全面描述产妇产后抑郁症对儿童发育的影响。 我们将利用先进的统计方法来确定产后抑郁症的发展后果，评估产后抑郁症母亲的孩子或多或少可能出现问题，无论是由母亲的特征解释，如抑郁症的时间，严重程度，亚型（有和没有精神病）或共病条件，儿童特征，如性别，或背景因素，如贫困。 这项研究的目标是雄心勃勃的，但我们已经建立了一个具有长期合作历史的国际专家团队，非常适合解决这项研究的目标。为了预测的目的，评估一套全面的产后抑郁症的潜在决定因素将产生新的见解，以帮助预测，识别，并最终帮助预防和治疗这种疾病。因为孩子出生后的这段时间是一个关键的时间，产后抑郁症对婴儿的健康构成严重威胁，临床上显著的产后抑郁症的流行病学特征及其对儿童发育结果的相关影响是制定适当治疗计划的第一个必要步骤。

DESCRIPTION (provided by applicant): The Aims of this project are a direct answer to the mission of the NIMH to address the epidemiology of postpartum depression, to identify associated risk factors and characterize child developmental and mental health outcomes associated with clinically significant postpartum mood change. Postpartum depression is the most common complication of childbearing (Wisner KL, Chambers C, Sit D. Postpartum depression: A major public health problem. JAMA 2006~296:2616-2618), evident in approximately 11%-19% of all new mothers (Evidence Report / Technology Assessment 119. AHRQ Publication 05-E006-2). To date, most research on postpartum depression has relied on small convenience samples from clinics or hospitals that cannot generate normative data and utilize varying diagnostic criteria that more often focus on depressive symptomatology rather than clinical diagnoses of depression. This study builds on the unique resources for research on mental health available in Sweden. Linking a constellation of Swedish registers, including the National Patient Registers of health and health service utilization, National School Register, National Pharmacy Register, Total Population Register and Housing Census, we will: (a) expand upon the current knowledge base of the epidemiology of postpartum depression by more accurately describing the magnitude and pattern of clinically significant postpartum depression (hospitalized and non-hospitalized) and associated risk factors and~ (b) comprehensively characterize the child development outcomes of maternal postpartum depression. We will utilize advanced statistical methods to identify the developmental consequences of postpartum depression assessing which children of postpartum depressed mothers are more or less likely to develop problems, whether explained by maternal characteristics, such as depression timing, severity, subtypes (with and without psychosis) or comorbid conditions, child characteristics such as gender, or contextual factors such as poverty. The aims of the study are ambitious, but we have established a team of international experts with a long history of collaboration, which is well suited to address the study Aims. For predictive purposes, evaluating a comprehensive set of potential determinants of postpartum depression will generate new insights to help predict, identify, and ultimately help to prevent and treat this disorder. Because the period immediately following the birth of a child is a critica time and postpartum depression constitutes a serious threat to the infant's well-being, the epidemiologic characterization of clinically significant postpartum depression and its associated impact on childhood developmental outcomes is the first necessary step in developing adequate treatment plans.