The Epidemiology of Postpartum Depression and Associated Childhood Outcomes.

描述(由申请人提供)：该项目的目的是直接回应NIMH的使命，即解决产后抑郁的流行病学问题，确定相关的风险因素，并描述与临床上显著的产后情绪变化相关的儿童发育和心理健康结果。产后抑郁症是分娩最常见的并发症(Wisner KL，Chambers C，Site D.)产后抑郁症：一个主要的公共卫生问题。JAMA 2006~296：2616-2618)，在大约11%-19%的所有新妈妈中很明显(证据报告/技术评估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样本，这些样本无法生成标准化数据，也无法利用不同的诊断标准，这些标准更多地侧重于抑郁症状，而不是抑郁症的临床诊断。这项研究建立在瑞典现有的心理健康研究的独特资源的基础上。将一系列瑞典登记簿联系起来，包括国家健康和卫生服务利用病人登记簿、国家学校登记簿、 通过《国家药房登记》、《总人口登记》和《住房普查》，我们将：(A)通过更准确地描述临床上显著的产后抑郁症(住院和非住院)的程度和模式以及相关的危险因素，扩展现有的产后抑郁症流行病学知识基础；以及(B)全面描述产妇产后抑郁症的儿童发育结局。我们将利用先进的统计方法来确定产后抑郁的发育后果，评估哪些产后抑郁母亲的孩子更有可能或更少地出现问题，无论是通过母亲的特征来解释，如抑郁的时间、严重程度、亚类型(有或没有精神病)或共病情况、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支具有长期合作历史的国际专家团队，这非常适合实现研究目标。出于预测的目的，评估一组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。由于婴儿出生后紧随其后的时期是关键时期，产后抑郁对婴儿的健康构成严重威胁，因此，临床上严重的产后抑郁及其对儿童发展结果的相关影响的流行病学特征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.