2/2 Predictors and Course of Postpartum Obsessions and Compulsions

2/2 产后强迫症的预测因素和过程

• 批准号: 9817012
• 负责人: GERALD NESTADT
• 金额: $ 38.58万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-15 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9817012
• 关键词: Adverse effects; Allopregnanolone; Anxiety; Attitude; Belief; Biological; Biological Factors; Biological Markers; Biological Phenomena; Budgets; CSF3 gene; Characteristics; Child; Child Rearing; Childbirth; Childhood; Clinical; Clinical Research; Clinical Trials; Data Analyses; Data Analytics; Development; Discipline of obstetrics; Empirical Research; Ensure; Estradiol; Frequencies; Fright; Future; Granulocyte-Macrophage Colony-Stimulating Factor; IL8 gene; Individual; Infant; Infant Health; Inflammatory; Infrastructure; Interleukin-15; Interleukin-6; Life; Life Stress; Link; Locales; Long-Term Effects; Maternal Health; Mediator of activation protein; Mental Depression; Mental Health; Mental disorders; Mothers; Nature; Negative Valence; Newborn Infant; North Carolina; Obsession; Outcome; Patient Self-Report; Perinatal; Personal Satisfaction; Phenotype; Physiology; Postpartum Period; Pregnancy; Prevention; Prevention program; Progesterone; Prospective Studies; Psychological Factors; Public Health; Research; Research Domain Criteria; Research Personnel; Risk; Risk Factors; Ritual compulsion; Role; Rural; Sampling; Severities; Site; Symptoms; TNF gene; Time; Training; United States National Institutes of Health; Universities; Woman; Work; adverse outcome; antenatal; anxious; chemokine; compulsion; cytokine; data management; depressive symptoms; evidence base; experience; improved; interest; maternal stress; middle childhood; multidisciplinary; perinatal period; peripartum depression; postnatal; prenatal; prospective; psychologic; psychosocial; recruit; response; screening program; treatment program; unborn child

Project Summary/Abstract Obsessional anxiety and compulsive rituals arising during pregnancy and the postpartum have a significant detrimental short-term impact on the well-being of the mother, the pregnancy, the unborn child, and the newborn infant. They also can have negative long-term effects on maternal and infant health, as well as on the mother-infant relationship and on into childhood. Although research has focused on perinatal depressive and anxious states, there is now strong evidence that obsessions and compulsions (OCS) are precipitated or exacerbated by pregnancy and childbirth and may have a deleterious impact on mother and infant. Despite an increased risk of developing OCS during pregnancy and postnatally (i.e., the perinatal period), there is almost no empirical research on its predictors and precursors, how it is related to other postpartum negative valence states such as anxiety and depression, or the specific impact of postpartum OCS on the mother. Accordingly, we will prospectively examine the predictive utility of psychological and biological phenomena (e.g., self-report, physiology) empirically linked to perinatal/postpartum OCS (pOCS), anxiety, and depression, and how these states relate with one another. We also aim to evaluate the extent to which pOCS manifest adverse effects on functionally-related outcomes of significant public health concern, such as obstetric outcomes, maternal health, maternal attitudes, and parenting behaviors during the first year of life. Consistent with the Research Domain Criteria (RDoC) framework, women will be screened antenatally for diatheses empirically demonstrated to predispose to the development or exacerbation of pOCS; and that are thus hypothesized to also put one at risk for pOCS. High- and low-risk groups will be followed during pregnancy and for 6 months postpartum, and repeatedly assessed to identify those experiencing more frequent, intense, and prolonged pOCS and the variables associated with such problems. The two recruitment sites for this study are the University of North Carolina (UNC) at Chapel Hill and Johns Hopkins University (JHU). JHU will provide data management and analytic support. Considering estimates of the high rates of pOCS, together with the limited available information on this subject, the results of this study will help clinicians and researchers 1) use psychological and biological markers elucidated in the current study to identify women at increased risk of developing OCD and its adverse consequences, and 2) reduce the risk of developing OC symptoms in pregnancy, and its adverse consequences, by modifying these psychological and biological factors prior to pregnancy, and in the early prenatal period. Moreover, the risk factors elucidated in this study may be applicable to development of non-pregnancy- related OC symptoms.

项目总结/摘要 怀孕期间和产后出现的强迫性焦虑和强迫性仪式， 对母亲的福祉、怀孕、 未出生的孩子和新生儿。它们还可能对孕产妇的健康产生长期的负面影响。 和婴儿健康，以及母婴关系和儿童期。虽然 研究集中在围产期抑郁和焦虑状态，现在有强有力的证据 强迫症和强迫症（OCS）是由怀孕引起或加剧的， 分娩，并可能对母亲和婴儿产生有害影响。尽管风险增加， 在怀孕期间和出生后发展OCS（即，（围产期），几乎没有 实证研究其预测因子和前兆，它与其他产后负性的关系如何 情绪状态，如焦虑和抑郁，或产后OCS对 母亲因此，我们将前瞻性地研究心理和 生物现象（例如，自我报告，生理学）经验上与围产期/产后 OCS（pOCS），焦虑和抑郁，以及这些状态如何相互关联。我们也 目的是评估pOCS对功能相关的 重大公共卫生问题的结果，如产科结果、孕产妇健康、 母亲的态度和养育行为在生命的第一年。符合 研究领域标准（RDoC）框架，将对妇女进行产前素质筛查 经验证明易导致pOCS的发展或加重;并且 因此假设也会使人处于pOCS的风险中。高风险和低风险人群将被跟踪 在怀孕期间和产后6个月，并反复评估，以确定那些 经历更频繁、更强烈和更长时间的pOCS以及与这些相关的变量 问题这项研究的两个招募地点是北卡罗来纳州大学（University of North Carolina，简称北卡罗来纳大学）， 查佩尔山和约翰霍普金斯大学（JHU）。JHU将提供数据管理和分析 支持.考虑到对pOCS高发生率的估计，以及有限的可用数据， 关于这个问题的信息，这项研究的结果将有助于临床医生和研究人员1）使用 在目前的研究中阐明的心理和生物标志物，以确定妇女在 增加发展强迫症及其不良后果的风险，2）降低 在怀孕期间出现OC症状，及其不良后果，通过修改这些 怀孕前和产前早期的心理和生物因素。此外，委员会认为， 本研究中阐明的风险因素可能适用于非妊娠的发展， 相关症状