SSRI Rx: Effects on Self Efficacy and Maternal Role

描述（由申请人提供）：13%的妇女在产后的头12个月内经历抑郁，这对母亲角色功能的关键方面产生不利影响，即母婴互动、婴儿照顾、母亲角色的满足感以及对婴儿的预防性保健服务（免疫接种和儿童健康访问）。抗抑郁药，如选择性血清素再摄取抑制剂（SSRIs）可改善抑郁症状和社会功能，但其对母亲角色功能的影响尚未确定。这项自然的纵向补充研究的目的是调查SSRI治疗对产后第一年女性母亲角色功能的影响。此外，我们将确定接受SSRI类药物治疗的抑郁女性的自我效能是否更高，我们将测试自我效能、抑郁、SSRI使用和社会支持的模型是否能预测母亲的角色功能。样本（N=270）将由3组产后妇女（抑郁，接受SSRIs治疗；抑郁，未接受治疗；未抑郁，未接受治疗）组成，对她们进行4次评估。该研究是NIMH资助的调查“孕期抗抑郁药物使用”（5 R01 MH60335-02, Katherine L. Wisner， M.D. PI）的补充，该调查研究了孕期和产后抑郁症和药物干预对母亲和婴儿的影响。在这项研究中，收集了关于怀孕和养育妇女的心理社会环境的许多方面的数据，以便隔离产前药物暴露对婴儿的发育和其他影响。利用大部分相同的数据，该补充报告通过提出一个国家卫生优先考虑的额外问题，加强和扩展了目前由NIMH资助的研究：用抗抑郁药治疗产后抑郁症是否能提高女性履行母性角色关键方面的能力？研究结果将使妇女及其保健提供者了解抑郁症产后妇女使用ssri类药物的结果，协助制定产后抑郁症治疗决策。

DESCRIPTION (provided by applicant): Thirteen percent of women experience depression during the first 12 months postpartum, which adversely impacts key aspects of maternal role functioning, i.e. maternal-infant interaction, infant caretaking, gratification in the maternal role, and use of preventive health services for the infant (immunizations and well-child visits). Antidepressants, such as Selective Serotonin Reuptake Inhibitors (SSRIs) improve depression symptoms and social functioning, but their impact upon maternal role functioning has not been determined. The purpose of this naturalistic, longitudinal supplement is to investigate the impact of SSRI treatment on maternal role functioning in women during the first postpartum year. In addition, we will determine if self-efficacy is higher in depressed women who are treated with SSRIs, and we will test if a model of self-efficacy, depression, SSRI use, and social support predicts maternal role functioning. The sample (N=270) will consist of 3 groups of postpartum women (depressed, treated with SSRIs; depressed and not treated; not depressed, not treated) who are evaluated 4 times. The study is a supplement to an NIMH funded investigation, Antidepressant Use During Pregnancy (5 R01 MH60335-02, Katherine L. Wisner, M.D. PI), which addresses the effects of both depression and drug intervention during pregnancy and the postpartum period on mothers and infants. In this study, data on many aspects of the psychosocial environment of pregnant and parenting women are collected in order to isolate developmental and other effects of prenatal drug exposure on the infant. Using much of the same data, the supplement enhances and extends research currently funded by NIMH to Dr. Wisner by asking an additional question that is a national health priority: Does treatment of PPD with antidepressants improve a woman's ability to fulfill key aspects of functioning in the maternal role? Results of the study will inform women and their health care providers on outcomes of the use of SSRIs in depressed, postpartum women, assisting with decision-making on the treatment of postpartum depression.