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Lancet Psychiatry:产后抑郁症临床表征异质性潜类分析研究

2014-12-23 MedSci MedSci原创

  研究背景: 产后抑郁症发病率和死亡率逐年增加,但是,产后抑郁症的定义仍存在很多争议。研究人员主要研究了产后抑郁症表征的异质性,即在于鉴定产后抑郁症的临床亚型。 研究方法: 研究数据来自7个国家19所国际围产期精神病学研究机构的《产后抑郁症病因和治疗》项目(Postpartum Depression: Action Towards Causes and Treatment (

研究背景:
产后抑郁症发病率和死亡率逐年增加,但是,产后抑郁症的定义仍存在很多争议。研究人员主要研究了产后抑郁症表征的异质性,即在于鉴定产后抑郁症的临床亚型。

研究方法:

研究数据来自7个国家19所国际围产期精神病学研究机构的《产后抑郁症病因和治疗》项目(Postpartum Depression: Action Towards Causes and Treatment (PACT) Consortium)。共收集17912例具有产后抑郁症表征的病例。研究人员根据潜类分析方法,在两个层次评估了产后抑郁症临床亚型经验性诊断的有效性。一级分析结果为以爱丁堡产后抑郁症量表完整数据为依据的产后抑郁症异质性评估,二级分析结果为以异质性特点为依据的产后抑郁症患者的基本状况。

研究结果:

6556个病例参与一级分析,4245个病例参与二级分析。最终,研究模型分为3个类别。与产后抑郁症相关的最显著特性为疾病的严重程度、起病时间、伴发的焦虑症和自杀意念。第一类妇女的疾病严重度最轻(EPDS均值为10.5),其次为第二类妇女(EPDS均值为14.8)和第三类妇女(EPDS均值为20.1)。产后抑郁症的重症表征与心情不佳(EPDS均值为20.1)、焦虑情绪的加剧、孕期起病时间、产科并发症和自杀意念显著相关。在第二类人群,大部分妇女(62%)在产后4周内出现症状,与其他两个类别人群相比,更多的人出现了孕期并发症(69%,第一类别为67%,第三类别为29%)。

研究展望:

产后抑郁症具有不同的临床亚型,鉴定不同的临床表征有利于后续的生物学和遗传学研究,也有利于疾病的诊断和后续治疗方案的策划。

原始出处:
Postpartum Depression: Action Towards Causes and Treatment (PACT) Consortium.Heterogeneity of postpartum depression: a latent class analysis. The Lancet Psychiatry Volume 2, Issue 1, January 2015, Pages 59–67

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    2015-07-14 howi
  2. [GetPortalCommentsPageByObjectIdResponse(id=1827958, encodeId=c0d2182e958ed, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Jul 14 18:26:00 CST 2015, time=2015-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=21419, encodeId=e478214195d, content=原文失效。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0dcd1622180, createdName=ZChWei, createdTime=Sun Apr 19 18:59:00 CST 2015, time=2015-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1791901, encodeId=411a1e9190172, content=<a href='/topic/show?id=696a14818df' target=_blank style='color:#2F92EE;'>#Psychiatry#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14818, encryptionId=696a14818df, topicName=Psychiatry)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c192448, createdName=diushouji, createdTime=Fri Dec 26 20:26:00 CST 2014, time=2014-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1797550, encodeId=3e401e975506d, content=<a href='/topic/show?id=7b932300084' target=_blank style='color:#2F92EE;'>#临床表征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23000, encryptionId=7b932300084, topicName=临床表征)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55f6293, createdName=lishizhe, createdTime=Sun Jul 19 05:26:00 CST 2015, time=2015-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=13758, encodeId=466013e58de, content=看不到原文, beContent=null, objectType=article, channel=null, level=null, likeNumber=145, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=985d1602717, createdName=zengzhi7621, createdTime=Tue Jan 06 09:33:00 CST 2015, time=2015-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=13513, encodeId=d710135136a, content=这篇原文链接提示错误啊 看不到原文~, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a4bd1605278, createdName=dapengpku, createdTime=Sat Dec 27 21:54:00 CST 2014, time=2014-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1331386, encodeId=72ec133138641, content=<a href='/topic/show?id=fc09244566d' target=_blank style='color:#2F92EE;'>#产后抑郁#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24456, encryptionId=fc09244566d, topicName=产后抑郁)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/fa8I6JticHgohY5FSGE98I1F4gpCjrpl2nbN6jZJY6JEqAjUibjItOA9AsgbBwTuBzAPbU5Tl8DxfemWUFFzBOYw/132, createdBy=24c12500054, createdName=ms2186806800017884, createdTime=Thu Dec 25 07:26:00 CST 2014, time=2014-12-25, status=1, ipAttribution=)]
    2015-04-19 ZChWei

    原文失效。。。

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1827958, encodeId=c0d2182e958ed, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Jul 14 18:26:00 CST 2015, time=2015-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=21419, encodeId=e478214195d, content=原文失效。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0dcd1622180, createdName=ZChWei, createdTime=Sun Apr 19 18:59:00 CST 2015, time=2015-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1791901, encodeId=411a1e9190172, content=<a href='/topic/show?id=696a14818df' target=_blank style='color:#2F92EE;'>#Psychiatry#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14818, encryptionId=696a14818df, topicName=Psychiatry)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c192448, createdName=diushouji, createdTime=Fri Dec 26 20:26:00 CST 2014, time=2014-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1797550, encodeId=3e401e975506d, content=<a href='/topic/show?id=7b932300084' target=_blank style='color:#2F92EE;'>#临床表征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23000, encryptionId=7b932300084, topicName=临床表征)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55f6293, createdName=lishizhe, createdTime=Sun Jul 19 05:26:00 CST 2015, time=2015-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=13758, encodeId=466013e58de, content=看不到原文, beContent=null, objectType=article, channel=null, level=null, likeNumber=145, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=985d1602717, createdName=zengzhi7621, createdTime=Tue Jan 06 09:33:00 CST 2015, time=2015-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=13513, encodeId=d710135136a, content=这篇原文链接提示错误啊 看不到原文~, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a4bd1605278, createdName=dapengpku, createdTime=Sat Dec 27 21:54:00 CST 2014, time=2014-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1331386, encodeId=72ec133138641, content=<a href='/topic/show?id=fc09244566d' target=_blank style='color:#2F92EE;'>#产后抑郁#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24456, encryptionId=fc09244566d, topicName=产后抑郁)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/fa8I6JticHgohY5FSGE98I1F4gpCjrpl2nbN6jZJY6JEqAjUibjItOA9AsgbBwTuBzAPbU5Tl8DxfemWUFFzBOYw/132, createdBy=24c12500054, createdName=ms2186806800017884, createdTime=Thu Dec 25 07:26:00 CST 2014, time=2014-12-25, status=1, ipAttribution=)]
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1827958, encodeId=c0d2182e958ed, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Jul 14 18:26:00 CST 2015, time=2015-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=21419, encodeId=e478214195d, content=原文失效。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0dcd1622180, createdName=ZChWei, createdTime=Sun Apr 19 18:59:00 CST 2015, time=2015-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1791901, encodeId=411a1e9190172, content=<a href='/topic/show?id=696a14818df' target=_blank style='color:#2F92EE;'>#Psychiatry#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14818, encryptionId=696a14818df, topicName=Psychiatry)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c192448, createdName=diushouji, createdTime=Fri Dec 26 20:26:00 CST 2014, time=2014-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1797550, encodeId=3e401e975506d, content=<a href='/topic/show?id=7b932300084' target=_blank style='color:#2F92EE;'>#临床表征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23000, encryptionId=7b932300084, topicName=临床表征)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55f6293, createdName=lishizhe, createdTime=Sun Jul 19 05:26:00 CST 2015, time=2015-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=13758, encodeId=466013e58de, content=看不到原文, beContent=null, objectType=article, channel=null, level=null, likeNumber=145, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=985d1602717, createdName=zengzhi7621, createdTime=Tue Jan 06 09:33:00 CST 2015, time=2015-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=13513, encodeId=d710135136a, content=这篇原文链接提示错误啊 看不到原文~, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a4bd1605278, createdName=dapengpku, createdTime=Sat Dec 27 21:54:00 CST 2014, time=2014-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1331386, encodeId=72ec133138641, content=<a href='/topic/show?id=fc09244566d' target=_blank style='color:#2F92EE;'>#产后抑郁#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24456, encryptionId=fc09244566d, topicName=产后抑郁)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/fa8I6JticHgohY5FSGE98I1F4gpCjrpl2nbN6jZJY6JEqAjUibjItOA9AsgbBwTuBzAPbU5Tl8DxfemWUFFzBOYw/132, createdBy=24c12500054, createdName=ms2186806800017884, createdTime=Thu Dec 25 07:26:00 CST 2014, time=2014-12-25, status=1, ipAttribution=)]
    2015-01-06 zengzhi7621

    看不到原文

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1827958, encodeId=c0d2182e958ed, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Jul 14 18:26:00 CST 2015, time=2015-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=21419, encodeId=e478214195d, content=原文失效。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0dcd1622180, createdName=ZChWei, createdTime=Sun Apr 19 18:59:00 CST 2015, time=2015-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1791901, encodeId=411a1e9190172, content=<a href='/topic/show?id=696a14818df' target=_blank style='color:#2F92EE;'>#Psychiatry#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14818, encryptionId=696a14818df, topicName=Psychiatry)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c192448, createdName=diushouji, createdTime=Fri Dec 26 20:26:00 CST 2014, time=2014-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1797550, encodeId=3e401e975506d, content=<a href='/topic/show?id=7b932300084' target=_blank style='color:#2F92EE;'>#临床表征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23000, encryptionId=7b932300084, topicName=临床表征)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55f6293, createdName=lishizhe, createdTime=Sun Jul 19 05:26:00 CST 2015, time=2015-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=13758, encodeId=466013e58de, content=看不到原文, beContent=null, objectType=article, channel=null, level=null, likeNumber=145, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=985d1602717, createdName=zengzhi7621, createdTime=Tue Jan 06 09:33:00 CST 2015, time=2015-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=13513, encodeId=d710135136a, content=这篇原文链接提示错误啊 看不到原文~, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a4bd1605278, createdName=dapengpku, createdTime=Sat Dec 27 21:54:00 CST 2014, time=2014-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1331386, encodeId=72ec133138641, content=<a href='/topic/show?id=fc09244566d' target=_blank style='color:#2F92EE;'>#产后抑郁#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24456, encryptionId=fc09244566d, topicName=产后抑郁)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/fa8I6JticHgohY5FSGE98I1F4gpCjrpl2nbN6jZJY6JEqAjUibjItOA9AsgbBwTuBzAPbU5Tl8DxfemWUFFzBOYw/132, createdBy=24c12500054, createdName=ms2186806800017884, createdTime=Thu Dec 25 07:26:00 CST 2014, time=2014-12-25, status=1, ipAttribution=)]
    2014-12-27 dapengpku

    这篇原文链接提示错误啊 看不到原文~

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1827958, encodeId=c0d2182e958ed, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Jul 14 18:26:00 CST 2015, time=2015-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=21419, encodeId=e478214195d, content=原文失效。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0dcd1622180, createdName=ZChWei, createdTime=Sun Apr 19 18:59:00 CST 2015, time=2015-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1791901, encodeId=411a1e9190172, content=<a href='/topic/show?id=696a14818df' target=_blank style='color:#2F92EE;'>#Psychiatry#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14818, encryptionId=696a14818df, topicName=Psychiatry)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c192448, createdName=diushouji, createdTime=Fri Dec 26 20:26:00 CST 2014, time=2014-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1797550, encodeId=3e401e975506d, content=<a href='/topic/show?id=7b932300084' target=_blank style='color:#2F92EE;'>#临床表征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23000, encryptionId=7b932300084, topicName=临床表征)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55f6293, createdName=lishizhe, createdTime=Sun Jul 19 05:26:00 CST 2015, time=2015-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=13758, encodeId=466013e58de, content=看不到原文, beContent=null, objectType=article, channel=null, level=null, likeNumber=145, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=985d1602717, createdName=zengzhi7621, createdTime=Tue Jan 06 09:33:00 CST 2015, time=2015-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=13513, encodeId=d710135136a, content=这篇原文链接提示错误啊 看不到原文~, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a4bd1605278, createdName=dapengpku, createdTime=Sat Dec 27 21:54:00 CST 2014, time=2014-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1331386, encodeId=72ec133138641, content=<a href='/topic/show?id=fc09244566d' target=_blank style='color:#2F92EE;'>#产后抑郁#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24456, encryptionId=fc09244566d, topicName=产后抑郁)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/fa8I6JticHgohY5FSGE98I1F4gpCjrpl2nbN6jZJY6JEqAjUibjItOA9AsgbBwTuBzAPbU5Tl8DxfemWUFFzBOYw/132, createdBy=24c12500054, createdName=ms2186806800017884, createdTime=Thu Dec 25 07:26:00 CST 2014, time=2014-12-25, status=1, ipAttribution=)]

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