Aims: To investigate clinically relevant subtypes of perinatal depressive symptoms.
Design: Cross-sectional study.
Methods: A sample of 2,783 women at different prenatal and postnatal periods was recruited between August 2015 - August 2017. The Patient Health Questionnaire-9 (PHQ-9) was used to assess depressive symptoms. Data analyses consisted of latent class analysis (LCA), analysis of variance and multinomial logistic regression.
Results: (a) Five latent subtypes (Classes 5/4/3/1/2) were identified: 'no symptoms', 'mild physio-somatic symptoms', 'severe physio-somatic symptoms and moderate anhedonia', 'moderate-to-severe symptoms' and 'severe symptoms'; (b) Postpartum women were more likely to belong to the severe depressive symptoms group, whereas pregnant women were likely to report severe physio-somatic symptoms; and (c) History of abortion and perinatal complications increased the likelihood of belonging to all moderate-to-severe classes. Lower levels of education increased the probability of belonging to Class 2. Younger women were more likely to be categorized into Classes 1 and 2.
Conclusions: This is the first study to examine heterogeneity of perinatal depressive symptoms and delineate the characteristics of subtypes at different prenatal and postnatal periods via the PHQ-9, using LCA in a Chinese general population.
Impact: This research details the heterogeneity of perinatal depressive symptoms and delineates the characteristics of subtypes at different prenatal and postnatal periods in a Chinese general population.
目的: 调查围产期抑郁症状的临床相关亚型 设计: 横断设计。 方法: 2015年8月至2017年8月期间,我们招募了2783名处于不同产前和产后阶段的女性作为样本。我们使用患者健康问卷9(PHQ-9)来评估抑郁症状。数据分析包括潜在类组分析(LCA)、方差分析和多项逻辑回归。 结果: (a)确定五种潜在亚型(5/4/3/1/2类):“无症状”、“轻度生理症状”、“重度生理症状及轻度快感缺乏”、“中度到重度症状”和“重度症状”;(b)产后女性多为重度抑郁症状组,而产前女性多表现出重度生理症状;(c)流产史和围产期并发症增加了归入所有中度到重度类别的可能性。较低的教育水平增加了归入第二类的可能性。年轻女性更有可能被归入第一类和第二类。 结论: 本研究首次在中国普通人群中使用潜在类组分析(LCA),并通过PHQ-9探讨围产期抑郁症状异质性并描述产前和产后不同阶段亚型的特征。 影响: 本研究详细描述了围产期抑郁症状的异质性,并描述中国普通人群在产前和产后不同阶段的亚型特征。.
Keywords: Chinese; PHQ-9; heterogeneity; latent class analysis; nurse; perinatal depression.
© 2019 John Wiley & Sons Ltd.