孕产妇情绪与防御应付方式及神经递质的关系

The relationship between mood ,defense style ,coping style and neurotransmitters of the puperperas

目的了解孕产妇临产前和产后焦虑、抑郁情绪与单胺类神经递质、防御方式、应付方式的关系.方法于入院第2天和产后第3天用焦虑自评量表(SAS)、抑郁自评量表(SDS)、医学应对方式问卷和防御方式问卷对203名孕产妇进行测评,产前、产后SAS、SDS评分≥51分为情绪紊乱组,＜50分为情绪稳定组.并对其产前、产后血浆中的多巴胺(DA)、5-羟色胺(5-HT)、去甲肾上腺素(NE)进行了检测.结果产前焦虑、抑郁情绪的发生率分别为38.4%、22.2%,产后焦虑、抑郁情绪的发生率分别为20.2%、12.8%,产前焦虑、抑郁情绪发生率高于产后(P＜0.01),产前DA、NE含量高于产后,5-HT含量低于产后(P＜0.01).情绪紊乱组的DA、NE含量高于情绪稳定组,5-HT含量低于情绪稳定组(P＜0.05～0.001).情绪紊乱组的不成熟防御方式、中间型防御方式及消极应对因子得分高于情绪稳定组,而积极应对方式得分低于稳定组,差异均有显著性(P＜0.001).结论孕产妇是焦虑抑郁情绪的高发人群,产前焦虑抑郁情绪发生率高于产后,焦虑抑郁情绪与血浆中5-HT、NE、DA含量改变、防御方式及应对方式不良有关.

Objective To investigate the relationship between anxiety, depression, neurotransmitters, defence style and coping style of the puperperas pre or after their deliveries. Methods 203 puperperas were assessed by self-anxiety scoring （SAS） , self-depression scoring （SDS） , simplified coping style questionnaire （ CPS ） and defence style questionnaire（DSQ） on the 2^ml day in hospital and on 3^ml day after their deliveries while their DA,5-HT,NE was measured before and after delivery. Results The prevalance rate of prepartum anxiety and depression was 38.4% and 22.2% respectively. And the incident rate of postpartum anxiety and depression was 20.2% and 12.8% respectively. The prevalance rate of prepartum anxiety was higher than postpartum anxiety（ χ^2= 16.14,χ^2=6.25, P〈 0.01 ）. The concentration of DA、NE in prepartum was higher than that in postpartum while 5-HT of prepartum was lower than postpartum （ P 〈 0.01 ）. The amount of DA and NE of the motion disorder was higher than that of non- motion disorder while the amount of 5-HT of the motion disorder was lower than that of non- motion disorder（ P 〈 0.05～0. 001 ）. Conclusion The purperperas are declined to have anxiety and depression. The prevalance rate of prepartum anxiety was higher than postpartum anxiety. The anxiety and depression have the correlation with plasm 5-HT,NE and DA as the same as defence style and the poor coping style.