抑郁归因风格、失控感及社会支持与大龄经产妇产后抑郁关系

Relationship between depression attribution style,feeling of losing control,social support and occurrence of postpartum depression of elderly puerpera

目的:分析抑郁归因风格、失控感以及社会支持与大龄经产妇产后抑郁发生的关系。方法:选取2016年5月—2019年5月来本院门诊心理咨询和住院治疗的大龄经产妇150例为研究对象,均填写《一般情况调查表》、《爱丁堡产后抑郁量表》(EPDS),依据EPDS评分结果分为抑郁组(EPDS评分≥13分)、正常组(EPDS评分<13分),对比其一般资料、抑郁归因方式[归因方式问卷(ASQ)]、失控感[习得性无助感量表(LHS)、绝望感量表(HS)、一般自我效能感量表(GSES)]、社会支持度[中文版产后社会支持量表(PSQ)],分析大龄经产妇产后抑郁相关因素,以Pearson法分析各评分与EPDS评分的关系。结果:抑郁组(35例,23.3%)年龄、丈夫在外地、不良孕产史占比高于正常组,而父母照顾月子占比及家庭年收入低于正常组,ASQ总分、正性事件、人际事件、成就事件、内外维度、普遍维度、持续维度得分低于正常组,负性事件得分高于正常组(均P<0.05);抑郁组LHS、HS评分高于正常组,而GSES评分低于正常组,PSQ中社会支持重要性得分高于正常组,而社会支持实际程度得分低于正常组(P<0.01),两组PSQ总分无差异(P>0.05);Pearson分析结果显示,抑郁组EPDS评分与LHS评分、HS评分、ASQ负性事件评分、PSQ社会支持重要性评分均呈正相关,与GSES评分、ASQ总评分、PSQ社会支持实际程度评分均呈负相关(P<0.05)。结论:大龄经产妇产后抑郁发生率高,而抑郁归因风格、失控感及社会支持度低与其有关,提示临床及家庭应积极采取针对性措施改善产妇不良心理状态,避免发生产后抑郁。

Objective:To analyze the relationship between depression attribution style,feeling of losing control,social support and occurrence of postpartum depression of elderly puerpera.Methods:150 elderly puerpera who had been given psychological counseling and hospitalization were enrolled in the study from May 2016 to May 2019.The General Condition Questionnaire and Edinburgh Postnatal Depression Scale(EPDS)were filled out by these puerpera themselves.According to the results of EPDS scores,these puerpera were divided into depression group(EPDS score not less than 13 points)and normal group(EPDS score less than 13 points).The general data,depression attribution mode score by Attributional Style Questionnaire(ASQ),feeling of losing control score by Learning Helplessness Scale(LHS),Hopelessness Scale(HS),and Genera Self-Efficacy Scale(GSES),and social support score by Postpartum Social Support Questionnaire of Chinese Version(PSQ)of these puerperal were compared.The related factors of postpartum depression of elderly puerpera were analyzed.The relationship between all scores and EPDS scores was analyzed by Pearson method.Results:The age,and the proportions of husband in other places and the adverse pregnancy history of puerpera in depression group were significant higher than those of puerpera in normal group,while the proportion of caring by parents after delivery and family annualincome of puerpera in depression group were significant lower(P<0.05).ASQ total score,and scores of positive events,interpersonal events,achievement events,internal and external dimension,universal dimension and continuous dimension of puerpera in depression group were significant lower than those of puerpera in normal group,while negative events score was significant higher than that in normal group(P<0.05).LHS and HS scores of puerpera in depression group were significant higher than those of women in normal group,while GSES score of puerpera in depression group was significant lower(P<0.05).The score of social support importance in PSQ of women in depression group was significant higher than that of normal group,while actual score of social support of puerpera in depression group was significant lower(P<0.01).There was no significant difference in total scores of PSQ of puerpera between the two groups(P>0.05).The results of Pearson analysis showed that EPDS score of puerpera in depression group was positively correlated with LHS score,HS score,ASQ negative event score,and PSQ social support importance score in depression group,while was negatively correlated with GSES score,ASQ total score,and PSQ actual score of social support(P<0.05).Conclusion:The incidence of postpartum depression of elderly puerpera is high,which is closely related to the depression attribution style,feeling of losing control and low social support.It is suggested that clinical providers and family should take targeted measures to improve the poor mental state of puerpera for avoiding postpartum depression.