基于CIDI-SF量表的体外受精-胚胎移植妇女抑郁状况及影响因素

Study on the depression status and its influencing factors of women who had experinced in vitro fertilization and embryo transfer based on CIDI-SF scale

目的:探讨接受体外受精-胚胎移植(IVT-EF)妇女过去1年的抑郁状况及其影响因素。方法:2018年6月—2019年6月本院对接受IVT-EF治疗的妇女进行问卷调查。采用世界卫生组织(WHO)短版复合性国际诊断访谈表(CIDI-SF)评估接受IVT-EF治疗的妇女过去1年内的抑郁状况,自设问卷测量其影响因素。结果:293例接受IVT-EF治疗的妇女中60例(20.5%)在过去1年内曾出现过抑郁状态,经CIDI-SF诊断为重度抑郁发作(MDE)的有12例,粗患病率为4.1%。MDE人群中出现自杀观念8例,3例从未将自己的情况告知过医务人员和家人,接受过正规精神治疗的只有2例。Logistic回归分析结果显示,IVT-EF妇女抑郁状态的影响因素有学历(OR=3.20,95%CI 1.48~6.92)、体重变化(OR=2.77,95%CI 1.35~5.68)、睡眠情况(OR=0.24,95%CI 0.12~0.47)及近2年重大负性事件(OR=0.30,95%CI 0.14~0.66)。结论:应用CIDI-SF量表可发现IVT-EF妇女抑郁状态及重度抑郁发作的发生率均较高,特别是有自杀观念者占比较高,而主动求医者较少;IVF-ET妇女抑郁状态的影响因素具有一定的特异性,医务人员应结合患者自身特点及影响因素主动识别及时干预。

Objective:To discuss the depression status and its influencing factors of women in the past year after in vitro fertilization-embryo transfer(IVT-EF).Methods:The women who underwent IVT-EF were investigated by questionnaire from June 2018 to June 2019.The short version of Composite International Diagnostic Interview Scale Form(CIDI-SF)was used to assess the depression status of these women in the past 1 year,and the self-designed questionnaire was used to measure the influencing factors.Results:Among 293 women after IVT-EF,60(20.5%)women had depressive state within the past 1 year,and 12(4.1%)women were diagnosed with severe depressive episode(MDE)by CIDI-SF.Among the women with MDE,8 women(66.4%)had suicidal ideation,3 women(25.0%)had never told the medical staff to their family members,and only 2 women(16.7%)had received formal psychiatric treatment.Logistic regression analysis showed that the influencing factors of depressive status of women with IVT-EF were educational background(OR=3.20,95%CI:1.48-6.92),the value of weight change(OR=2.77,95%CI:1.35-5.68),sleep situation(OR=0.24,95%CI:0.12-0.47),and the situation of major negative events in the past two years(OR=0.30,95%CI:0.14–0.66).Conclusion:The incidences of depressive status and MDE by CIDI-SF of women with IVF-ET are all high,especially the women with suicidal ideation account for a relatively high proportion with less voluntarily sought medical treatment.The influencing factors of depression of women with IVF-ET have some specificity,so they should be identified initiatively and intervened timely by medical staff.