家庭功能和安全感与产后抑郁症的关系分析

Correlation of Family function,sense of safety and postpartum depression

目的 探讨家庭功能、安全感与产后抑郁症(Postpartum depression,PPD)的关系。方法 方便取样法选取产后抑郁症患者118人(病例组)和健康产妇100人(对照组),施测汉密尔顿抑郁量表(Hamilton depression scale,HAMD)、家庭关怀度指数问卷(Family APGAR index,APGAR)、安全感量表(Security questionnaire,SQ)。结果 PPD病例组APGAR总分在0~6之间人数(57人,48.31%)显著多于对照组(25人,25.00%)(P<0.01);病例组APGAR总分、人际安全感、确定控制感得分均显著低于对照组(P<0.05或0.01)。除体重、日夜变化外,其他HAMD因子与APGAR、SQ因子分显著负相关(P<0.05或0.01);产后抑郁影响因素的回归分析显示APGAR、确定控制感对HAMD有显著预测作用(P<0.001),可解释HAMD方差变异的78.4%。安全感在家庭功能和产后抑郁症之间起部分中介作用,中介效应占总效应的47.62%。结论 家庭功能、安全感是产后抑郁症的预测因子,家庭功能可通过损害安全感进一步加重个体的产后抑郁。

Objective To explore the relationship between family function,sense of security and postpartum depression. Methods 118 patients with postpartum depression(case group)and 100 healthy maternity women(control group)were recruited by convenient sampling method. HAMD,APGAR and SQ were utilized for assessment.Results The participants in case group(57,48.31%)whose total scores of APGAR ranged from 0 to 6 were significantly more than control group(25,25.00%)(P<0.01). Score of APGAR,interpersonal sense of security,assured sense of security in case group were significantly lower than those in control group(P<0.05 or 0.01). Except body weight and diurnal variation,other HAMD factors negatively correlated with APGAR and SQ factor scores(P<0.05 or 0.01). Multiple regression analysis for influencing factors of HAMD suggested APGAR and assured sense of security had predictive effect on HAMD(P<0.001),and could explain 78.4% of HAMD variance. SQ was partial mediator between family function and postpartum depression and the mediating effect accounted for 47.62% of the total effect.Conclusions Family function and sense of security are predictors of postpartum depression and family function can aggravate postpartum depression by furtherly impairing sense of security.