產後抑鬱症通常始於產前

A large new study has documented unexpected links in the timing and severity of symptoms of maternal depression, which could help mothers and doctors better anticipate and treat the condition.
一項新的大型研究記錄了孕產婦抑鬱症的發作時間與症狀嚴重性之間出人意料的聯繫，這能幫助產婦和醫生更好地預測和治療這種疾病。

The study of more than 8,200 women from 19 centers in seven countries, published last month in Lancet Psychiatry, found that in those with the severest symptoms — suicidal thoughts, panic, frequent crying — depression most often began during pregnancy, not after giving birth, as is often assumed.
該研究上月發表在《柳葉刀精神病學》雜誌(Lancet Psychiatry)上，它調查了七個國家19箇中心的8200多名婦女。研究發現，症狀最嚴重的抑鬱症——自殺念頭、恐慌、經常大哭——最常在懷孕期間開始，而非人們通常認爲的分娩之後。

Moderately depressed women often developed their symptoms postpartum, and were more likely than severely depressed women to have experienced complications during pregnancy like pre-eclampsia, gestational diabetes or hypertension.
中度抑鬱的孕產婦通常在產後出現症狀，而且與重度抑鬱的孕產婦相比，她們更多地在懷孕期間經歷過先兆子癇、孕期糖尿病或高血壓等併發症。

Severely depressed women, however, more often reported complications during delivery.
不過，患有重度抑鬱症的產婦更常在分娩時出現併發症。

“This is the largest study to date on postpartum depressive symptoms,” said Leah Rubin, an assistant professor in the Women’s Mental Health Research Program at University of Illinois at Chicago, a co-author of a commentary about the study. “This is definitely a first step in the right direction, knowing that depression isn’t one-size-fits-all.”
“這是迄今爲止關於產後抑鬱症狀的最大型研究，”伊利諾伊大學芝加哥分校女子精神健康研究項目的助理教授利亞·魯賓(Leah Rubin)說，他曾與人合寫了一篇關於這項報告的評論文章，“知道抑鬱症有多種情況，這無疑是通往正確研究方向的第一步。”

Ten to 20 percent of mothers experience depression, anxiety, bipolar disorder or other symptoms at some point from pregnancy to a year after giving birth. The study could aid efforts to find causes and treatments.
10%至20%的孕產婦在懷孕至產後一年的某個時候出現過抑鬱、焦慮、躁鬱或其他症狀。這項研究可以幫助找到原因和治療方法。

The study participants were all mothers. Some had been found to have postpartum depression by clinicians, while others were assessed via a widely used questionnaire. (Some participants fell into both groups.)
這項研究的參與者都是孕產婦。其中一些人的產後抑鬱症是臨牀醫生髮現的，還有一些是通過被普遍採用的問卷調查評估出來的（有些參與者上述兩種情況兼有）。

Each group could be separated into three subgroups representing women with severe, moderate, and either mild or clinically insignificant depression, said Dr. Samantha Meltzer-Brody, the director of University of North Carolina’s perinatal psychiatry program and the study’s corresponding author.
這項研究的通訊作者、北卡羅來納大學圍產期精神病研究項目的負責人薩曼莎·梅爾策-布羅迪博士(Samantha Meltzer-Brody)說，每組可以分成三個小組，分別代表患有重度、中度以及輕度或無臨牀症狀的抑鬱症的孕產婦。

Dr. Meltzer-Brody said the finding that two-thirds of severe depression began during pregnancy raised scientific questions. The biological factors at work could differ from those affecting women with classic postpartum depression, which scientists think may be linked to plummeting hormone levels after delivery.
梅爾策-布羅迪博士說，三分之二的重度抑鬱是在懷孕期間開始的，這個發現引出了一些科學問題。導致懷孕期間出現抑鬱症的生物因素可能與導致典型產後抑鬱症的生物因素不同，科學家們認爲後者的影響因素可能是分娩後激素水平驟降。

She also wondered whether the finding that 60 percent of moderately depressed women reported issues like diabetes suggested that immune system problems might underlie their symptoms.
她還說，患有中度抑鬱症的產婦60%出現過糖尿病等問題。她想弄清，這一發現是否說明免疫系統問題是抑鬱症的誘因。

Dr. Meltzer-Brody and her colleagues will begin seeking answers this year by collecting DNA from thousands of women through an international online registry.
梅爾策-布羅迪博士和她的同事們今年將開始尋找這個問題的答案，他們計劃通過國際在線登記收集上萬名婦女的DNA。

“Ideally, you could determine who’s at risk,” she said. “What we do now is wait for people to get sick.”
“如果一切順利，我們將能確定哪些人存在風險，”她說，“我們現在在做的事就是等人們生病。”