CAJ | 학술논문

目的：探讨分娩前后述情障碍、不安全依恋和抑郁变化以及三者之间的关系。方法选取安阳市人民医院就诊的孕期≥28周的525名孕妇为研究对象,采用爱丁堡产后抑郁量表( EPDS)、依恋方式问卷[ ASQ,包括安全型依恋(Attachment-secure)、焦虑/矛盾型依恋(Insecure- ambivalent)、回避型依恋(Insecure-avoidant)3个分量表]、多伦多述情障碍量表( TAS -20)进行测评。结果分娩后产妇焦虑/矛盾型依恋因子得分低于产前[(47.78±9.61)vs.(46.03±8.48)],差异有统计学意义(P<0.05)。产妇EPDS得分与回避型依恋因子得分、焦虑/矛盾型依恋因子得分、TAS-20得分呈正相关(r=0.31~0.39,P均<0.01)。逐步多元线性回归分析显示,产后EPDS得分与TAS-20得分、焦虑/矛盾型依恋得分呈正相关(β=0.24~0.28),焦虑型依恋得分× TAS-20得分、回避型依恋× TAS-20得分与EPDS得分回归关系成立(β=0.15~0.32,P均<0.05)。结论产妇焦虑型依恋分娩后降低,产后不安全依恋直接或间接与述情障碍相互作用于抑郁情绪。
목적：탐토분면전후술정장애、불안전의련화억욱변화이급삼자지간적관계。방법선취안양시인민의원취진적잉기≥28주적525명잉부위연구대상,채용애정보산후억욱량표( EPDS)、의련방식문권[ ASQ,포괄안전형의련(Attachment-secure)、초필/모순형의련(Insecure- ambivalent)、회피형의련(Insecure-avoidant)3개분량표]、다륜다술정장애량표( TAS -20)진행측평。결과분면후산부초필/모순형의련인자득분저우산전[(47.78±9.61)vs.(46.03±8.48)],차이유통계학의의(P<0.05)。산부EPDS득분여회피형의련인자득분、초필/모순형의련인자득분、TAS-20득분정정상관(r=0.31~0.39,P균<0.01)。축보다원선성회귀분석현시,산후EPDS득분여TAS-20득분、초필/모순형의련득분정정상관(β=0.24~0.28),초필형의련득분× TAS-20득분、회피형의련× TAS-20득분여EPDS득분회귀관계성립(β=0.15~0.32,P균<0.05)。결론산부초필형의련분면후강저,산후불안전의련직접혹간접여술정장애상호작용우억욱정서。
Objective To explore the variation of depression, alexithymia ,unsure attachment of women who were in antenatal and postpartum, the relationship between postpartum depression, alexithymia and unsure attachment. Methods Totally 525 pregnant women were selected and followed-up. They were assessed with the Edinburgh Postnatal Depression Scale( EPDS) to evaluate post-partum depression,assessed with the 20-item Toronto Alexithymia Scale (TAS-20) to evaluate alexithymia,assessed with the Attach-ment Style Questionnaire( ASQ) consisting of the sub-scales of Attachment-secure, Insecure-ambivalent and Insecure-avoidant to evaluate insecure attachment. Results The scores of Insecure-ambivalent were lower in women after delivery than before [(47. 78 ± 9. 61)vs. (46. 03 ± 8. 48), P<0. 05]. The EPDS scores were positively correlated with the TAS-20 scores, Attachment-secure scores, Insecure-ambivalent scores(r=0. 31~0. 39,P<0. 001) in postpartum women. Regression analysis showed that the EPDS scores were positively correlated with the TAS-20 scores and Insecure-ambivalent scores (β=0. 24~0. 28, P<0. 05). Regression analysis also revealed a dependency between the EPDS scores and the score of Insecure-ambivalent multiplied by TAS-20 , and In-secure-avoidant multiplied by TAS-20 (β=0. 15~0. 32, P<0. 05). Conclusion It suggests that alexithymia t may play a media-ting role between unsure attachment and postpartum depressions.