产后抑郁症病理生理和影响因素的研究进展

Research Progress on Pathophysiology and Influencing Factors of Postpartum Depression

摘要: 产后抑郁症(Postpartum depression, PPD)是产后最常见的精神疾病，每年约有50万妇女受到此病困扰。最危险的影响因素是情绪或焦虑等精神障碍史，特别是怀孕妇女更易受到体内激素或外界环境影响而患病。有证据表明围产期是包括抑郁症在内的心理疾病特别高发的时期，产后六个月妇女的抑郁症发生率是未生育女性的2~3倍。国际上认为产后抑郁症的患病率约为10%~20%，然而其流行程度在不同文化和不同经济状况的国家中表现出很大差异。本文综述了产后抑郁症主要的病理生理机制和影响因素，旨在为产后抑郁的神经生物学基础提供理论依据，着重讨论产后抑郁症生理学中神经内分泌变化、神经递质改变及遗传学的参与，整合这些发现来理解产后抑郁症的病理生理机制。

Abstract: Postpartum depression (PPD) is the most common Postpartum psychiatric disorder, affecting about half a million women each year. The greatest risk factor is a history of mood or anxiety disorders, especially in pregnant women, who are more likely to be affected by hormones or the environment. Evidence shows that during the period of perinatal period, the incidence of psychological diseases including depression is especially high, and the incidence of depression in women six months after delivery is 2~3 times that of women who have not given birth. It is internationally believed that the prevalence of postpartum depression is about 10%~20%, but its prevalence varies greatly among countries with different cultures and economic conditions. This paper reviews the main pathological physiological mechanism and influence factors of postpartum depression, aims to provide theoreti-cal basis for postpartum depression neurobiological basis, focuses on postpartum depression neu-roendocrine changes in physiology, altered the neurotransmitter, and the participation of genetics, integration of these findings for understanding the pathophysiology of postpartum depression.