中国全科医学 ›› 2023, Vol. 26 ›› Issue (14): 1775-1782.DOI: 10.12114/j.issn.1007-9572.2022.0726

所属专题: 精神卫生最新文章合辑

• 医学循证 • 上一篇    下一篇

不同人格特质和产后抑郁关系的Meta分析

袁德慧1, 李玉红1,*(), 董袁圆2, 王明欢1   

  1. 1.230601 安徽省合肥市,安徽医科大学护理学院
    2.230001 安徽省合肥市,安徽省妇幼保健院危急重产科
  • 收稿日期:2022-08-26 修回日期:2023-01-10 出版日期:2023-05-15 发布日期:2023-02-03
  • 通讯作者: 李玉红

  • 作者贡献:袁德慧、董袁圆、王明欢进行文献筛选、数据提取和质量评价;袁德慧进行数据分析和文章撰写;李玉红指导论文写作,负责文章的质量控制及审阅,对文章整体负责。
  • 基金资助:
    安徽省自然科学基金面上项目--妊娠女性不同时期非稳态负荷风险预测模型的研究(2108085MG242)

Relationship between Different Personality Traits and Postpartum Depression: a Meta-analysis

YUAN Dehui1, LI Yuhong1,*(), DONG Yuanyuan2, WANG Minghuan1   

  1. 1. College of Nursing, Anhui Medical University, Hefei 230601, China
    2. Critical Obstetrics Department, Anhui Provincial Maternal and Child Health Hospital, Hefei 230001, China
  • Received:2022-08-26 Revised:2023-01-10 Published:2023-05-15 Online:2023-02-03
  • Contact: LI Yuhong

摘要: 背景 产后抑郁和人格问题对母婴健康有不良影响,目前对不同人格特质和产后抑郁关系的研究结果尚存争议,且国内缺乏系统评价。目的 系统评价不同人格特质与产后抑郁的关系。方法 计算机检索Web of Science、PubMed、EBSCOhost、Embase、PsycInfo(Proquest)、中国知网、万方数据知识服务平台和维普网。检索自建库至2021-06-04有关不同人格特质与产后抑郁关系的研究。文献质量评价后,提取相关数据。运用Stata 16.0进行Meta分析。对神经质与产后抑郁的关系进行亚组分析和发表偏倚检验。使用翻转效应模型对不同人格特质和产后抑郁的关系进行敏感性分析。结果 最终纳入19篇文献和9类人格特质进行Meta分析,包括神经质(14篇)、外向性(6篇)、宜人性(5篇)、开放性(4篇)、责任心(4篇)、易感人格(3篇)、强迫性人格障碍(2篇)、回避性(2篇)和依赖性(2篇)。Meta分析结果显示:人格特质中的神经质〔OR=1.30,95%CI(1.20,1.40)〕、易感性〔OR=1.39,95%CI(1.10,1.76)〕、回避性〔OR=6.27,95%CI(2.55,15.40)〕和依赖性〔OR=7.11,95%CI(1.62,31.14)〕是产后抑郁的危险因素(P<0.05),外向性〔OR=0.86,95%CI(0.77,0.97)〕、开放性〔OR=0.94,95%CI(0.90,0.98)〕是产后抑郁的保护因素(P<0.05)。亚组分析结果显示,爱丁堡产后抑郁量表(EPDS)的临界值不同(EPDS≥12分:OR=1.71,EPDS≥9分:OR=1.14;P=0.028)以及产后抑郁的调查时间不同(<产后1周:OR=1.13,产后2~12周:OR=1.33,≥产后13周:OR=2.22;P=0.008)是合并结果的异质性来源。敏感性分析结果显示,除强迫性人格外,其他人格特质的合并结果可靠。结论 人格特质类型对产后抑郁有着不同的影响,其中人格特质中的神经质和易感性是产后抑郁的危险因素;人格特质中的外向性和开放性是产后抑郁的保护因素;神经质个性的产妇的产后抑郁可能更严重,且更可能在产后13周以后发生产后抑郁。因国内外研究结果尚不一致,未来还需进一步探讨回避性、依赖性和强迫性人格障碍和产后抑郁的关系。

关键词: 产后抑郁, 人格, 神经质, 易感性, 外向性, 开放性, Meta分析

Abstract:

Background

Postpartum depression and personality problems have adverse effects on maternal and infant health. At present, the research results on the relationship between different personality traits and postpartum depression are still controversial, and there is a lack of the systematic reviews on it in China.

Objective

To systematically review the relationship between different personality traits and postpartum depression.

Methods

The research was performed Web of Science, PubMed, EBSCOhost, Embase, PsycInfo (Proquest) , CNKI, Wanfang Data Knowledge Service Platform, and VIP for studies on the relationship between different personality traits and postpartum depression from inception until June 4, 2021. The relevant data extraction was conducted after the quality evaluation of literature. Stata 16.0 was used for meta-analysis. Subgroup analysis and publication bias tests were performed for the relationship between neuroticism and postpartum depression. Sensitivity analysis of the relationship between different personality traits and postpartum depression was performed using rollover effect models.

Results

A total of 19 articles and 9 personality traits were finally included in the meta-analysis, including neuroticism (14 studies) , extraversion (6 studies) , agreeableness (5 studies) , openness (4 studies) , conscientiousness (4 studies) , vulnerability (3 studies) , obsessive-compulsive personality disorder (2 studies) , avoidant personality disorder (2 studies) and dependent personality disorder (2 studies) . The result of Meta-analysis showed that neuroticism 〔OR=1.30, 95%CI (1.20, 1.40) 〕, vulnerability 〔OR=1.39, 95%CI (1.10, 1.76) 〕, avoidant personality 〔OR=6.27, 95%CI (2.55, 15.40) 〕and dependent personality 〔OR=7.11, 95%CI (1.62, 31.14) 〕 were risk factors of postpartum depression (P<0.05) . Extraversion 〔OR=0.86, 95%CI (0.77, 0.97) 〕 and openness 〔OR=0.94, 95%CI (0.90, 0.98) 〕 were protective factors of postpartum depression (P<0.05) . The results of the subgroup analysis showed that the different threshold value of Edinburgh Postnatal Depression Scale (EPDS≥12 scores: OR=1.71, EPDS≥9 scores: OR=1.14, P=0.028) and different investigation time of postpartum depression (OR=1.13 for <1 week postpartum, OR=1.33 for 2-12 weeks postpartum, OR=2.22 for ≥13 weeks postpartum; P=0.008) were the sources of heterogeneity in the pooled results. Sensitivity analysis showed that the pooled results about personality traits were reliable except for obsessive-compulsive personality disorder.

Conclusion

Personality traits have different effects on postpartum depression, among which neuroticism and vulnerable personality are risk factors of postpartum depression, extraversion and openness are protective factors of postpartum depression. Postpartum depression may be more severe and more likely to occur after 13 weeks postpartum in postpartum women with neuroticism. Due to the inconsistent results of domestic and foreign researches, the relationships between avoidant, dependent, and obsessive-compulsive personality disorders and postpartum depression need to be further explored in the future.

Key words: Postpartum depression, Personality, Neuroticism, Vulnerability, Extraversion, Openness, Meta analysis