A Correlative Study Of Psychosocial Factors And Cognitive-Behavioral Therapy Of Postpartum Depression

Objective:To investigate the influence of the risk psychosocial factors such as life events,coping style,social support,personality character,education background,negative automatic thoughts,relation of marriage,obstetrics complication etc on postpartum depression(PPD).To contrast study the function of cognitive behavior therapy(CBT) to PPD and the correlation between the personality character,coping styie,social support and negative automatic thoughts toCBT.Methods:(1) 120 PPD patients made up of the research group,and 120 normal lying-in women made up of the control group.Analysis the psychosocial factors of postpartum depression(PPD) by applying the general condition questionnaire,Life Event Scale(LES),Trait Coping Style Questionnaire(TCSQ),Social Support Rating Scale(SSRS), Eysenck Personality Questionnaire(EPQ),Index of marital satisfaction(IMS),automatic thought questionnaire(ATQ).(2) 120 PPD women were randomly divided into two groups,one is the drug treatment group,the other is the combined group(drug treatment combined with CBT).In order to compare the effect and the influencing factors,these two groups were all evaluated by Hamilton Depression Scale(HAMD),TCSQ,SSRS,EPQ and ATQ scales before and after the treatment.Result:(1) The average education term in PPD group was shorter than that in control group.(2) The score of the negative life events,negative coping,negative automatic thought and neurotic character in PPD group were higher than that in control group,while the the score of positive coping,social support and marital satisfaction were lower.(3) The score of anxiety,somatization disorder,cognitive hindrance and hopelessness in PPD group were higher than that in control group.(4) The score of obstetrics complication in PPD group was higher than that in control group.(5) In combined group,the total score and the factors score of HAMD,the score of negative coping and negative automatic thought decreased more obviously than that in drug treatment group,while the score of positive coping,subjective social support and support utilization degree increased more evidently.(6) The patients with positive coping,high subjective social support,high support utilization degree,less automatic thought had higher compliance with cognitive therapy,and had better effect of cognitive therapy.(7) The patients with negative coping, low subjective social support,low support utilization degree and high neurotic character had lower compliance with cognitive therapy,and had worse effect of cognitive therapy.Conclusion:The occurrence of PPD is closely related to the psychosocial factors. Less education,more negative life events,negative coping,low social support,neurotic character,low marital satisfaction,more negative automatic thought and obstetrics complication are all the risk factors of the PPD.Well education,positive coping,high social support,high marital satisfaction,less negative automatic thought can reduce the occurrence of PPD.CBT combined with drug treatment can raise the mental health level, the subjective social support and the support utilization,and it also can improve the PPD, reduce negative coping and negative automatic thought,the result was obviously better than pure drug treatment.The lying-in woman with positive coping,high subjective social support and support utilization and less automatic thought had higher compliance with cognitive therapy,or otherwise the compliance would be low and the healing effect of the cognitive therapy would be affected.