Forman David R, O'Hara Michael W, Stuart Scott, Gorman Laura L, Larsen Karin E, Coy Katherine C
Department of Psychology, Concordia University, Montreal, Quebec, Canada.
Dev Psychopathol. 2007 Spring;19(2):585-602. doi: 10.1017/S0954579407070289.
Maternal depression is prevalent, and puts children at risk. Little evidence addresses whether treatment for maternal depression is sufficient to improve child outcomes. An experiment was conducted testing whether psychotherapeutic treatment for mothers, suffering from major depression in the postpartum period, would result in improved parenting and child outcomes. Participants included depressed women randomly assigned to interpersonal psychotherapy (n = 60) or to a waitlist (n = 60), and a nondepressed comparison group (n = 56). At 6 months, depressed mothers were less responsive to their infants, experienced more parenting stress, and viewed their infants more negatively than did nondepressed mothers. Treatment affected only parenting stress, which improved significantly but was still higher than that for nondepressed mothers. Eighteen months later, treated depressed mothers still rated their children lower in attachment security, higher in behavior problems, and more negative in temperament than nondepressed mothers. Initial response to treatment did not predict reduced risk for poor child outcomes. Early maternal negative perceptions of the child predicted negative temperament and behavior problems 18 months after treatment. Treatment for depression in the postpartum period should target the mother-infant relationship in addition to the mothers' depressive symptoms.
产后抑郁很常见，并会使儿童面临风险。几乎没有证据表明对产后抑郁的治疗是否足以改善儿童的状况。开展了一项实验，以测试对产后患有重度抑郁症的母亲进行心理治疗是否会改善育儿方式和儿童状况。参与者包括随机分配到人际心理治疗组（n = 60）或候补名单组（n = 60）的抑郁女性，以及一个非抑郁对照组（n = 56）。在6个月时，与非抑郁母亲相比，抑郁母亲对婴儿的反应较少，育儿压力更大，对婴儿的看法也更消极。治疗仅对育儿压力有影响，育儿压力虽有显著改善，但仍高于非抑郁母亲。18个月后，接受治疗的抑郁母亲对孩子的依恋安全性评价仍较低，行为问题较多，气质较消极，与非抑郁母亲相比情况依然如此。对治疗的初始反应并不能预测儿童出现不良状况的风险降低。母亲早期对孩子的负面看法预示着治疗18个月后孩子的气质和行为问题会更消极。产后抑郁的治疗除了针对母亲的抑郁症状外，还应针对母婴关系。
