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产后抑郁母亲接受团体人际心理治疗的长期结局轨迹。

Trajectories of long-term outcomes for postnatally depressed mothers treated with group interpersonal psychotherapy.

机构信息

Academic Unit of Psychological Medicine, The Canberra Hospital, Australian National University Medical School, Level 2, Building 4, PO Box 11, Woden, ACT 2606, Australia.

出版信息

Arch Womens Ment Health. 2012 Jun;15(3):217-28. doi: 10.1007/s00737-012-0280-4. Epub 2012 Apr 26.

Abstract

There is evidence that psychological treatments for postnatal depression are effective in the short-term; however, whether the effects are enduring over time remains an important empirical question. The aim of this study was to investigate the depressive symptoms and interpersonal functioning of participants in a randomised controlled trial (RCT) of group interpersonal psychotherapy (IPT-G) at 2 years posttreatment. The study also examined long-term trajectories, such as whether participants maintained their recovery status, achieved later recovery, recurrence or persistent symptoms. Approximately 2 years posttreatment, all women in the original RCT (N = 50) were invited to participate in a mailed follow-up. A repeated measures analysis of variance assessed differences between the treatment and control conditions on depression and interpersonal scores across five measurement occasions: baseline, mid-treatment, end of treatment and 3-month and 2-year follow-up. Chi-square tests were used to analyse the percentage of participants in the four recovery categories. Mothers who received IPT-G improved more rapidly in the short-term and were less likely to develop persistent depressive symptoms in the long-term. Fifty seven percent of IPT-G mothers maintained their recovery over the follow-up period. Overall, IPT-G participants were significantly less likely to require follow-up treatment. Limitations include the use of self-report questionnaires to classify recovery. The positive finding that fewer women in the group condition experienced a persistent course of depression highlights its possible enduring effects after treatment discontinuation. Further research is needed to improve our long-term management of postnatal depression for individuals who are vulnerable to a recurrent or chronic trajectory.

摘要

有证据表明,心理治疗产后抑郁症在短期内是有效的;然而,治疗效果是否能持久仍有待进一步的实证研究。本研究旨在调查随机对照试验(RCT)中接受团体人际心理治疗(IPT-G)的参与者在治疗后 2 年的抑郁症状和人际关系功能。该研究还探讨了长期轨迹,例如参与者是否保持恢复状态、后来是否恢复、复发或持续存在症状。大约在治疗后 2 年,原始 RCT 中的所有女性(N=50)都被邀请参加邮寄随访。重复测量方差分析评估了治疗组和对照组在五次测量时的抑郁和人际关系评分之间的差异:基线、治疗中期、治疗结束时以及 3 个月和 2 年随访。卡方检验用于分析四个恢复类别的参与者百分比。接受 IPT-G 的母亲在短期内改善更快,在长期内不太可能出现持续性抑郁症状。57%的 IPT-G 母亲在随访期间保持了恢复状态。总体而言,IPT-G 组的参与者不太可能需要后续治疗。研究的局限性包括使用自我报告问卷来分类恢复。群组治疗组中有较少的女性经历持续性抑郁病程的积极发现,突出了其在治疗停止后可能具有持久的效果。需要进一步的研究来改善我们对易复发或慢性病程的产后抑郁症个体的长期管理。

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