Department of Psychiatry, Women's Mood Disorders Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Arch Womens Ment Health. 2012 Dec;15(6):469-80. doi: 10.1007/s00737-012-0311-1. Epub 2012 Oct 4.
Although poor partner support is a key risk factor for depression in pregnant and postpartum women, partners are not generally involved in treatment beyond psychoeducation. The aim of this "proof of concept" study was to test safety, acceptability, and feasibility of Partner-Assisted Interpersonal Psychotherapy (PA-IPT), an intervention that includes the partner as an active participant throughout treatment. Women more than 12 weeks estimated gestational age and less than 12 weeks postpartum were invited to participate if they fulfilled DSM-IV criteria for Major Depressive Disorder and reported moderate symptom severity (HAM-D(17) ≥16). The open trial included eight acute-phase sessions and a 6-week follow-up assessment. Ten couples completed the acute phase treatment and nine presented for a 6-week follow-up assessment. There were no study-related adverse events, and no women had symptomatic worsening from intake to Session Eight. All partners attended all sessions, no couples dropped out of treatment, and all reported positive treatment satisfaction at the conclusion of the study. Nine of ten women (90 %) met the criteria for clinical response (HAM-D(17) = 9) at the conclusion of acute phase treatment, and eight of the nine (89 %) presenting at a 6-week follow-up assessment met criteria for symptomatic recovery. Incorporating partners in the treatment of major depressive disorders during the perinatal period is safe, acceptable, and feasible, but needs further testing in a larger population to evaluate efficacy.
尽管伴侣支持不足是导致孕妇和产后女性抑郁的一个关键风险因素,但除了心理教育之外,伴侣通常不会参与治疗。本“概念验证”研究旨在测试夫妻共同参与的人际心理治疗(Partner-Assisted Interpersonal Psychotherapy,PA-IPT)的安全性、可接受性和可行性,该干预措施在整个治疗过程中都将伴侣作为积极参与者纳入其中。如果女性符合 DSM-IV 重性抑郁障碍标准,且报告中度症状严重程度(HAM-D(17) ≥16),且妊娠 12 周以上且产后 12 周以内,将邀请她们参加本开放性试验。该试验包括八次急性期治疗和 6 周随访评估。十对夫妇完成了急性期治疗,九对夫妇接受了 6 周随访评估。没有与研究相关的不良事件,且没有女性的症状从入组到第八次治疗 session 恶化。所有伴侣都参加了所有的治疗 session,没有夫妇退出治疗,所有伴侣在研究结束时都报告了积极的治疗满意度。在急性期治疗结束时,十名女性中有九名(90%)符合临床反应标准(HAM-D(17) = 9),在 6 周随访评估时,九名中有八名(89%)符合症状缓解标准。在围产期将伴侣纳入重性抑郁障碍的治疗中是安全、可接受和可行的,但需要在更大的人群中进一步测试以评估疗效。