Department of Psychology, Emory University, Atlanta, GA, USA.
Can J Psychiatry. 2012 Sep;57(9):530-6. doi: 10.1177/070674371205700903.
Taking a developmental psychopathology perspective, our objective was to identify ways in which psychosocial treatment of depression during pregnancy may be enhanced. We first consider the state of evidence on psychosocial interventions for antenatal depression, next define key developmental psychopathology concepts that are relevant to antenatal depression, and finally discuss implications for clinical practice and research. We found a limited, but promising, evidence base for effective psychosocial interventions for depression during pregnancy. Examining antenatal depression from a developmental psychopathology perspective revealed suggestions for improving treatment. A developmental psychopathology perspective suggests that treatment of depression during pregnancy may be improved by attention to the continuum of depression, from subclinical to severe major depressive disorder; personalized care based on individual women's pattern of risk and resilience factors and correlated risks; consideration of the potential benefits of treating the couple's relationship, the mother's qualities of parenting, and infants' and children's mental health needs; and, including a detailed understanding of the developmental pathways to antenatal depression for each patient in treatment planning.
从发展心理病理学的角度来看，我们的目标是确定如何加强怀孕期间对抑郁症的心理社会治疗。我们首先考虑产前抑郁症的心理社会干预措施的现有证据状况，其次定义与产前抑郁症相关的关键发展心理病理学概念，最后讨论对临床实践和研究的影响。我们发现，针对怀孕期间抑郁症的有效心理社会干预措施的证据有限，但前景可观。从发展心理病理学的角度研究产前抑郁症，发现了改善治疗的建议。发展心理病理学的观点表明，通过关注从亚临床到严重的重度抑郁症的抑郁连续体，以及基于个体女性的风险和适应力因素及相关风险的个性化护理，可能会改善对怀孕期间抑郁症的治疗。同时，还需要考虑治疗夫妻关系、母亲的育儿质量以及婴儿和儿童心理健康需求的潜在益处，并在治疗计划中为每位患者详细了解产前抑郁症的发展途径。
