Department of Pediatrics, Johns Hopkins University School of Medicine, 200 North Wolfe Street, Baltimore, MD, 21287, USA,
Matern Child Health J. 2014 May;18(4):873-81. doi: 10.1007/s10995-013-1313-y.
Perinatal depression (PD) has negative consequences for mothers and children and is more prevalent among women of low socioeconomic status. Home visitation programs serve low-income pregnant women at risk for PD. This study tested the efficacy of a group-based cognitive behavioral intervention (Mothers and Babies Course; MB) in reducing depressive symptoms and preventing the onset of perinatal depression among low-income women enrolled in home visitation. A randomized controlled trial was conducted. Seventy-eight women who were pregnant or had a child less than 6 months of age and who were assessed as at risk for PD were randomized to the MB intervention or usual home visiting services. Depressive symptoms were assessed at baseline and 1-week, 3- and 6-months post-intervention; depressive episodes were assessed with a clinical interview at the 6-month follow-up. Depressive symptoms declined at a significantly greater rate for intervention participants than usual care participants between baseline and 1-week, 3 and 6 months post-intervention. At the 6-month follow-up, 15 % of women who received the MB intervention had experienced a major depressive episode as compared with 32 % of women receiving usual care. Integrating mental health interventions into home visitation appears to be a promising approach for preventing PD. Cognitive behavioral techniques can be effective in preventing depression in perinatal populations and treating it.
围产期抑郁(PD)对母亲和儿童都有负面影响,并且在社会经济地位较低的女性中更为普遍。家访计划为有 PD 风险的低收入孕妇提供服务。本研究测试了一种基于小组的认知行为干预(母亲和婴儿课程;MB)在减少抑郁症状和预防低收入妇女在接受家访时出现围产期抑郁方面的效果。进行了一项随机对照试验。78 名孕妇或有 6 个月以下婴儿且被评估为有 PD 风险的妇女被随机分配到 MB 干预组或常规家访服务组。在基线和干预后 1 周、3 个月和 6 个月评估抑郁症状;在 6 个月的随访中,通过临床访谈评估抑郁发作。与常规护理组相比,干预组的参与者在基线和干预后 1 周、3 个月和 6 个月之间的抑郁症状下降速度明显更快。在 6 个月的随访中,接受 MB 干预的女性中有 15%经历了重度抑郁发作,而接受常规护理的女性中有 32%。将心理健康干预措施纳入家访似乎是预防 PD 的一种很有前途的方法。认知行为技术可以有效预防围产期人群的抑郁并对其进行治疗。