Goodman Janice H, Guarino Anthony, Chenausky Kerry, Klein Lauri, Prager Joanna, Petersen Rebecca, Forget Avery, Freeman Marlene
MGH Institute of Health Professions, School of Nursing, 36 1st Ave, Boston, MA, 02129, USA,
Arch Womens Ment Health. 2014 Oct;17(5):373-87. doi: 10.1007/s00737-013-0402-7. Epub 2014 Jan 22.
Many women experience anxiety during pregnancy with potential negative effects on maternal, birth, and child outcomes. Because of potential risks of fetal exposure to psychotropic medications, efficacious non-pharmacologic approaches are urgently needed. However, no published studies of psychotherapeutic treatments for anxiety in pregnancy exist. Mindfulness-based cognitive therapy (MBCT) may substantially reduce anxiety and co-morbid symptoms in people with anxiety disorders. Coping with Anxiety through Living Mindfully (CALM) Pregnancy is an adaptation of MBCT designed to address anxiety in pregnant women. This study examined the feasibility, acceptability, and clinical outcomes of the CALM Pregnancy intervention in pregnant women anxiety. Twenty-four pregnant women with generalized anxiety disorder (GAD) or prominent symptoms of generalized anxiety participated in an open treatment trial of the CALM Pregnancy group intervention. Psychiatric diagnoses were determined by structured clinical interview, and self-report measures of anxiety, worry, depression, self-compassion, and mindfulness were completed at baseline and post-intervention. Qualitative feedback was elicited via questionnaire. Twenty-three participants completed the intervention with high attendance and good compliance with home practice. Completers showed statistically and clinically significant improvements in anxiety, worry, and depression, and significant increases in self-compassion and mindfulness. Of the 17 participants who met GAD criteria at baseline, only one continued to meet criteria post-intervention. Participants regarded their experience in the intervention to be overwhelmingly positive. MBCT in the form of the CALM Pregnancy intervention holds potential to provide effective, non-pharmacological treatment for pregnant women with anxiety. These promising findings warrant further testing of the intervention with a randomized controlled trial.
许多女性在孕期会经历焦虑，这可能会对母亲、分娩和孩子的结局产生负面影响。由于胎儿接触精神药物存在潜在风险，因此迫切需要有效的非药物治疗方法。然而，目前尚无关于孕期焦虑症心理治疗的已发表研究。基于正念的认知疗法（MBCT）可能会显著减轻焦虑症患者的焦虑及共病症状。“通过正念生活应对焦虑（CALM）孕期项目”是MBCT的一种改编形式，旨在解决孕妇的焦虑问题。本研究考察了CALM孕期干预对孕妇焦虑症的可行性、可接受性和临床疗效。24名患有广泛性焦虑症（GAD）或有明显广泛性焦虑症状的孕妇参与了CALM孕期团体干预的开放性治疗试验。通过结构化临床访谈确定精神科诊断，并在基线和干预后完成焦虑、担忧、抑郁、自我同情和正念的自我报告测量。通过问卷调查获取定性反馈。23名参与者完成了干预，出勤率高，且对家庭练习的依从性良好。完成干预者在焦虑、担忧和抑郁方面有统计学和临床意义上的显著改善，自我同情和正念也有显著增加。在基线时符合GAD标准的17名参与者中，干预后只有1人仍符合标准。参与者认为他们在干预中的体验总体上是积极的。以CALM孕期干预形式呈现的MBCT有可能为患有焦虑症的孕妇提供有效的非药物治疗。这些有前景的发现值得通过随机对照试验对该干预进行进一步测试。
