Holden J M, Sagovsky R, Cox J L
Department of Psychiatry, University of Edinburgh.
BMJ. 1989 Jan 28;298(6668):223-6. doi: 10.1136/bmj.298.6668.223.
To determine whether counselling by health visitors is helpful in managing postnatal depression.
Controlled, random order trial.
Health centres in Edinburgh and Livingston.
Sixty women identified as depressed by screening at six weeks post partum and by psychiatric interview at about 13 weeks post partum. Five women did not wish to participate, and a further five did not complete the trial. Age, social and obstetric factors, and diagnosis were similar in women who completed the trial and those who withdrew.
Eight weekly counselling visits by health visitors who had been given a short training in counselling for postnatal depression.
Reduction of depression. MEASUREMENTS and main results--Standardised psychiatric interviews and a 10 point self report scale were used to identify depression before and after intervention. The psychiatrist was not told to which group women were allocated. After three months 18 (69%) of the 26 women in the treatment group had fully recovered compared with nine (38%) of the 24 in the control group. The difference between the groups was thus 32% (95% confidence interval 5 to 58).
Counselling by health visitors is valuable in managing non-psychotic postnatal depression.
确定健康访视员提供的咨询服务对产后抑郁症的管理是否有帮助。
对照、随机顺序试验。
爱丁堡和利文斯顿的健康中心。
60名在产后六周通过筛查以及在产后约13周通过精神科访谈被确定为抑郁的女性。5名女性不想参与，另有5名未完成试验。完成试验的女性与退出试验的女性在年龄、社会和产科因素以及诊断方面相似。
由接受过产后抑郁症咨询短期培训的健康访视员进行为期八周的每周一次咨询访问。
抑郁症状减轻。测量方法及主要结果——采用标准化精神科访谈和10分自我报告量表来确定干预前后的抑郁情况。精神科医生未被告知女性被分配到哪一组。三个月后，治疗组26名女性中有18名（69%）完全康复，而对照组24名女性中有9名（38%）完全康复。两组之间的差异为32%（95%置信区间5%至58%）。
健康访视员提供的咨询服务在管理非精神病性产后抑郁症方面很有价值。
