de Camps Meschino Diane, Philipp Diane, Israel Aliza, Vigod Simone
Department of Psychiatry, University of Toronto, 250 College Street 8th Floor, Toronto, ON, M5T 1R8, Canada.
Women's College Hospital, 76 Grenville Street 7th Floor, Toronto, ON, M5S 1B2, Canada.
Arch Womens Ment Health. 2016 Apr;19(2):243-51. doi: 10.1007/s00737-015-0551-y. Epub 2015 Aug 5.
Dyadic interactions associated with maternal depression and anxiety may perpetuate maternal mental illness and impact infant attachment. Individual and maternal-dyadic therapies are effective but resource intensive. We assessed feasibility, acceptability, and preliminary efficacy of a newly developed maternal-infant dyadic group therapy intervention. This was an open-label pilot study targeting mothers with mood or anxiety disorders, and their infants aged 6 to 12 months. We conducted three 12-week groups combining evidence-based maternal and mother-infant dyadic strategies to enhance mood, insight, parenting, and mentalizing capacity. We measured recruitment and retention rates, reasons for nonparticipation, and missed sessions. Acceptability of the intervention was assessed via questionnaires and semi-structured interviews. Efficacy outcomes were the Parenting Stress Index (PSI), Edinburgh Postnatal Depression Scale (EDPS), and the Beck Anxiety Inventory (BAI), measured pretreatment and posttreatment. The feasibility and acceptability were excellent. There was a significant reduction in mean depressive symptom scores (t 3.31; p 0.008 sig) and a trend toward decreasing anxiety scores (t 1.96; p 0.08). The total PSI score decreased, approaching statistical significance (t 2.23; p 0.057). Enhanced insight, parenting capacity, affect regulation, and positive interaction with baby were supported with self-report surveys and interviews. This resource-efficient novel mother-baby dyadic group intervention shows excellent feasibility, acceptability, and has good preliminary efficacy results. It has the potential to improve depression, anxiety, affect regulation, parenting, and maternal mentalization.
与母亲抑郁和焦虑相关的二元互动可能会使母亲的精神疾病持续存在,并影响婴儿的依恋关系。个体治疗和母婴二元治疗是有效的,但资源密集。我们评估了一种新开发的母婴二元团体治疗干预措施的可行性、可接受性和初步疗效。这是一项开放标签的试点研究,针对患有情绪或焦虑障碍的母亲及其6至12个月大的婴儿。我们开展了三个为期12周的团体治疗,结合了基于证据的母亲和母婴二元策略,以改善情绪、洞察力、育儿能力和心理化能力。我们测量了招募率和留存率、未参与的原因以及错过的疗程。通过问卷调查和半结构化访谈评估干预措施的可接受性。疗效指标为育儿压力指数(PSI)、爱丁堡产后抑郁量表(EDPS)和贝克焦虑量表(BAI),在治疗前和治疗后进行测量。可行性和可接受性都非常好。平均抑郁症状评分显著降低(t = 3.31;p = 0.008 显著),焦虑评分有下降趋势(t = 1.96;p = 0.08)。PSI总分下降,接近统计学显著性(t = 2.23;p = 0.057)。自我报告调查和访谈支持了洞察力、育儿能力、情感调节以及与婴儿积极互动的增强。这种资源高效的新型母婴二元团体干预措施显示出极佳的可行性、可接受性,并取得了良好的初步疗效结果。它有潜力改善抑郁、焦虑、情感调节、育儿和母亲心理化。