Johnson Jennifer E, Price Ann Back, Kao Jennifer Chienwen, Fernandes Karen, Stout Robert, Gobin Robyn L, Zlotnick Caron
College of Human Medicine, Michigan State University, 200 East 1st Street, Room 332, Flint, MI, 48502, USA.
Brown University, Providence, RI, USA.
Arch Womens Ment Health. 2016 Oct;19(5):845-59. doi: 10.1007/s00737-016-0625-5. Epub 2016 Mar 22.
This randomized controlled pilot trial examined the feasibility, acceptability, and preliminary efficacy of an adapted interpersonal psychotherapy (IPT) for major depressive disorder (MDD) following perinatal loss (miscarriage, stillbirth, or early neonatal death). Fifty women who experienced a perinatal loss within the past 18 months, whose current depressive episode onset occurred during or after the loss, were randomized to the group IPT adapted for perinatal loss (the Group IPT for Major Depression Following Perinatal Loss manual developed for this study is available at no cost by contacting either of the first two authors) or to the group Coping with Depression (CWD), a cognitive behavioral treatment which did not focus on perinatal loss nor social support. Assessments occurred at baseline, treatment weeks 4 and 8, post-treatment, and 3 and 6 months after the end of treatment. IPT was feasible and acceptable in this population. Although some participants were initially hesitant to discuss their losses in a group (as occurred in IPT but not CWD), end of treatment satisfaction scores were significantly (p = 0.001) higher in IPT than in CWD. Confidence intervals around between-groups effect sizes favored IPT for reductions in depressive symptoms during treatment as well as for improvement in mode-specific targets (social support, grief symptoms) and recovery from a post-traumatic stress disorder over follow-up. This group IPT treatment adapted for MDD after perinatal loss is feasible, acceptable, and possibly efficacious.
这项随机对照试验研究了一种针对围产期丧失(流产、死产或早期新生儿死亡)后重度抑郁症(MDD)的适应性人际心理治疗(IPT)的可行性、可接受性和初步疗效。50名在过去18个月内经历围产期丧失、当前抑郁发作在丧失期间或之后开始的女性被随机分为接受针对围产期丧失的团体IPT组(可通过联系前两位作者中的任何一位免费获得为本研究制定的《围产期丧失后重度抑郁症团体IPT手册》)或应对抑郁症组(CWD),后者是一种不关注围产期丧失和社会支持的认知行为治疗。评估在基线、治疗第4周和第8周、治疗后以及治疗结束后3个月和6个月进行。IPT在该人群中是可行且可接受的。尽管一些参与者最初对在团体中讨论他们的丧失有所犹豫(如在IPT组中出现但在CWD组中未出现),但治疗结束时IPT组的满意度得分显著高于CWD组(p = 0.001)。组间效应量的置信区间表明,在治疗期间IPT组在减轻抑郁症状以及改善特定模式目标(社会支持、悲伤症状)和随访期间从创伤后应激障碍中恢复方面更具优势。这种针对围产期丧失后MDD的团体IPT治疗是可行、可接受且可能有效的。