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孕产妇抑郁症与早期干预:呼吁整合服务。

Maternal Depression and Early Intervention: A Call for an Integration of Services.

作者信息

Alvarez Shanna L, Meltzer-Brody Samantha, Mandel Marcia, Beeber Linda

机构信息

University of Washington.

University of North Carolina Chapel Hill.

出版信息

Infants Young Child. 2015 Jan-Mar;28(1):72-87. doi: 10.1097/IYC.0000000000000024.

Abstract

Depression is a serious disorder with severe and far-reaching consequences. Two decades of observational research have shown robust associations between maternal depression and adverse consequences on offspring (Campbell et al., 2004; Campbell, Matestic, von Stauffenberg, Mohan, & Kirchner, 2007; Campbell, Morgan-Lopez, Cox, & McLoyd, 2009; National Research Council & Institute of Medicine, 2009). Depressive symptoms may pose particular risk to infants and toddlers with neurodevelopmental disabilities, whose long-term outcomes depend heavily on the provision of Early Intervention (EI). EI is most effective with active parental engagement. Maternal depressive symptoms may reduce parental engagement, thereby limiting EI benefits to the child (Gaynes, Gavin & Meltzer -Brody, 2005; O'Hara & Swain, 1996). At present, maternal mental health is not directly addressed in EI. The purpose of this paper is to discuss the literature and significance of maternal depression and apply that evidence to mothers of children with developmental delays and disabilities. We conclude that maternal mental health and well-being is currently insufficiently addressed in the EI population. An increased integration of mental health and EI services is needed to serve the unique needs of families who face an increased risk of stress and depression while coping with their child's special needs.

摘要

抑郁症是一种严重的疾病,会产生严重且影响深远的后果。二十年的观察性研究表明,母亲患抑郁症与对子女产生的不良后果之间存在紧密联系(坎贝尔等人,2004年;坎贝尔、马泰斯蒂克、冯·施陶芬贝格、莫汉和基尔希纳,2007年;坎贝尔、摩根-洛佩斯、考克斯和麦克洛伊德,2009年;国家研究委员会和医学研究所,2009年)。抑郁症状可能会给患有神经发育障碍的婴幼儿带来特别的风险,这些孩子的长期预后在很大程度上取决于早期干预(EI)的提供情况。早期干预在家长积极参与时最为有效。母亲的抑郁症状可能会减少家长的参与度,从而限制了早期干预对孩子的益处(盖恩斯、加文和梅尔策-布罗迪,2005年;奥哈拉和斯温,1996年)。目前,早期干预并未直接关注母亲的心理健康。本文的目的是探讨有关母亲抑郁症的文献及其重要性,并将这些证据应用于发育迟缓或残疾儿童的母亲。我们得出结论,目前早期干预人群对母亲的心理健康和幸福关注不足。需要加强心理健康与早期干预服务的整合,以满足那些在应对孩子特殊需求时面临压力和抑郁风险增加的家庭的独特需求。

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