Shi Zhenrong, MacBeth Angus
Clinical and Health Psychology, School of Health in Social Science, Old Medical Quad, University of Edinburgh, Scotland, UK.
Mindfulness (N Y). 2017;8(4):823-847. doi: 10.1007/s12671-016-0673-y. Epub 2017 Jan 19.
Presenting with common mental health difficulties, particularly depression and anxiety, there is also preliminary evidence that mindfulness-based interventions (MBIs) including mindfulness-based cognitive therapy (MBCT), mindfulness-based stress reduction (MBSR) and integrated mindfulness yoga practices may also be effective in reducing common mental health difficulties during pregnancy. We systematically reviewed and synthesized the current literature on the effectiveness of MBIs in reducing severity of perinatal anxiety and depression. Databases including PubMed, Cochrane Library, IndMED and PsychoInfo were searched for relevant studies. Manual searches were conducted in relevant articles and Google Scholar. Seventeen cohorts representing 18 studies were included. Pre-post effect sizes were reported for both treatment and control groups. Seven randomized controlled trials (RCTs), two non-randomized controlled trials and nine treatment evaluations were included. Maternal participation in an MBI was associated with reductions in perinatal anxiety of moderate to large magnitude. Results for the effect of MBIs on depression were less consistent, with pre-post treatment reductions of moderate magnitude, but no significant differences in depression scores when MBI was compared with a control group. There was some evidence that MBIs were associated with increased mindfulness. Risk of bias in studies was variable. Our review offers preliminary evidence for the effectiveness of MBIs in reducing perinatal anxiety, with more equivocal findings with regard to perinatal depressive symptoms. Further methodologically rigorous evaluation using RCTs and longer follow-up periods are recommended.
患有常见心理健康问题，尤其是抑郁症和焦虑症的孕妇，也有初步证据表明，包括正念认知疗法（MBCT）、正念减压疗法（MBSR）和综合正念瑜伽练习在内的基于正念的干预措施（MBIs），在减轻孕期常见心理健康问题方面可能也有效。我们系统地回顾并综合了关于MBIs在减轻围产期焦虑和抑郁严重程度方面有效性的现有文献。检索了包括PubMed、Cochrane图书馆、IndMED和PsychoInfo在内的数据库以查找相关研究。还在相关文章和谷歌学术上进行了手动检索。纳入了代表18项研究的17个队列。报告了治疗组和对照组的前后效应大小。纳入了7项随机对照试验（RCT）、2项非随机对照试验和9项治疗评估。母亲参与MBI与围产期焦虑程度的中度至大幅降低有关。MBIs对抑郁症影响的结果不太一致，治疗前后抑郁症程度有中度降低，但将MBI与对照组相比时，抑郁症评分没有显著差异。有一些证据表明MBIs与正念增强有关。研究中的偏倚风险各不相同。我们的综述为MBIs在减轻围产期焦虑方面的有效性提供了初步证据，而对于围产期抑郁症状的研究结果则更具争议性。建议使用RCT进行进一步方法学严谨的评估，并延长随访期。
