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正念认知疗法团体干预作为产后抑郁和焦虑的辅助治疗的可行性。

Feasibility of a mindfulness-based cognitive therapy group intervention as an adjunctive treatment for postpartum depression and anxiety.

机构信息

Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.

Reproductive Mental Health Program, BC Children's Hospital, Mental Health Building P1-228 - 4500 Oak Street Vancouver, British Columbia, Canada V6H3N1.

出版信息

J Affect Disord. 2018 Aug 1;235:61-67. doi: 10.1016/j.jad.2017.12.065. Epub 2018 Jan 2.

Abstract

BACKGROUND

Many women experience moderate-to-severe depression and anxiety in the postpartum period for which pharmacotherapy is often the first-line treatment. Many breastfeeding mothers are reticent to increase their dose or consider additional medication, despite incomplete response, due to potential adverse effects on their newborn. These mothers are amenable to non-pharmacological intervention for complete symptom remission. The current study evaluated the feasibility of an eight-week mindfulness-based cognitive therapy (MBCT) intervention as an adjunctive treatment for postpartum depression and anxiety.

METHODS

Women were recruited at an outpatient reproductive mental health clinic based at a maternity hospital. Participants had a diagnosis of postpartum depression/anxiety within the first year following childbirth. They were enrolled in either the MBCT intervention group (n = 14) or the treatment-as-usual control group (n = 16), and completed the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7) questionnaire, and the Mindful Attention Awareness Scale (MAAS) at baseline and at 4 weeks, 8 weeks, and 3 months following baseline.

RESULTS

Multivariate analyses demonstrated that depression and anxiety levels decreased, and mindfulness levels increased, in the MBCT group, but not in the control group. Many of the between-group and over time comparisons displayed trends towards significance, although these differences were not always statistically significant. Additionally, the effect sizes for anxiety, depression, and mindfulness were frequently large, indicating that the MBCT intervention may have had a clinically significant effect on participants.

LIMITATIONS

Limitations include small sample size and the non-equivalent control group design.

CONCLUSIONS

We demonstrated that MBCT has potential as an adjunctive, non-pharmacological treatment for postpartum depression/anxiety that does not wholly remit with pharmacotherapy. (249 words).

摘要

背景

许多女性在产后期间会经历中度至重度的抑郁和焦虑,药物治疗通常是首选治疗方法。许多哺乳期母亲由于担心对新生儿产生潜在的不良反应,即使治疗反应不完全,也不愿增加剂量或考虑额外的药物治疗。这些母亲愿意接受非药物干预以实现完全症状缓解。本研究评估了为期八周的正念认知疗法(MBCT)干预作为产后抑郁和焦虑的辅助治疗的可行性。

方法

研究人员在一家妇产医院的门诊生殖心理健康诊所招募了参与者。这些参与者在产后一年内被诊断出患有产后抑郁/焦虑症。他们被纳入正念认知疗法干预组(n=14)或常规治疗对照组(n=16),并在基线以及基线后 4 周、8 周和 3 个月时完成了患者健康问卷-9(PHQ-9)、广泛性焦虑障碍-7(GAD-7)问卷和正念注意意识量表(MAAS)。

结果

多变量分析表明,MBCT 组的抑郁和焦虑水平下降,正念水平升高,但对照组则没有。许多组间和随时间的比较显示出趋势,但这些差异并不总是具有统计学意义。此外,焦虑、抑郁和正念的效应大小经常较大,表明 MBCT 干预可能对参与者具有临床意义。

局限性

局限性包括样本量小和非等效对照组设计。

结论

我们证明了 MBCT 作为一种辅助性的、非药物治疗方法,对那些不完全缓解的产后抑郁/焦虑症有潜在的治疗作用,这些患者的药物治疗效果不完全。(249 个单词)

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