University of Toronto, Department of Psychiatry, Canada; Division of Child and Youth Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
University of Toronto, Department of Psychiatry, Canada; Campbell Family Mental Health Research Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Asian J Psychiatr. 2018 Oct;37:112-120. doi: 10.1016/j.ajp.2018.08.014. Epub 2018 Aug 17.
Perinatal depression has been associated with infant low birth weight and with multiple health indicators affecting childhood morbidity and mortality. The condition is twice as prevalent in low and middle-income countries (LMICs) compared to high-income countries but poorly studied.
To conduct a review of published literature on interventions for perinatal depression in LMICs.
A search of the literature was performed for articles published up to October 2017. The key inclusion criteria were peer-reviewed studies focusing on interventions for perinatal depression during pregnancy and/or up to one-year postpartum.
1088 citations were retrieved, of which 18 studies with representation from countries in Africa, Asia, North America (Mexico) and South America were included. The majority of interventions were conducted in lower-income settings. Most were psychosocial in nature and often provided by lay health workers and in the community. Interventions integrated as part of general health programs and employing psychotherapeutic approaches were more effective and were also preferred. Only one study incorporated the use of psychiatric medications.
Despite the limited publications, there is reasonable evidence for the benefit of psychological interventions in perinatal depression in LMICs. More research is needed to verify and extend these results and, in particular, to evaluate the benefit of adjunctive medications when treating moderate to severe depression and whether interventions can increase social supports.
围产期抑郁与婴儿低出生体重以及影响儿童发病率和死亡率的多个健康指标有关。与高收入国家相比，中低收入国家（LMICs）的围产期抑郁发病率高出一倍，但研究不足。
对中低收入国家围产期抑郁干预措施的已发表文献进行综述。
对截至 2017 年 10 月的文献进行检索。主要纳入标准为针对妊娠期间和/或产后一年期间围产期抑郁的干预措施的同行评审研究。
共检索到 1088 条引文，其中纳入了来自非洲、亚洲、北美（墨西哥）和南美洲国家的 18 项研究。大多数干预措施在低收入环境中进行。大多数为心理社会性质，通常由非专业卫生工作者在社区中提供。作为一般卫生项目的一部分并采用心理治疗方法的干预措施更有效，也更受欢迎。只有一项研究纳入了使用精神科药物。
尽管出版物有限，但有合理的证据表明心理干预措施对中低收入国家围产期抑郁有益。需要进一步研究来验证和扩展这些结果，特别是评估在治疗中重度抑郁时辅助药物的益处，以及干预措施是否可以增加社会支持。
