NHS Foundation Trust, Liverpool Women's Hospital , Liverpool , UK.
Institute of Psychology Health and Society, University of Liverpool , Liverpool , UK.
J Psychosom Obstet Gynaecol. 2019 Dec;40(4):250-263. doi: 10.1080/0167482X.2018.1512577. Epub 2018 Sep 11.
Poor maternal mental health during the perinatal period has been shown to have potentially long-lasting effects for mother and child. In recognition of this, maternal mental health is receiving increased attention from political and healthcare organizations, with a growing focus on preventing the onset of common mental health disorders. The objective for this review is to provide an update of randomized controlled trials examining the use of interventions targeted to prevent the onset of postnatal depression and anxiety in nondiagnostic populations with universal or selected samples. A total of four databases, EBSCO Host, Science Direct, Scopus, and Web of Science, incorporating PsychINFO were searched and papers selected according to clearly specified inclusion criteria. A large Health Technology review was published in 2016, for which the final search was conducted in December 2012. Therefore inclusion criteria were studies published from January 2013 onwards, available in English language, had a focus on prevention of postnatal maternal depression and anxiety, and used psychological interventions. Drug intervention trials were excluded. 12 studies were identified as examining antenatal or postnatal intervention trials with an aim of preventing maternal postnatal depression and/or anxiety. There continues to be limited evidence to recommend specific prevention strategies for universal samples without further testing. There is evidence to suggest the use of rational-emotive behavioral therapy in an antenatal sample may have some utility, and the use of psychotherapy-based interventions in a postnatal setting is also supported although both require further investigation. Additionally, there is a need to gather information on acceptability, as many trials were hindered by poor adherence to interventions and high attrition that were otherwise unexplained.
围产期产妇心理健康状况不佳已被证明对母婴都有潜在的长期影响。鉴于此，产妇心理健康受到政治和医疗保健组织的日益关注，越来越关注预防常见精神疾病的发生。本次综述的目的是提供最新的随机对照试验，评估针对普遍性或选择性样本中无诊断人群预防产后抑郁和焦虑发生的干预措施的使用。共检索了 4 个数据库，EBSCOHost、Science Direct、Scopus 和 Web of Science，其中包含 PsychINFO，并根据明确规定的纳入标准选择论文。2016 年发表了一项大型卫生技术评价，最后一次检索是在 2012 年 12 月进行的。因此，纳入标准是 2013 年 1 月以后发表的、英文发表的、关注预防产后产妇抑郁和焦虑的研究，并使用心理干预措施。排除药物干预试验。确定了 12 项研究，这些研究检查了产前或产后干预试验，目的是预防产妇产后抑郁和/或焦虑。在没有进一步测试的情况下，仍然没有足够的证据推荐针对普遍性样本的特定预防策略。有证据表明，在产前样本中使用理性情绪行为疗法可能具有一定的效用，在产后环境中使用基于心理治疗的干预措施也得到支持，尽管这两种方法都需要进一步研究。此外，需要收集可接受性方面的信息，因为许多试验因干预措施的依从性差和无法解释的高脱落率而受阻。
