Department of Psychiatry (Lawson, Dalfen) and Department of Obstetrics and Gynaecology (Murphy, Milligan), Mount Sinai Hospital, Toronto; Department of Psychiatry (Lawson, Dalfen, Lancee) and Department of Obstetrics and Gynaecology (Murphy, Milligan), University of Toronto, Toronto.
Psychiatr Serv. 2019 May 1;70(5):389-395. doi: 10.1176/appi.ps.201800269. Epub 2019 Feb 5.
The objective of this study was to evaluate the feasibility of using text messages to enhance mental health screening and education of women in the immediate postpartum period.
A total of 937 postpartum women were recruited from an obstetrics and gynecology clinic of a large urban hospital. Participants received a text message containing a two-question screen for postpartum depression every two weeks and three text messages per week about postpartum mental health for the first 12 weeks postpartum. Those who screened positive were administered the Edinburgh Postnatal Depression Scale. They were matched with a subset of women who were also assessed with the Edinburgh Postnatal Depression Scale after screening negative for depression with the text messaging screen. At 12 to 13 weeks postpartum, all participants received an online survey assessing satisfaction with the text messages.
Of 937 participants, 126 (13%) screened positive. Agreement between the texted screen and the Edinburgh Postnatal Depression Scale was moderate (κ=0.45), with good sensitivity (0.90, 95% confidence interval [95% CI]=0.81-0.96) and specificity (0.82, 95% CI=0.79-0.85). Nine hundred thirty (99%) participants responded to at least one of the six texted screens, whereas 632 (67%) responded to all six. Of the 589 (63%) who responded to the satisfaction survey, 459 (78%) recommended that all women be screened for postpartum depression via text messaging and that all women in the postpartum period be sent information texts about postpartum depression (N=504, 91%).
Using text messaging technology to screen women for postpartum depression and provide information on postpartum mental health appears to be sensitive, feasible, and well accepted.
本研究旨在评估使用短信来增强产后女性心理健康筛查和教育的可行性。
共有 937 名产后妇女从一家大型城市医院的妇产科诊所招募。参与者每两周收到一条包含两个问题的产后抑郁症筛查短信，在产后前 12 周每周收到三条关于产后心理健康的短信。筛查阳性者接受爱丁堡产后抑郁量表评估。他们与另一组通过短信筛查无抑郁的女性进行匹配，这些女性也接受了爱丁堡产后抑郁量表评估。产后 12 至 13 周，所有参与者都收到了一份在线调查，评估对短信的满意度。
在 937 名参与者中，有 126 人（13%）筛查阳性。短信筛查与爱丁堡产后抑郁量表之间的一致性为中度（κ=0.45），具有较高的敏感性（0.90，95%置信区间[95%CI]=0.81-0.96）和特异性（0.82，95%CI=0.79-0.85）。930 名（99%）参与者至少回复了六条短信中的一条，而 632 名（67%）参与者回复了全部六条。在 589 名（63%）回复满意度调查的参与者中，有 459 名（78%）建议通过短信对所有女性进行产后抑郁症筛查，建议向所有产后女性发送有关产后抑郁症的信息短信（N=504，91%）。
使用短信技术对女性进行产后抑郁症筛查和提供产后心理健康信息似乎具有敏感性、可行性和良好的可接受性。
