Clinical Research Unit for Anxiety and Depression (CRUfAD), UNSW School of Psychiatry, Level 4, O'Brien Centre, St Vincent's Hospital, 394 Victoria Street, Sydney, New South Wales, 2010, Australia.
School of Psychiatry, University of New South Wales, Sydney, Australia.
Arch Womens Ment Health. 2019 Dec;22(6):737-750. doi: 10.1007/s00737-019-00961-9. Epub 2019 May 17.
Perinatal anxiety and depression are common and associated with negative outcomes if left untreated. Internet-delivered treatments can improve treatment accessibility and have demonstrated effectiveness in treating anxiety and depression in the general adult population. However, little is known about how effective and acceptable these interventions are for perinatal women. This paper describes a systematic review and preliminary meta-analysis of internet-delivered psychological interventions for the treatment of clinical anxiety and depression in perinatal women. A systematic search was carried out of seven electronic databases. Seven studies evaluating six distinct internet-delivered psychological interventions were identified. Of the seven studies included, two were open trials and five were randomized controlled trials with a total of 595 participants. Preliminary findings indicate large improvements in depression (Hedges g = 1.67; 95% CI 1.38-1.96) and anxiety (Hedges g = 1.08; 95% CI 0.80-1.36) from pre- to post-treatment. However, between-group differences between interventions and control conditions were only moderate for depression (Hedges g = 0.60; 95% CI 0.43-0.78) and anxiety (Hedges g = 0.54; 95% CI 0.24-0.85). While our preliminary findings are promising, this review identifies an area of research still in its early stages with significant gaps in the literature that need to be addressed. Further research is needed to establish the efficacy and acceptability of these interventions in this population, especially for antenatal depression and anxiety disorders.
围产期焦虑和抑郁很常见,如果不加以治疗,会产生不良后果。互联网提供的治疗方法可以提高治疗的可及性,并已证明在治疗普通成年人群的焦虑和抑郁方面是有效的。然而,对于围产期女性来说,这些干预措施的有效性和可接受性还知之甚少。本文描述了一项针对围产期女性临床焦虑和抑郁的互联网心理干预治疗的系统评价和初步荟萃分析。系统地检索了七个电子数据库。确定了七项评估六种不同互联网心理干预措施的研究。在纳入的七项研究中,两项为开放试验,五项为随机对照试验,共有 595 名参与者。初步研究结果表明,从治疗前到治疗后,抑郁(Hedges g=1.67;95%置信区间 1.38-1.96)和焦虑(Hedges g=1.08;95%置信区间 0.80-1.36)有显著改善。然而,干预组与对照组之间的差异仅在抑郁(Hedges g=0.60;95%置信区间 0.43-0.78)和焦虑(Hedges g=0.54;95%置信区间 0.24-0.85)方面为中度。虽然我们的初步研究结果令人鼓舞,但本综述确定了一个仍处于早期阶段的研究领域,该领域的文献存在重大空白,需要加以解决。需要进一步的研究来确定这些干预措施在该人群中的疗效和可接受性,特别是针对产前抑郁和焦虑障碍。