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伊朗卡尚市精神干预对孕妇心理健康效果的调查:一项临床试验研究。

Investigation of the effectiveness of psychiatric interventions on the mental health of pregnant women in Kashan City - Iran: A clinical trial study.

机构信息

Psychosomatic Medicine Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran.

Department of Epidemiology and Statistics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran.

出版信息

Asian J Psychiatr. 2019 Dec;46:79-86. doi: 10.1016/j.ajp.2019.09.036. Epub 2019 Oct 1.

Abstract

AIM

Pregnancy is one of the most sensitive periods in a person's life; therefore maternal mental illness during pregnancy increases the risk for adverse developmental outcomes in children (Jha et al., 2018). The aim of this study was to determine the effectiveness of psychiatric interventions in the mental health of pregnant women in Kashan, Iran.

METHODS

The purpose of this clinical trial was to evaluate an integrated model of mental health during pregnancy over the period of 2015-2018 in Kashan. Subjects consisted in 202 pregnant women (101 in the intervention group and 101 in the control group) who were referred to Kashan Health Centers in the 6th to 10th weeks of pregnancy. The General Health Questionnaire-28, Golombok Rust Inventory of Marital State, an interview on psychiatric symptoms, and a review of the history of the mental health of the mother and first-degree relatives were utilized for data collection. In the intervention group, psychiatric measures and predictive drug treatments were presented.

RESULTS

Overall, from among 102 pregnant mothers, 39 women (37.14%) were identified as at-risk and high-risk. The highest number of mothers identified as at-risk and high-risk were in the first trimester of pregnancy and in the 6th to 10th weeks of care (64%). With the start of psychiatric interventions in the intervention group, the subscale of physical complaints and anxiety showed a significant decrease compared to the control group (P < 0.01). Mental health improvement was achieved in 95% of expectant mothers through Level I predictive measures, and only 5% of participants required the specialist level of intervention.

CONCLUSION

By identifying psychiatric disorders in pregnant mothers during the first level of pregnancy care services and taking suitable measures, an integrated model for mental health services in primary health care for pregnant women can help managers, policymakers, and decision-makers to improve health and reduce the costs in the health system in order to achieve the Sustainable Development Goals.

摘要

目的

妊娠是人生中最敏感的时期之一;因此,孕妇在妊娠期的精神疾病会增加儿童发育不良的风险(Jha 等人,2018)。本研究旨在确定伊朗卡尚的精神科干预措施对孕妇心理健康的有效性。

方法

本临床试验旨在评估 2015 年至 2018 年期间卡尚孕妇心理健康的综合模式。研究对象包括 202 名孕妇(干预组 101 名,对照组 101 名),她们在妊娠第 6 至 10 周被转诊到卡尚保健中心。采用一般健康问卷-28、Golombok Rust 婚姻状况量表、精神症状访谈和母亲及一级亲属心理健康史回顾收集数据。在干预组中,进行了精神科措施和预测性药物治疗。

结果

总体而言,在 102 名孕妇中,有 39 名(37.14%)被确定为高危和极高危。高危和极高危孕妇数量最多的是妊娠早期和第 6 至 10 周的护理期(64%)。随着干预组开始进行精神科干预,身体投诉和焦虑的子量表与对照组相比显著下降(P<0.01)。通过一级预测措施,95%的孕妇的心理健康得到改善,只有 5%的参与者需要专家级别的干预。

结论

通过在妊娠初级保健服务的第一级识别孕妇的精神疾病并采取适当措施,可为初级保健的孕妇心理健康服务建立一个综合模式,帮助管理者、政策制定者和决策者改善健康并降低医疗体系成本,以实现可持续发展目标。

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