Seghete Kristen L Mackiewicz, Graham Alice M, Shank Taylor M, Alsup Shelby L, Fisher Philip A, Wilson Anna C, Ewing Sarah W Feldstein
Department of Psychiatry, Oregon Health & Science University, Portland, OR.
School of Graduate Psychology, Pacific University, Hillsboro, OR.
Curr Addict Rep. 2020 Mar;7(1):61-67. doi: 10.1007/s40429-020-00296-x. Epub 2020 Jan 28.
This review examines how research focused on treatment for opioid use in perinatal populations and preventive interventions for postpartum psychopathology have remained separate, despite significant overlap.
Guidelines for best practice in caring for pregnant women with opioid use disorder suggest the use of medication-assisted treatment with additional comprehensive care, including behavioral and mental health interventions. However, intervention research often mutually excludes these two populations, with studies of behavioral interventions for opioid use excluding women with psychopathology and research on preventive interventions for postpartum psychopathology excluding women who are substance using.
There is a limited evidence-base to inform the selection of appropriate preventive interventions for pregnant women with opioid use disorder that can address opioid use and/or treatment adherence and concurrent mental health risks. We argue it is critical to integrate research on pregnant women who are opioid using and preventive perinatal mental health interventions to catalyze pivotal change in how we address the opioid epidemic within this growing population.
本综述探讨了尽管存在显著重叠，但专注于围产期人群阿片类药物使用治疗的研究与产后精神病理学预防干预措施为何一直相互独立。
针对患有阿片类药物使用障碍的孕妇的最佳护理实践指南建议采用药物辅助治疗并辅以全面护理，包括行为和心理健康干预。然而，干预研究往往相互排斥这两类人群，阿片类药物使用行为干预研究将患有精神病理学的女性排除在外，而产后精神病理学预防干预研究则将使用药物的女性排除在外。
对于患有阿片类药物使用障碍的孕妇，可供选择的合适预防干预措施十分有限，这些措施需能解决阿片类药物使用和/或治疗依从性以及并发心理健康风险问题。我们认为，将针对使用阿片类药物的孕妇的研究与围产期心理健康预防干预措施相结合至关重要，以推动我们在这一不断增长的人群中应对阿片类药物流行问题的关键变革。
