School of nursing, Xi'an Jiaotong University, 76 West Yanta Road, 710061 Xi'an, China.
School of Public Health, Xi'an Jiaotong University, Xi'an, China.
J Affect Disord. 2020 Jun 15;271:310-327. doi: 10.1016/j.jad.2020.03.019. Epub 2020 Apr 6.
The prevalence of perinatal depression is 16.3% in China and has shown a rising trend in the last decade. However, few studies summarized psychosocial interventions for perinatal depression in this country. This study aimed at evaluating and characterizing psychosocial interventions for perinatal depression in Mainland China.
Ten major English and Chinese language electronic bibliographic databases were searched for RCTs examining the effect of psychosocial interventions for perinatal depressed women in Mainland China. Studies meeting eligibility criteria and published before 25th February 2019 were included, while those focusing on a very specific sub-population or reporting non-psychosocial interventions were excluded. Data was extracted by a standard form. Meta-analysis was conducted to obtain a summary measure of the effectiveness of the interventions in reducing perinatal depressive symptoms. The theoretical underpinnings and implementation processes of the interventions were also characterised.
A total of 6857 articles were identified in the initial database searching, of which, 26 studies were eligible for data analysis, representing a sample size of 4673. Meta-analysis indicated that psychosocial interventions in China significantly reduced perinatal depressive symptoms (standard difference in means 0.81, 95% confidence intervals -1.03 to -0.58, P < 0.001). However, the overall evidence presented substantial heterogeneity (I = 91.12%). Most interventions were implemented in hospitals in urban areas by non-specialist health care providers. Few studies reported details of implementation procedures or scale-up strategies.
The evidence in this review is of moderate to low quality and therefore, should be interpreted with caution. Some of the trials were inadequately powered and tended to overestimate effect sizes.
Current psychosocial interventions in China are somewhat effective in reducing perinatal depressive symptoms. High quality RCTs on scale-up interventions are required, especially in rural areas.
中国围产期抑郁症的患病率为 16.3%，在过去十年中呈上升趋势。然而，很少有研究总结中国围产期抑郁症的心理社会干预措施。本研究旨在评估和描述中国大陆围产期抑郁症的心理社会干预措施。
检索了 10 个主要的英文和中文电子文献数据库，以寻找评估中国大陆围产期抑郁女性心理社会干预效果的 RCT。纳入符合入选标准且发表于 2019 年 2 月 25 日之前的研究，排除仅关注特定亚人群或报告非心理社会干预的研究。使用标准表格提取数据。Meta 分析用于获得干预措施降低围产期抑郁症状的有效性综合衡量指标。还对干预措施的理论基础和实施过程进行了描述。
最初在数据库中搜索到了 6857 篇文章，其中 26 项研究符合数据分析条件，代表 4673 名研究对象。Meta 分析表明，中国的心理社会干预显著降低了围产期抑郁症状（均数差值 0.81，95%置信区间 -1.03 至 -0.58，P < 0.001）。然而，整体证据存在较大的异质性（I = 91.12%）。大多数干预措施由非专科医疗保健提供者在城市医院实施。很少有研究报告实施程序或扩大规模策略的详细信息。
本综述中的证据质量为中等至较低，因此应谨慎解释。一些试验的效力不足，往往高估了效应大小。
目前中国的心理社会干预措施在一定程度上有效降低了围产期抑郁症状。需要开展关于扩大干预措施的高质量 RCT，特别是在农村地区。
