Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
Department of Obstetrics & Gynecology, Columbia University Irving Medical Center, New York, NY, USA.
Arch Womens Ment Health. 2021 Jun;24(3):367-380. doi: 10.1007/s00737-020-01066-4. Epub 2020 Oct 10.
Women who have experienced childhood trauma (CT) are at increased risk for depression during pregnancy and postpartum, pregnancy complications, and adverse child outcomes. There are effective psychotherapeutic interventions to treat depression during pregnancy and postpartum, yet there is a paucity of literature on the impact of CT on treatment outcomes. This review aims to determine whether and how maternal CT history affects the outcomes of psychological interventions for depression during pregnancy and postpartum. PubMed, PsycINFO, and Cochrane Library searches were conducted to identify papers on psychological interventions designed to treat depression during pregnancy and postpartum in women with CT. Seven manuscripts, describing six studies, met the inclusion criteria (N = 1234). Three studies utilized core principles of interpersonal psychotherapy (IPT). Two studies investigated interventions based on cognitive behavioral therapy (CBT). One study was based on a psychoeducation component. Results suggest that IPT-based interventions are beneficial for women with CT. The evidence regarding CBT-based interventions is less conclusive. This review is written in light of the paucity of research addressing the question systematically. The Childhood Trauma Questionnaire (CTQ) was the main measure used to assess CT. Trauma related to accidents, illness, and political violence was not included. The results are only applicable to interventions based on either IPT or CBT and cannot be generalized to other forms of psychotherapy. Psychotherapeutic interventions are beneficial for depressed women with history of CT during pregnancy and postpartum; however, further systematic research is needed.
经历过儿童期创伤（CT）的女性在怀孕期间和产后患抑郁症、妊娠并发症和不良儿童结局的风险增加。有有效的心理治疗干预措施可以治疗怀孕期间和产后的抑郁症，但关于 CT 对治疗结果的影响的文献却很少。本综述旨在确定 CT 病史是否以及如何影响针对怀孕期间和产后抑郁症的心理干预措施的结果。我们对 PubMed、PsycINFO 和 Cochrane Library 进行了检索，以确定针对 CT 女性的旨在治疗怀孕期间和产后抑郁症的心理干预措施的论文。有七篇论文，描述了六项研究，符合纳入标准（N=1234）。三项研究采用了人际心理治疗（IPT）的核心原则。两项研究调查了基于认知行为疗法（CBT）的干预措施。一项研究基于心理教育组成部分。结果表明，基于 IPT 的干预措施对 CT 女性有益。基于 CBT 的干预措施的证据不太确定。本综述是根据系统地解决该问题的研究较少而编写的。童年创伤问卷（CTQ）是主要用于评估 CT 的测量工具。未包括与事故、疾病和政治暴力有关的创伤。结果仅适用于基于 IPT 或 CBT 的干预措施，不能推广到其他形式的心理治疗。心理治疗干预措施对有 CT 病史的怀孕期间和产后抑郁女性有益；然而，还需要进一步的系统研究。
