Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.
Department of Psychology, Lund University, Lund, Sweden.
Infant Ment Health J. 2021 Jan;42(1):109-123. doi: 10.1002/imhj.21893. Epub 2020 Nov 6.
Randomized controlled trials (RCTs) demonstrate efficacy of parent-infant psychotherapy, but its applicability and effectiveness in public health care are less known. The method followed is Naturalistic study evaluating Short-term Psychodynamic Infant-Parent Interventions at Child Health Centers (SPIPIC) in Stockholm, Sweden. One hundred distressed mothers with infants were recruited by supervised nurses. Six therapists provided 4.3 therapy sessions on average (SD = 3.3). Sessions typically included the mothers, often with the baby present, while fathers rarely attended sessions. The Edinburgh Postnatal Depression Scale (EPDS) and the Ages and Stages Questionnaire: Social-Emotional (ASQ: SE) were distributed at baseline and at 3 and 9 months later. Data from a nonclinical group were collected simultaneously to provide norm data. Multilevel growth models on the mothers' questionnaire scores showed significant decreases over time on both measures. Nine months after baseline, 50% achieved a reliable change on the EPDS and 14% on the ASQ: SE. Prepost effect-sizes (d) were 0.70 and 0.40 for EPDS and ASQ: SE, figures that are comparable to results of other controlled studies. Psychotherapists integrated with public health care seem to achieve good results when supporting distressed mothers with brief interventions in the postnatal period. SPIPIC needs to be compared with other modalities and organizational frameworks.
随机对照试验 (RCT) 证明了父母-婴儿心理治疗的疗效,但它在公共卫生保健中的适用性和有效性知之甚少。本研究采用自然主义研究方法,评估了瑞典斯德哥尔摩儿童健康中心的短期心理动力学婴儿-父母干预 (SPIPIC)。100 名有困扰的母亲和她们的婴儿通过监督护士招募。6 名治疗师平均提供 4.3 次治疗课程(SD=3.3)。治疗通常包括母亲,通常有婴儿在场,而父亲很少参加治疗。研究在基线时以及 3 个月和 9 个月后使用爱丁堡产后抑郁量表 (EPDS) 和年龄与阶段问卷:社会情感 (ASQ: SE) 进行评估。同时收集非临床组的数据以提供正常数据。母亲问卷评分的多层次增长模型显示,两种测量方法的得分随时间显著下降。与基线相比,9 个月后,50%的人在 EPDS 上达到可靠的变化,14%的人在 ASQ: SE 上达到可靠的变化。EPDS 和 ASQ: SE 的前后效应量(d)分别为 0.70 和 0.40,与其他对照研究的结果相当。精神治疗师与公共卫生保健相结合,在产后期间为有困扰的母亲提供简短干预似乎可以取得良好的效果。SPIPIC 需要与其他模式和组织框架进行比较。