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心理干预在围产期抑郁治疗中的效果:系统评价和荟萃分析的系统综述。

Effectiveness of psychological interventions in the treatment of perinatal depression: A systematic review of systematic reviews and meta-analyses.

机构信息

University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Coimbra, Portugal.

Faculty of Psychology, Universidad Nacional de Educación a Distancia, Spain.

出版信息

J Affect Disord. 2021 Aug 1;291:294-306. doi: 10.1016/j.jad.2021.05.010. Epub 2021 May 13.

Abstract

BACKGROUND

Perinatal depression is a high prevalent mental health problem with serious consequences. Evidence about effective psychological interventions in treating perinatal depression has been increasing, but it lacks a comprehensive synthesis of findings.

METHODS

A systematic review of systematic reviews and meta-analyses concerning the effectiveness of psychological interventions in treating perinatal depression (depression during pregnancy and the first 12 months postpartum) in adult women was conducted. The electronic databases MEDLINE (PubMed), PsycINFO, The Cochrane Library, Web of Science and Prospero were searched, on May 2020, using a combination of keywords. Data were independently extracted by two authors and a synthesis of the results was presented. Methodological quality was independently assessed by two authors, using AMSTAR-2.

RESULTS

Seven systematic reviews were included and reported, overall, the effectiveness of psychological interventions in decreasing depressive symptoms in women in the perinatal period, both short and long-term. CBT was found to be the most effective intervention, regardless of the treatment format.

LIMITATIONS

Grey literature was not searched, and some studies may overlap among the included systematic reviews. These (the included reviews) were rated with low methodological quality, which weakens the evidence of the reported results.

CONCLUSIONS

CBT is currently the most evidence-based psychological intervention, provided in different delivery formats (individual, group, face-to-face or Internet-based). Further studies, including systematic reviews, with other types of psychological interventions (e.g., third-wave CBT) and with higher quality are needed.

摘要

背景

围产期抑郁症是一种高发的心理健康问题,后果严重。关于治疗围产期抑郁症(孕期和产后 12 个月内的抑郁症)的有效心理干预措施的证据不断增加,但缺乏对这些发现的综合综合分析。

方法

对治疗围产期抑郁症(孕期和产后 12 个月内的抑郁症)的成人女性有效心理干预措施(包括认知行为疗法(CBT)、人际心理疗法(IPT)、问题解决疗法(PS)、正念疗法(MBT)、接纳与承诺疗法(ACT)、群体心理疗法(GP)、放松疗法(RT)、运动疗法(EX)和基于互联网的心理疗法(I-IPT))的有效性的系统评价和荟萃分析进行了系统综述。于 2020 年 5 月,使用关键词组合在 MEDLINE(PubMed)、PsycINFO、The Cochrane Library、Web of Science 和 Prospero 电子数据库中进行了搜索。由两位作者独立提取数据,并呈现结果的综合分析。两位作者独立使用 AMSTAR-2 评估方法学质量。

结果

共纳入了 7 篇系统评价,报告了心理干预措施在减少围产期女性抑郁症状方面的短期和长期有效性。发现认知行为疗法无论治疗形式如何,都是最有效的干预措施。

局限性

未搜索灰色文献,并且纳入的系统评价中可能存在一些研究重叠。这些(纳入的综述)的方法学质量评分较低,这削弱了报告结果的证据。

结论

认知行为疗法目前是最有循证依据的心理干预措施,以不同的交付形式提供(个体、小组、面对面或基于互联网)。需要进一步开展其他类型的心理干预措施(如第三波认知行为疗法)的研究,包括系统评价,并提高研究质量。

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