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基于互联网的心理干预治疗围产期抑郁的有效性:系统评价和荟萃分析。

Effectiveness of Internet-based psychological interventions for treating perinatal depression: A systematic review and meta-analysis.

机构信息

School of Nursing, Wuhan University, Wuhan, China.

Colleagues in Global Health of Project HOPE, washington, USA.

出版信息

J Clin Nurs. 2023 Jul;32(13-14):3087-3101. doi: 10.1111/jocn.16399. Epub 2022 Jun 13.

Abstract

BACKGROUND

Perinatal depression can result in short- and long-term adverse effects for women and their children if untreated. Psychological interventions, the preferred treatment for most women with perinatal depression, can also be provided online.

AIMS

This study aimed to provide a comprehensive and systematic review of Internet-based psychological interventions and to evaluate their effectiveness in the treatment of perinatal depression.

DESIGN

Systematic review and meta-analysis.

METHODS

A systematic literature search was conducted of six databases, including CINAHL, PubMed, Embase, Web of Science, the Cochrane Library and PsycINFO. Depression and anxiety, which were the primary and secondary results of this search, were presented as standardised mean differences (SMD) and 95% confidence intervals (CIs). This review was conducted according to the PRISMA checklist.

RESULTS

Thirteen studies involving 2158 perinatal women were included. Content, method, duration and frequency of Internet-based psychological interventions were varied. Participants indicated a high rate of satisfaction with these interventions; participants' dropout rates ranged from 2.6% to 60.8%. Meta-analysis demonstrated that Internet-based psychological interventions improved perinatal depression (SMD = -0.72, CI = [-1.02, -0.42], p < .01) and anxiety symptoms (SMD = -0.52, CI = [-0.73, -0.30], p < .01), with heterogeneity of 86% and 59%, respectively.

CONCLUSIONS

Internet-based psychological interventions are considered as convenient and effective alternative treatment for perinatal depression and anxiety. In the future, additional studies are needed to investigate the long-term effects of these interventions on the mental health of perinatal women and the effects on the growth and development of infants while controlling for the dropout rate.

RELEVANCE TO CLINICAL PRACTICE

Internet-based psychological interventions are innovative approaches to improving perinatal depressive symptoms that can leverage mental health resources and improve accessibility while promoting multidisciplinary integration. The approach, content, frequency and duration of intervention should be considered comprehensively to achieve the objectives of the intervention while maintaining compliance of women with perinatal depression.

摘要

背景

未经治疗的围产期抑郁症会对女性及其子女造成短期和长期的不良影响。心理干预是大多数围产期抑郁症女性的首选治疗方法,也可以在网上进行。

目的

本研究旨在对基于互联网的心理干预措施进行全面系统的评价,并评估其在治疗围产期抑郁症中的效果。

设计

系统评价和荟萃分析。

方法

对六个数据库(包括 CINAHL、PubMed、Embase、Web of Science、Cochrane 图书馆和 PsycINFO)进行了系统的文献检索。抑郁和焦虑是此次检索的主要和次要结果,呈现为标准化均数差(SMD)和 95%置信区间(CI)。本综述按照 PRISMA 清单进行。

结果

共纳入 13 项涉及 2158 名围产期女性的研究。基于互联网的心理干预措施的内容、方法、持续时间和频率各不相同。参与者对这些干预措施的满意度很高;参与者的辍学率从 2.6%到 60.8%不等。荟萃分析表明,基于互联网的心理干预措施改善了围产期抑郁症状(SMD=-0.72,CI=-1.02,-0.42,p<.01)和焦虑症状(SMD=-0.52,CI=-0.73,-0.30,p<.01),异质性分别为 86%和 59%。

结论

基于互联网的心理干预措施被认为是治疗围产期抑郁和焦虑的一种方便有效的替代方法。未来需要进一步研究这些干预措施对围产期妇女心理健康的长期影响,以及在控制辍学率的情况下对婴儿生长发育的影响。

临床意义

基于互联网的心理干预措施是改善围产期抑郁症状的创新方法,可以利用心理健康资源,提高可及性,同时促进多学科整合。干预的方法、内容、频率和持续时间应综合考虑,以实现干预目标,同时保持围产期抑郁症女性的依从性。

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