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围产期心理健康中的认知行为疗法:系统评价概述。

Cognitive behavioral therapy in perinatal mental health: An overview of systematic reviews.

机构信息

Midwifery, Graduate School of Nursing, St. Luke's International University, Tokyo, Japan.

Global Health Nursing, Graduate School of Nursing, St. Luke's International University, Tokyo, Japan.

出版信息

Jpn J Nurs Sci. 2022 Oct;19(4):e12501. doi: 10.1111/jjns.12501. Epub 2022 Jun 14.

Abstract

AIM

The purpose of this study was to determine whether cognitive behavioral therapy (CBT) started in pregnancy can prevent depression and anxiety.

METHODS

We conducted an overview review by selecting systematic reviews (SRs) that compared CBT with usual care, no CBT, or interventions other than CBT in perinatal women. We restricted the review to studies that included randomized controlled trials. The results of included SRs were descriptively integrated according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

RESULTS

Seven SRs met our eligibility criteria. One SR was limited to CBT interventions, whereas others included psychoeducation and interpersonal psychotherapy. There was some variation in the number of sessions and timing of CBT, and whether there was a postpartum intervention. Five SRs showed that CBT reduced depression compared with usual care, an educational intervention, or no intervention. One SR that analyzed the effect on anxiety found that psychotherapy, including CBT, reduced anxiety compared with usual care or no intervention.

DISCUSSION

CBT starting from pregnancy may be effective as a preventive intervention for postpartum depression and anxiety, although the degree of effectiveness varied.

CONCLUSIONS

This overview review aimed to clarify whether CBT is effective in preventing depression and anxiety from pregnancy. CBT may be effective in reducing perinatal depression and anxiety.

摘要

目的

本研究旨在确定孕期开始的认知行为疗法(CBT)是否可以预防抑郁和焦虑。

方法

我们通过选择与常规护理、无 CBT 或除 CBT 以外的干预措施进行比较的系统评价(SR)进行概述性综述,纳入了围产期女性的随机对照试验。综述仅限于包括随机对照试验的研究。根据系统评价和荟萃分析的首选报告项目指南,对纳入的 SR 结果进行描述性综合。

结果

有 7 项 SR 符合我们的入选标准。一项 SR 仅限于 CBT 干预,而其他的包括心理教育和人际心理治疗。CBT 的疗程和时间以及是否有产后干预存在一定差异。有 5 项 SR 表明,与常规护理、教育干预或无干预相比,CBT 可降低抑郁发生率。有一项分析焦虑作用的 SR 发现,包括 CBT 在内的心理治疗与常规护理或无干预相比,可降低焦虑发生率。

讨论

从孕期开始的 CBT 可能是一种预防产后抑郁和焦虑的有效干预措施,尽管效果程度存在差异。

结论

本综述旨在阐明 CBT 是否对预防孕期抑郁和焦虑有效。CBT 可能对减少围产期抑郁和焦虑有效。

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