Dadhwal Vatsla, Sagar Rajesh, Choudhary Vandana, Kant Shashi, Perumal Vanamail, Misra Puneet, Bhattacharya Debabani
Dept. of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, Delhi, India.
Dept. of Psychiatry, All India institute of Medical Sciences, New Delhi, Delhi, India.
Indian J Psychol Med. 2022 Nov;44(6):567-574. doi: 10.1177/02537176211072690. Epub 2022 Mar 14.
The prevalence of postpartum depression (PPD) and anxiety (PPA) is rising in India and efforts at generating local evidence for psychological intervention are scanty. We conducted a single-arm pilot study in an Indian rural community to test the impact of multicomponent psychoeducational intervention (MCPI) on women with PPD and PPA.
Forty-three women with PPD/PPA/both received MCPI, which comprised three phases with in-person sessions held once weekly for a minimum of six and a maximum of ten weeks. Primary outcome variables were scores on depression and anxiety, assessed using the Edinburg postnatal depression scale and the state and trait anxiety inventory, along with evaluating the compliance rate to the intervention. The Mini-international neuropsychiatric interview (MINI) neuropsychiatric interview was used to confirm the diagnosis of depression and anxiety. Secondary outcome variables assessed were social support, functionality, parental stress, interpersonal violence, and marital satisfaction. We used Cohen's d effect size method for assessing the mean differences.
MCPI resulted in the improvement of 72% women (95% CI = 56.3%-84.7%). The overall compliance rate to the intervention was 85.63%, which was higher for responders than nonresponders (92.9% vs. 69.8%; P < 0.001). MCPI resulted in statistically significant improvement in the mean score of depression (P = 0.001, = 0.95) and anxiety (P = 0.001, = 1.30). On secondary outcome variables, significant improvement was obtained in the overall present social support (P = 0.001; = 4.65), present social support from partner (P = 0.027; = 0.45) and parents (P = 0.001; = 0.74), future social support from parents (P = 0.001; = 0.81), the performance of household responsibility (P = 0.001; = 0.97), lifestyle in the last two weeks (P = 0.001; = 3.57), parental stress (P = 0.001; = 1.04), and marital satisfaction (P = 0.014; = 0.52).
This pilot study shows that MCPI has a promising role in relieving depression and anxiety. It also improved the perception of social support from partner and parents, functionality, marital satisfaction, and reduced parental stress.
在印度，产后抑郁症（PPD）和产后焦虑症（PPA）的患病率正在上升，而针对心理干预开展本土研究的工作却很少。我们在印度一个农村社区进行了一项单臂试点研究，以测试多成分心理教育干预（MCPI）对患有PPD和PPA的女性的影响。
43名患有PPD/PPA/两者皆有的女性接受了MCPI，该干预包括三个阶段，每周进行一次面对面的课程，最少六周，最多十周。主要结局变量是抑郁和焦虑得分，使用爱丁堡产后抑郁量表、状态和特质焦虑量表进行评估，同时评估干预的依从率。使用小型国际神经精神病学访谈（MINI）来确诊抑郁和焦虑。评估的次要结局变量包括社会支持、功能、父母压力、人际暴力和婚姻满意度。我们使用科恩d效应量方法来评估均值差异。
MCPI使72%的女性病情得到改善（95%置信区间 = 56.3%-84.7%）。干预的总体依从率为85.63%，有反应者的依从率高于无反应者（92.9%对69.8%；P < 0.001）。MCPI使抑郁平均得分（P = 0.001，效应量 = 0.95）和焦虑平均得分（P = 0.001，效应量 = 1.30）有统计学意义的改善。在次要结局变量方面，总体当前社会支持（P = 0.001；效应量 = 4.65）、来自伴侣（P = 0.027；效应量 = 0.45）和父母（P = 0.001；效应量 = 0.74）的当前社会支持、来自父母的未来社会支持（P = 0.001；效应量 = 0.81）、家务责任履行情况（P = 0.001；效应量 = 0.97）、过去两周的生活方式（P = 0.001；效应量 = 3.57）、父母压力（P = 0.001；效应量 = 1.04）和婚姻满意度（P = 0.014；效应量 = 0.52）均有显著改善。
这项试点研究表明，MCPI在缓解抑郁和焦虑方面具有显著作用。它还改善了对来自伴侣和父母的社会支持的感知、功能、婚姻满意度，并减轻了父母压力。
