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动力性心理治疗对产后抑郁症的疗效:系统评价。

Psychodynamic Psychotherapy for Postpartum Depression: A Systematic Review.

机构信息

Faculty of Psychology, Department of Assessment, Personality and Clinical Psychology, Complutense University of Madrid, Campus of Somosaguas s/n, Madrid, 28040, Spain.

Department of Psychiatry and Mental Health, Southeast University Hospital of Madrid, Madrid, Spain.

出版信息

Matern Child Health J. 2023 Jul;27(7):1156-1164. doi: 10.1007/s10995-023-03655-y. Epub 2023 Apr 8.

Abstract

OBJECTIVES

Postpartum depression estimated prevalence in women is between 5 and 26% and it has adverse effects both on the mother, infant and her partner. Psychological treatments have proved to be effective for women with mild-to-moderate symptoms. Whereas several systematic reviews have assessed the effects of different psychological interventions for postpartum depression, such as cognitive-behavioural therapy or interpersonal therapy, no review assessing psychodynamic therapy has been carried out. A systematic review was conducted to evaluate the efficacy of psychodynamic therapy for postpartum depression.

METHODS

Studies were identified using the following databases: PsycINFO, Psycarticles and Pubmed over January 2023. The requirements for the studies were the following: they had to be quantitative, available in English, including a psychodynamic intervention targeting treatment or prevention of postpartum depression which starts during pregnancy or within the first 12 months after giving birth. Case studies, qualitative studies or studies focused on improving parent-infant relationship or infant outcome were excluded from this research.

RESULTS

Seven trials including 521 women met the inclusion criteria. In summary, three randomized controlled trials and four longitudinal studies were found. The most frequently used assessment tool was EPDS, five were individual interventions and the other two were group interventions.

DISCUSSION

All studies reported the efficacy of psychodynamic interventions for postpartum depression, both in home and clinical settings and both in group and individual format. The limited number of trials, small sample sizes and lack of appropriate control groups were the main limitations.

CONCLUSIONS FOR PRACTICE

Psychodynamic therapy is probably efficient intervention for postpartum depression. Future research with strong methodological designs is needed to confirm these findings.

SIGNIFICANCE

What is already known on this subject? Several systematic reviews have assessed the effects of different psychological interventions for postpartum depression, but no review assessing psychodynamic therapy has been carried out. What this study adds? A systematic review was conducted to evaluate the efficacy of psychodynamic therapy for postpartumdepression. This makes the systematic review a unique contribution to the literature.

摘要

目的

产后抑郁症在女性中的估计患病率为 5%至 26%,对母亲、婴儿及其伴侣都有不良影响。心理治疗已被证明对有轻至中度症状的女性有效。虽然已经有几项系统评价评估了不同的心理干预措施(如认知行为疗法或人际疗法)对产后抑郁症的效果,但没有评估动力心理疗法的综述。因此,进行了一项系统评价,以评估动力心理疗法治疗产后抑郁症的疗效。

方法

使用以下数据库:PsycINFO、Psycarticles 和 Pubmed 于 2023 年 1 月进行研究检索。研究要求如下:它们必须是定量的,以英文提供,包括针对治疗或预防产后抑郁症的动力干预措施,该干预措施应在怀孕期间或分娩后 12 个月内开始。本研究排除了案例研究、定性研究或专注于改善母婴关系或婴儿结局的研究。

结果

符合纳入标准的共有 7 项试验,包括 521 名女性。总的来说,发现了三项随机对照试验和四项纵向研究。最常使用的评估工具是 EPDS,五项为个体干预,另外两项为团体干预。

讨论

所有研究都报告了动力干预措施对产后抑郁症的疗效,无论是在家庭环境还是临床环境中,无论是个体形式还是团体形式。试验数量有限、样本量小以及缺乏适当的对照组是主要的局限性。

结论

动力疗法可能是治疗产后抑郁症的有效干预措施。需要进行具有强有力方法学设计的未来研究来证实这些发现。

意义

目前在这个主题上已经有哪些研究?已经有几项系统评价评估了不同的心理干预措施对产后抑郁症的效果,但没有评估动力心理疗法的综述。这项研究增加了什么?进行了一项系统评价,以评估动力心理疗法治疗产后抑郁症的疗效。这使得该系统评价成为文献中的一个独特贡献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a901/10232568/a513f17e0384/10995_2023_3655_Fig1_HTML.jpg

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