在线认知行为疗法在常规护理中用于孕产妇产前和产后焦虑和抑郁。

Online cognitive behaviour therapy for maternal antenatal and postnatal anxiety and depression in routine care.

机构信息

Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales 2010, Australia; School of Psychiatry, University of New South Wales, Sydney, New South Wales 2052, Australia.

Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales 2010, Australia; School of Clinical Medicine, University of New South Wales, Sydney, New South Wales 2052, Australia.

出版信息

J Affect Disord. 2023 Oct 1;338:121-128. doi: 10.1016/j.jad.2023.06.008. Epub 2023 Jun 8.

DOI:10.1016/j.jad.2023.06.008

PMID:37295653

Abstract

BACKGROUND

Perinatal depression and anxiety are associated with significant adverse effects for the mother and child. Online cognitive behavioural therapy (iCBT) can provide scalable access to psychological interventions to improve perinatal depression and anxiety, however, few studies have examined the effectiveness of these interventions in routine care. This study investigated the uptake and treatment outcomes of women living in the Australian community who enrolled in a pregnancy or postnatal iCBT program for their symptoms of depression and anxiety.

METHODS

1502 women commenced iCBT (529 pregnancy and 973 postnatal) and completed measures of anxiety and depression symptom severity, and psychological distress pre- and post-treatment.

RESULTS

35.0 % of women in the pregnancy program and 41.6 % in the postnatal program completed all 3 lessons, with lower pre-treatment depression symptom severity significantly associated with increased likelihood of perinatal program completion. Both iCBT programs were associated with medium pre- to post-treatment effect size reductions in generalised anxiety symptom severity (gs = 0.63 and 0.71), depression symptom severity (gs = 0.58 and 0.64), and psychological distress (gs = 0.52 and 0.60).

LIMITATIONS

Lack of control group and long-term follow-up, as well as detailed information on nature of the sample (e.g., health status, relationship status). Additionally, the sample was limited to Australian residents.

CONCLUSION

iCBT for perinatal anxiety and depression was associated with significant symptom improvement. Current findings support the use of iCBT in perinatal populations and its integration within routine healthcare provision.

摘要

背景

围产期抑郁和焦虑会对母亲和孩子产生重大的不良影响。在线认知行为疗法（iCBT）可以提供可扩展的心理干预途径，以改善围产期抑郁和焦虑，但很少有研究调查这些干预措施在常规护理中的有效性。本研究调查了澳大利亚社区中患有抑郁和焦虑症状的女性参与妊娠或产后 iCBT 计划的情况，包括其参与情况和治疗结果。

方法

共有 1502 名女性开始接受 iCBT（529 名妊娠和 973 名产后），并在治疗前后完成了焦虑和抑郁症状严重程度以及心理困扰的测量。

结果

妊娠组中 35.0%的女性和产后组中 41.6%的女性完成了所有 3 节课，治疗前抑郁症状严重程度较低与增加围产期计划完成的可能性显著相关。两个 iCBT 计划都与一般焦虑症状严重程度（gs = 0.63 和 0.71）、抑郁症状严重程度（gs = 0.58 和 0.64）和心理困扰（gs = 0.52 和 0.60）的中等到治疗后效应大小降低相关。