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房间里的大象:对患有双重病理(心理健康和物质相关障碍)的孕妇心理治疗的应用与效果的系统评价

The Elephant in the Room: A Systematic Review of the Application and Effects of Psychological Treatments for Pregnant Women with Dual Pathology (Mental Health and Substance-Related Disorders).

作者信息

Caro-Cañizares Irene, López Carpintero Nayara, Carmona-Camacho Rodrigo

机构信息

Facultad de Ciencias de la Salud y la Educación, Universidad a Distancia de Madrid, UDIMA, 28400 Collado Villalba, Spain.

Departamento de Obstetricia y Ginecología, Hospital Universitario del Tajo, 28300 Aranjuez, Spain.

出版信息

Int J Environ Res Public Health. 2024 Mar 23;21(4):392. doi: 10.3390/ijerph21040392.

Abstract

PURPOSE

Maternal mental health and substance use, referred to as dual pathology, represent significant concerns associated with adverse pregnancy and birth outcomes, a prevalence higher than commonly anticipated. Nonetheless, a notable dearth exists ofevidence-based treatment protocols tailored for pregnant women with dual pathology.

METHODS

A systematic review, adhering to the PRISMA methodology, was conducted.

RESULTS

Out of the 57 identified papers deemed potentially relevant, only 2were ultimately included. Given the limited number of studies assessing the efficacy of psychological interventions utilizing randomized controlled trials (RCTs) for both mental health and substance misuse, and considering the diverse objectives and measures employed, definitive conclusions regarding the effectiveness of psychological interventions in this domain prove challenging.

CONCLUSIONS

Maternal mental health appears to be the proverbial "elephant in the room". The development of specialized and integrated interventions stands as an imperative to effectively address this pressing issue. As elucidated in the present review, these interventions ought to be grounded in empirical evidence. Furthermore, it is essential that such interventions undergo rigorous evaluation through RCTs to ascertain their efficacy levels. Ultimately, the provision of these interventions by psychology/psychiatric professionals, both within clinical practice and the RCTs themselves, is recommended to facilitate the generalizability of the results to specialized settings.

摘要

目的

孕产妇心理健康与物质使用(称为双重病理)是与不良妊娠和分娩结局相关的重大问题,其患病率高于通常预期。尽管如此,针对患有双重病理的孕妇的循证治疗方案却明显匮乏。

方法

按照PRISMA方法进行了系统综述。

结果

在57篇被认为可能相关的已识别论文中,最终仅纳入2篇。鉴于评估心理健康和物质滥用方面心理干预疗效的随机对照试验(RCT)研究数量有限,且考虑到所采用的目标和措施各不相同,因此很难就该领域心理干预的有效性得出明确结论。

结论

孕产妇心理健康似乎是个众所周知的“房间里的大象”(即明显却被忽视的问题)。制定专门的综合干预措施对于有效解决这一紧迫问题至关重要。正如本综述所阐明的,这些干预措施应以实证证据为基础。此外,此类干预措施必须通过随机对照试验进行严格评估,以确定其疗效水平。最后,建议由心理学/精神病学专业人员在临床实践和随机对照试验中提供这些干预措施,以便将结果推广至专业环境。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73be/11050033/6f999e2217c0/ijerph-21-00392-g001.jpg

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