Human Development Research Foundation, Islamabad, Pakistan.
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Transcult Psychiatry. 2024 Aug;61(4):689-698. doi: 10.1177/13634615241250206. Epub 2024 May 20.
Anxiety during pregnancy affects women worldwide and is highly prevalent in Pakistan. The Psychological Outcome Profiles (PSYCHLOPS) questionnaire is an instrument used in therapy to assess patient-generated problems and the consequent functional difficulties. Using the PSYCHLOPS, we aimed to describe the type of problems and the consequent functional difficulties faced by anxious pregnant women in Pakistan. Secondarily, we sought to explore if a cognitive behavioral therapy (CBT)-based intervention brought about changes in the severity score for certain problems or functional difficulties. Anxious pregnant women were recruited from the Obstetrics/Gynecology Department of a tertiary hospital in Rawalpindi, Pakistan. Of 600 pregnant women randomized to receive a psychosocial intervention for prenatal anxiety delivered by non-specialist providers, 450 received ≥1 intervention session and were administered the PSYCHLOPS. Eight types of problems were identified; worries about the unborn baby's health and development (23%), concerns about family members (13%), and financial constraints (12%) were the most frequently reported primary problems. Severity scores between baseline and the last available therapy session indicated the largest decrease for relationship problems (mean = 2.4) and for concerns about family members (mean = 2.2). For functional difficulties, 45% of the participants reported difficulties in performing household chores, but the intervention showed the greatest decrease in severity scores for mental or emotional functional difficulties. Focus on certain types of patient-generated problems, e.g., relationship problems, could anchor therapy delivery in order to have the greatest impact. Tailored CBT-based intervention sessions have the potential to address important but neglected problems and functional difficulties in anxious pregnant women.
怀孕期间的焦虑影响着全世界的女性，在巴基斯坦也非常普遍。《心理结局概况量表》（PSYCHLOPS）是一种在治疗中用于评估患者产生的问题和随之而来的功能障碍的工具。使用 PSYCHLOPS，我们旨在描述巴基斯坦焦虑孕妇所面临的问题类型和随之而来的功能障碍。其次，我们试图探讨认知行为疗法（CBT）为基础的干预是否会改变某些问题或功能障碍的严重程度评分。从巴基斯坦拉瓦尔品第的一家三级医院的妇产科招募了焦虑的孕妇。在 600 名随机接受非专业提供者提供的产前焦虑的心理社会干预的孕妇中，有 450 名接受了≥1 次干预，并接受了 PSYCHLOPS 测试。确定了 8 种类型的问题；对胎儿健康和发育的担忧（23%）、对家庭成员的担忧（13%）和经济限制（12%）是最常报告的主要问题。基线和最后一次可获得的治疗会议之间的严重程度评分表明，在人际关系问题（平均 2.4）和对家庭成员的担忧（平均 2.2）方面的严重程度评分下降最大。在功能障碍方面，45%的参与者报告在做家务方面有困难，但干预在心理或情绪功能障碍方面的严重程度评分下降最大。关注某些类型的患者产生的问题，例如人际关系问题，可以为治疗提供依据，以产生最大的影响。基于 CBT 的定制干预有潜力解决焦虑孕妇中重要但被忽视的问题和功能障碍。
