Shahrokhi Shirin, Basirat Zahra, Barat Shahnaz, Kheirkhah Farzan, O'Connor Elizabeth, Mirtabar Seyyedeh Mahboubeh, Gholinia Hemmat, Faramarzi Mahbobeh
Behshahr Azad University, Behshahr, Islamic Republic of Iran.
Department of Obstetrics and Gynecology, School of Medicine, Infertility and Reproductive Health Research Center, Health Research Institute Rouhani Hospital, Fatima Al-Zahra Research Center for Fertility and Infertility, Babol University of Medical Sciences, Babol, Islamic Republic of Iran.
J Obstet Gynaecol India. 2025 Apr;75(Suppl 1):242-249. doi: 10.1007/s13224-024-01946-0. Epub 2024 Mar 5.
Despite ample evidence of high depression rates among women with high-risk pregnancies, there is limited information available regarding the effectiveness of Internet-based psychotherapies in this population. This study aimed to assess the effectiveness of internet-based psychotherapy in treating depression and anxiety in pregnant women with high-risk pregnancies admitted to the hospital.
In a quasi-experimental study, 60 inpatient women with high-risk pregnancies exhibiting mild to moderate depression were allocated to either the experimental ( = 30) or control ( = 30) group. The experimental group received medical therapy with Internet-based Synchronous Individualized Therapy for six sessions, each lasting 50-60 min, conducted over six weeks. The control group solely received medical therapy. All participants completed questionnaires, including the Brief Symptom Inventory (BSI-18) and Edinburgh Postnatal Depression Scale, at both baseline and the post-trial stage (6 weeks after the study commencement).
The mean scores for depression and anxiety in both groups were elevated (experimental group: = 11.36, SD = 4.84; = 13.82, SD = 4.78; control group: = 11.4, SD = 4.8; = 13.6, SD = 4.6). Symptom severity decreased more significantly in the group receiving internet psychotherapy in addition to medical treatment than in the control group, with medium effect sizes observed for depression symptoms ( = 0.145, = 0.003) and anxiety symptoms ( = 0.238, < 0.001). Furthermore, the reduction in anxiety and depression scores in the internet psychotherapy group was notably more significant than in the control group, with a moderate effect size ( = 0.177, = 0.041).
Augmenting medical therapy with therapist-guided internet-based psychotherapy may effectively reduce depression, anxiety, and psychological distress in pregnant women experiencing high-risk pregnancies and comorbid depression. These findings suggest that hospitalized, depressed pregnant women with high-risk pregnancies should be offered internet-based psychotherapy as an adjunctive treatment option.
尽管有充分证据表明高危妊娠女性的抑郁症发病率很高，但关于基于互联网的心理治疗在该人群中的有效性的信息有限。本研究旨在评估基于互联网的心理治疗对住院的高危妊娠孕妇抑郁症和焦虑症的治疗效果。
在一项准实验研究中，60名患有轻度至中度抑郁症的高危妊娠住院女性被分为实验组（n = 30）或对照组（n = 30）。实验组接受基于互联网的同步个体化治疗的药物治疗，共六个疗程，每个疗程持续50 - 60分钟，为期六周。对照组仅接受药物治疗。所有参与者在基线和试验后期（研究开始后6周）均完成了问卷调查，包括简明症状量表（BSI - 18）和爱丁堡产后抑郁量表。
两组的抑郁和焦虑平均得分均有所升高（实验组：抑郁 = 11.36，标准差 = 4.84；焦虑 = 13.82，标准差 = 4.78；对照组：抑郁 = 11.4，标准差 = 4.8；焦虑 = 13.6，标准差 = 4.6）。除药物治疗外接受互联网心理治疗的组中症状严重程度的下降比对照组更显著，抑郁症状（效应量 = 0.145，p = 0.003）和焦虑症状（效应量 = 0.238，p < 0.001）的效应量为中等。此外，互联网心理治疗组的焦虑和抑郁得分下降明显比对照组更显著，效应量为中等（效应量 = 0.177，p = 0.041）。
在药物治疗的基础上增加治疗师指导的基于互联网的心理治疗可能有效降低高危妊娠合并抑郁症孕妇的抑郁、焦虑和心理困扰。这些发现表明，对于住院的高危妊娠抑郁症孕妇，应提供基于互联网的心理治疗作为辅助治疗选择。
