Treating depression during pregnancy and the postpartum: A preliminary meta-analysis
Treating depression during pregnancy and the postpartum: A preliminary meta-analysis
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DOI：
10.1177/1049731505282202
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发表时间：
2006-03-01
影响因子：
1.8
通讯作者：
Grote, NK
中科院分区：
文献类型：
--
作者：
Bledsoe, SE;Grote, NK
目的：这项荟萃分析评估了妊娠期和产后非精神病性重度抑郁症的治疗效果，比较了不同类型和时间的干预措施。方法：包括应用治疗试验和标准化措施来降低怀孕期间和产后抑郁严重程度的研究。计算连续变量结果数据的标准化平均差异。结果： 13 项干预措施报告了积极的影响大小，一项报告了轻微的积极影响大小，一项报告没有影响，其余的报告了轻微的消极影响大小。按治疗类型划分，认知行为疗法药物治疗（CBT；3.871，p < .001）和单独药物治疗（3.048，p < .001）报告的效果最大，其次是团体治疗（CBT 教育和交易分析；2.045，p < .001）、人际心理治疗（1.260，p < .001）、CBT（.642，p < .001） .001）、心理动力学（.526，p = .014）、咨询（.418，p = .014）和教育（.100，p = .457）。产后实施产生的效应量（. 837，p < .001）比怀孕期间实施（. 377，p = .002）更大。当排除药物干预时，产后效应大小为 0.704 (p < 0.001)。结论：初步研究结果建议单独使用药物治疗或与 CBT 联合治疗；包含 CBT、教育和交易分析成分的团体治疗；人际心理治疗；在测试的干预措施中，CBT 对该人群产生的影响最大。
Objectives: This meta-analysis evaluates treatment effects for nonpsychotic major depression during pregnancy and postpartum comparing interventions by type and timing. Methods: Studies for decreasing depressive severity during pregnancy and postpartum applying treatment trials and standardized measures were included. Standardized mean differences were calculated for continuous variable outcome data. Results: Thirteen interventions reported positive effect sizes, one reported marginally positive effect size, one reported no effect, and the remaining reported marginally negative effect size. By type of treatment, medication with cognitive behavioral therapy (CBT; 3.871, p < .001) and medication alone (3.048, p < .001) reported largest effect size, followed by group therapy (CBT educational, and transactional analysis; 2.045, p < .001), interpersonal psychotherapy (1.260, p < .001), CBT (.642, p < .001), psychodynamic (.526, p = .014), counseling (.418, p = .014), and educational(. 100, p = .457). Postpartum implementation produced larger effect size(. 837, p < .001) than implementation during pregnancy(. 377, p = .002). When medication interventions are excluded, postpartum effect size is .704 (p < .001). Conclusions: Preliminary findings suggest medication, alone or with CBT; group therapy with CBT, educational, and transactional analysis components; interpersonal psychotherapy; and CBT produce largest effect sizes in this population among interventions tested.