A Systematic Review of Interventions That Integrate Perinatal Mental Health Care Into Routine Maternal Care in Low- and Middle-Income Countries.
A Systematic Review of Interventions That Integrate Perinatal Mental Health Care Into Routine Maternal Care in Low- and Middle-Income Countries.
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DOI：
10.3389/fpsyt.2022.859341
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发表时间：
2022
影响因子：
4.7
通讯作者：
Byatt N
中科院分区：
文献类型：
--
作者：
Prom MC;Denduluri A;Philpotts LL;Rondon MB;Borba CPC;Gelaye B;Byatt N
低收入和中等收入国家 (LMIC) 的妇女受到围产期抑郁和焦虑的影响尤为严重，并且缺乏获得心理保健的机会。建议将围产期心理保健纳入常规孕产妇护理，以解决资源贫乏地区获得心理保健的差距。了解将围产期心理保健纳入中低收入国家常规孕产妇护理的干预措施的有效性对于持续制定、实施和扩大干预措施至关重要。本系统评价旨在评估将围产期心理保健纳入常规孕产妇护理以改善中低收入国家孕产妇心理健康和婴儿健康结果的干预措施的有效性。根据 PRISMA 指南，进行了电子数据库检索，寻找旨在将围产期心理保健纳入中低收入国家常规孕产妇保健的干预措施的对照试验出版物。摘要和全文文章由两位作者使用 Covidence 审阅软件独立审阅以纳入。提取数据并进行叙述合成。从 2,382 条独特引用的初步搜索结果来看，有 20 项研究符合资格标准。研究样本、干预设计和结果评估之间存在很大的异质性。不到一半的研究关注的是患有活动性抑郁或焦虑的女性。大多数研究（85%）实施了单一干预设计，涉及心理、社会心理、心理教育或辅助情绪/压力管理。很少有利用多成分方法、药物疗法或转诊心理健康专家的干预措施。结果衡量和评估时间差异很大。十八项研究表明，与对照组相比，干预组的抑郁和/或焦虑指标有显着改善。综合干预措施对中低收入国家可能有效。研究结果提供了对当前干预措施设计差距的批判性理解。这包括缺乏全面的干预设计，其中包括增加对更严重疾病的治疗强度、药物治疗、心理健康专家转诊以及非心理健康专业培训和监督。研究结果还提供了克服中低收入国家设计和实施障碍的策略。研究结果为未来基于证据的调整、实施和扩大干预措施奠定了基础，将围产期心理保健纳入中低收入国家的常规孕产妇护理。 [https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021259092]，标识符[CRD42021259092]。
Women in low- and middle-income countries (LMICs) are disproportionally affected by perinatal depression and anxiety and lack access to mental health care. Integrating perinatal mental health care into routine maternal care is recommended to address gaps in access to mental health care in such under-resourced settings. Understanding the effectiveness of interventions that integrate perinatal mental health care into routine maternal care in LMICs is critical to inform ongoing intervention development, implementation, and scale-up. This systematic review aims to assess the effectiveness of interventions that integrate perinatal mental health care into routine maternal care to improve maternal mental health and infant health outcomes in LMICs. In accordance with the PRISMA guidelines, an electronic database search was conducted seeking publications of controlled trials examining interventions that aimed to integrate perinatal mental health care into routine maternal care in LMICs. Abstracts and full text articles were independently reviewed by two authors for inclusion utilizing Covidence Review Software. Data was extracted and narrative synthesis was conducted. Twenty studies met eligibility criteria from the initial search results of 2,382 unique citations. There was substantial heterogeneity between the study samples, intervention designs, and outcome assessments. Less than half of the studies focused on women with active depression or anxiety. Most studies (85%) implemented single intervention designs involving psychological, psychosocial, psychoeducational, or adjuvant emotion/stress management. There were few interventions utilizing multicomponent approaches, pharmacotherapy, or referral to mental health specialists. Outcome measures and assessment timing were highly variable. Eighteen studies demonstrated significantly greater improvement on depression and/or anxiety measures in the intervention group(s) as compared to control. Integrated interventions can be effective in LMICs. The findings provide a critical understanding of current interventions design gaps. This includes the lack of comprehensive intervention designs that incorporate increasing intensity of treatment for more severe illness, pharmacotherapy, mental health specialist referrals, and non-mental health professional training and supervision. The findings also provide strategies to overcome design and implementation barriers in LMICs. Study findings provide a foundation for future evidence-based adaptation, implementation, and scale-up of interventions that integrate perinatal mental health care into routine maternal care in LMICs. [https://www.crd.york.ac.uk/prospero/display_ record.php?ID=CRD42021259092], identifier [CRD42021259092].
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DOI：
10.1080/0167482x.2017.1383380
发表时间：
2018-12
期刊：
Journal of psychosomatic obstetrics and gynaecology
影响因子：
--
作者：
Byatt N;Moore Simas TA;Biebel K;Sankaran P;Pbert L;Weinreb L;Ziedonis D;Allison J
通讯作者：
Allison J
影响因子：
--
作者：
Grote, Nancy K.;Bridge, Jeffrey A.;Gavin, Amelia R.;Melville, Jennifer L.;Iyengar, Satish;Katon, Wayne J.
通讯作者：
Katon, Wayne J.
童年时期的身体和性虐待与亲密伴侣的暴力，孕妇的一般健康状况不佳和抑郁症状的关联。
影响因子：
3.7
作者：
Barrios YV;Gelaye B;Zhong Q;Nicolaidis C;Rondon MB;Garcia PJ;Sanchez PA;Sanchez SE;Williams MA
通讯作者：
Williams MA
DOI：
10.1016/j.bpobgyn.2013.08.013
发表时间：
2014-01
影响因子：
5.5
作者：
Chowdhary, Neerja;Sikander, Siham;Atif, Najia;Singh, Neha;Ahmad, Ikhlaq;Fuhr, Daniela C.;Rahman, Atif;Patel, Vikram
通讯作者：
Patel, Vikram
影响因子：
3.1
作者：
Asadzadeh, Leila;Jafari, Elham;Taremian, Farhad
通讯作者：
Taremian, Farhad