A Randomized Controlled Trial of Culturally Relevant, Brief Interpersonal Psychotherapy for Perinatal Depression
A Randomized Controlled Trial of Culturally Relevant, Brief Interpersonal Psychotherapy for Perinatal Depression
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DOI：
10.1176/appi.ps.60.3.313
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发表时间：
2009-03-01
影响因子：
3.8
通讯作者：
Frank, Ellen
中科院分区：
文献类型：
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作者：
Grote, Nancy K.;Swartz, Holly A.;Frank, Ellen
目的：妊娠期抑郁是产后抑郁的最强预测因子之一，产后抑郁又会对婴幼儿的健康和父母的心理健康产生有害的、持久的影响。指导这项随机对照试验的主要问题是，在这一人群中，与文化相关的增强型短暂人际心理治疗(IPT-B)是否比那些通过加强日常护理来治疗抑郁症的低收入孕妇具有更大的优势？增强型IPT-B是一种旨在治疗产前抑郁的多成分护理模式，包括一次参与会议，然后是分娩前的八次紧急IPT-B会议，以及产后长达六个月的维持IPT。特别加强了IPT-B，使其在文化上与处于社会经济不利地位的妇女有关。方法：53名在大型城市妇产科门诊接受产前服务且符合爱丁堡产后抑郁量表(评分12分，0~30分)的未寻求治疗的非裔美国人和白人孕妇被随机分配到接受增强IPT-B(N=25)或加强常规护理(N=28)的患者中，两组均在该诊所提供。参与者在治疗前和治疗后对抑郁诊断、抑郁症状和社会功能进行评估。结果：意向治疗分析表明，与加强常规护理的参与者相比，加强IPT-B的参与者在分娩前(基线后3个月)和产后6个月时抑郁诊断和抑郁症状显著减少，产后6个月时社会功能显著改善。结论：研究结果表明，增强的IPT-B可以缓解妊娠期间的抑郁，防止抑郁复发，并在产后6个月内改善社会功能。(精神科服务60：313-321,2009)
Objectives: Depression during pregnancy is one of the strongest predictors of postpartum depression, which, in turn, has deleterious, lasting effects on infant and child well-being and on the mother's and father's mental health. The primary question guiding this randomized controlled trial was, Does culturally relevant, enhanced brief interpersonal psychotherapy (IPT-B) confer greater advantages to low-income, pregnant women than those that accrue from enhanced usual care in treating depression in this population? Enhanced IPT-B is a multicomponent model of care designed to treat antenatal depression and consists of an engagement session, followed by eight acute IPT-B sessions before the birth and maintenance IPT up to six months postpartum. IPT-B was specifically enhanced to make it culturally relevant to socioeconomically disadvantaged women. Methods: Fifty-three non-treatment-seeking, pregnant African-American and white patients receiving prenatal services in a large, urban obstetrics and gynecology clinic and meeting criteria for depression on the Edinburgh Postnatal Depression Scale (score > 12 on a scale of 0 to 30) were randomly assigned to receive either enhanced IPT-B (N=25) or enhanced usual care (N=28), both of which were delivered in the clinic. Participants were assessed before and after treatment on depression diagnoses, depressive symptoms, and social functioning. Results: Intent-to-treat analyses showed that participants in enhanced IPT-B, compared with those in enhanced usual care, displayed significant reductions in depression diagnoses and depressive symptoms before childbirth (three months postbase-line) and at six months postpartum and showed significant improvements in social functioning at six months postpartum. Conclusions: Findings suggest that enhanced IPT-B ameliorates depression during pregnancy and prevents depressive relapse and improves social functioning up to six months postpartum. (Psychiatric Services 60: 313-321, 2009)