Parenting enhancement, interpersonal psychotherapy to reduce depression in low-income mothers of infants and toddlers: a randomized trial.
Parenting enhancement, interpersonal psychotherapy to reduce depression in low-income mothers of infants and toddlers: a randomized trial.
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育儿增强，人际心理治疗可减少婴儿和幼儿的低收入母亲的抑郁：一项随机试验。
DOI：
10.1097/nnr.0b013e31828324c2
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发表时间：
2013-03
期刊：
影响因子：
2.5
通讯作者：
Hall HW
中科院分区：
文献类型：
--
作者：
Beeber LS;Schwartz TA;Holditch-Davis D;Canuso R;Lewis V;Hall HW
抑郁症状和临床抑郁症在低收入母亲中非常普遍，并对其婴儿和幼儿产生负面影响。探讨人际心理治疗结合亲职强化对抑郁症状及亲职行为的影响，并与常规护理进行比较。来自美国东南部和东北部的早期开端婴儿和幼儿的母亲（n = 226）被随机分配到由精神心理健康高级实践护士在家中提供的干预或由通才护士提供的常规护理。严格的临床抑郁症状和抑郁症的评估和录像，编码的母子互动被用作基线和14，22和26周的干预后措施。与基线相比，干预组和对照组在随后的每个时间点的汉密尔顿抑郁量表评分均显著降低（p <0.0001）。然而，只有接受干预的母亲对孩子的积极参与显着增加，这是通过T4时的亲密度、积极情感、感情和温暖触摸来衡量的（t = 2.22，df = 156，p < .03）。干预和控制条件导致症状减轻，但只有干预母亲表现出显着的互动变化与他们的孩子，减少负面的孩子的结果与母亲抑郁症状的一个重要步骤。结果表明，可以使用的组合的通才和专科护士来治疗抑郁症状，这些母亲。需要进一步研究更长的干预后观察，看看随着时间的推移，干预是否导致更持久的症状减轻。
Depressive symptoms and clinical depression are highly prevalent in low-income mothers and negatively affect their infants and toddlers. To test interpersonal psychotherapy combined with parenting enhancement on depressive symptoms and parenting behavior, compared with usual care. Mothers (n = 226) of Early Head Start infants and toddlers from the southeastern and northeastern United States were randomized to the intervention delivered in-home by psychiatric mental health advanced practice nurses or usual care delivered by generalist nurses. Rigorous clinical depressive symptom and depression assessments and videotaped, coded mother-child interactions were used as baseline and 14-, 22-, and 26-week postintervention measures. Both the intervention and control groups had significantly reduced Hamilton Rating Scale for Depression scores at each subsequent time point compared to baseline (p < .0001). However, only mothers receiving the intervention showed a significant increase in positive involvement with their child, as measured by closeness, positive affect, affection, and warm touch at T4 (t = 2.22, df = 156, p < .03). Both intervention and control conditions resulted in symptom reduction, but only the intervention mothers showed significant interaction changes with their child, an essential step in reducing the negative child outcomes associated with maternal depressive symptoms. Results suggest that a combination of generalist and specialist nurses could be used to treat depressive symptoms in these mothers. Further study with longer postintervention observation is needed to see if, over time, the intervention led to longer-lasting symptom reduction.