孕期心理干预对产后焦虑、抑郁的作用

Effect of psychological intervention during pregnancy on postpartum depression and anxiety

目的探讨孕期心理干预对产后焦虑和抑郁的预防作用。方法采用随机对照研究设计将500名孕妇随机分配至干预组(n=250名)和对照组(n=250名)。干预组在常规孕妇学校的基础上给予集体心理干预课程,对照组予以常规的孕妇保健。对所有的对象在干预前、干预结束后1周采用焦虑自评量表(SAS)、抑郁自评量表(SDS)自评,产后3 d、7 d和30 d采用爱丁堡产后抑郁量表(EPDS)和SAS进行评定。结果经过两次集体心理干预后,干预组SAS、SDS得分较对照组有明显的下降,两组比较差异有统计学意义(P<0.05)。产后3个随访时点的SAS分值比较,干预组低于对照组(P<0.05)。产后3个随访时点的EPDS分值,干预组与对照组比较差异均无统计学意义(P>0.05)。结论孕期的心理干预在短时间内对孕期的焦虑和抑郁有效,并能明显减轻产后的焦虑情绪,但对产后的抑郁效果不明显。

Objective To explore the effect of psychological intervention during pregnancy on postpartum anxiety and depression. Methods A total of 500 pregnant women were randomized into study group （250 subjects） treated with group psychological intervention plus general pregnancy health care and control group （250 subjects ） treated with pregnancy health care. All subjects were assessed with Self-rating Anxiety Scale （SAS） and Self-rating Depression Scale （SDS） at the baseline and at the 1st weekend after the intervention, and were assessed with SAS and Edinburgh Postnatal Depression Scale （EPDS） at the 3rd day, 7th day, 30th day after the parturition. Results Scores of SAS and SDS in study group were significantly lower than those in control group （P 〈 0.05） after the intervention. Scores of SAS at three time-points after the parturition in study group were significantly lower than those in control group （P 〈 0.05 ）. No significant difference was found in scores of EPDS at three time-points after the parturition between the two groups （P 〉 0.05）. Conclusion Psychological intervention is effeetive for the anxiety and depression during the pregnancy, as well as for postpartum anxiety. But it has no obvious effect on postpartum depression.