DSM-Ⅳ诊断标准指导下的分层早期干预在产妇产后抑郁中的应用价值

The application value of stratified early intervention under the guidance of DSM-Ⅳdiagnostic criteria for maternal postpartum depression

目的探讨《精神障碍诊断和统计手册(第4版)》(DSM-Ⅳ)诊断标准指导下的分层早期干预在产妇产后抑郁中的应用价值。方法选取100例待产妇,采用随机数字表法分为对照组与干预组,每组50例。对照组采取常规干预,干预组采取DSM-Ⅳ诊断标准指导下的分层早期干预。比较两组干预前后抑郁评分及干预满意度。结果两组产前1 d及产后4周汉密顿抑郁量表(HAMD)评分比较,无显著差异(P>0.05);而两组产后4周HAMD评分高于产前1 d,差异显著(P<0.05)。产后8周随访,干预组抑郁症发生率为4.00%(2/50),低于对照组的16.00%(8/50),差异显著(P<0.05)。干预组产后8周爱丁堡产后抑郁量表(EPDS)评分明显低于对照组及产后4周,差异显著(P<0.05)。干预组总满意度98.00%高于对照组的84.00%,差异显著(P<0.05)。结论DSM-Ⅳ诊断标准指导下的分层早期干预能够有效缓解产妇不良情绪,降低产后抑郁发生率,同时还能提高产妇干预满意度。

Objective To explore the application value of stratified early intervention guided by Diagnostic and Statistical Manual of Mental Disorders(DSM-Ⅳ)diagnostic criteria in maternal postpartum depression.Methods 100 expectant parturients were randomly divided into control group and observation group,with 50 cases in each group.The control group received routine intervention,while the observation group received stratified early intervention under the guidance of DSM-Ⅳdiagnostic criteria.The depression scores and intervention satisfaction were compared between the two groups before and after intervention.Results There was no significant difference in the Hamilton Depression Scale(HAMD)scores between the two groups at 1 day before and 4 weeks,no significant difference(P>0.05).The HAMD score of the two groups at 4 weeks after delivery was higher than that at 1 day before delivery,with a significant difference(P<0.05).At 8 weeks postpartum follow-up,the incidence of depression in the observation group was 4.00%(2/50),which was lower than 16.00%(8/50)in the control group,with a significant difference(P<0.05).The Edinburgh Postpartum Depression Scale(EPDS)score at 8 weeks postpartum in the observation group was significantly lower than that in the control group and 4 weeks postpartum,with a significant difference(P<0.05).The total satisfaction of the observation group was 98.00%higher than that of the control group 84.00%,with a significant difference(P<0.05).Conclusion Stratified early intervention under the guidance of DSM-Ⅳdiagnostic criteria can effectively relieve maternal negative emotions,reduce the incidence of postpartum depression,and improve patients'satisfaction with intervention.