心理健康教育对孕期焦虑抑郁及产后抑郁的影响  

Value of group psychological intervention in preventing anxiety/depression during pregnancy and postpartum depression

作　　者：陈焱[1] 陆雯[1] 汤月芬[2] 余文[3] 王青青[1] 罗剑锋[4] 朱雍雍[2] 杨杰[2] 程利南[1] 施慎逊[2] 

机构地区：[1]中国福利会国际和平妇幼保健院产科,上海200030 [2]复旦大学附属华山医院精神科 [3]中国福利会国际和平妇幼保健院儿保科,上海200030 [4]复旦大学医学院社会医学与统计教研室

出　　处：《上海医学》2007年第12期907-910,共4页Shanghai Medical Journal

基　　金：上海市卫生局科技发展基金(044108)

摘　　要：目的探讨集体心理健康教育对孕期焦虑或抑郁症状及产后抑郁症状产生的影响。方法选择在我科登记的孕妇200名,采用随机、单盲的前瞻性队列研究。200名孕妇按简单随机法分为干预组和对照组,干预组接受为期6周的集体心理健康教育。在孕期每月随访1次,采用综合医院焦虑/抑郁量表(HAD)进行评估;产后3、42 d和3个月,采用爱丁堡产后抑郁量表(EPDS)及HAD进行评估,EPDS≥13分或HAD中A或D项分≥9分用《诊断与统计手册:精神障碍》第4版(DSM-Ⅳ)配套的诊断问卷(SCID)进行产后抑郁评估。结果对照组孕期总焦虑及抑郁症状的检出率分别为7.0%和5.0%,干预组分别为3.2%和3.2%,两组间差异均无统计学意义(P值均>0.05)。干预组产后42 d的抑郁症状检出率为6.5%,显著低于对照组的17.0%(P<0.05)。结论孕期集体心理健康教育能降低产后42 d的抑郁症状检出率,并能在一定程度上缓解孕期焦虑/抑郁症状。Objective To evaluate the effects of group psychological intervention in the prevention of anxiety/depression during pregnancy and postpartum depression. Methods A prospective randomized controlled trial was conducted in 200 pregnant women, who were assigned randomly to psychological intervention group or the control group. Women in the intervention group received group psychological intervention for 6 weeks during pregnancy. Evaluation with Hospital Anxiety and Depression（HAD） Scale was performed on a monthly basis in both the antenatal and postpartum period, and at 3 days, 6 weeks and 3 months postpartum; the subjects were assessed for postpartum depression using Edinburgh Postnatal Depression Scale （EPDS） and HAD Scale. Subjects with EPDS scores no less than 13, or with A or D scores no less than 9 in HAD Scale assessment, were referred to evaluation with Structured Clinical Interview for DSM-Ⅳ （SCID） for the diagnosis of postpartum depression. Results The incidences of antenatal anxiety and depression in the control group were 7.0% and 5.0%, respectively, which were lowered to 3. 2% and 3. 2% in the intervention group, but the differences were not statistically significant （P 〉 0.05）. Psychological intervention, however, reduced the incidence of depression 42 days postpartum （6.5%） as compared to that（17.0%） in the control group （P〈0.05） . Conclusion Group psychological intervention can significantly reduce the incidence of postpartum depression and help relieve the symptoms of anxiety and depression during pregnancy. （Shanghai Med J, 2007, 30..907-910）

关 键 词：孕期焦虑 孕期抑郁 产后抑郁 集体心理健康教育 

分 类 号：R749.4[医药卫生—神经病学与精神病学] R395.6[医药卫生—临床医学]