正念分娩疗法对伴快感缺失孕期抑郁障碍疗效对照研究  

A controlled trial of mindfulness-based childbirth therapy in depressed pregnant women with anhedonia

作　　者：霍耀芳 胡雪英[1] 于丽燕[2] 狄亚琴[2] 王策 李媛媛[2] 严保平[2] HUO Yaofang;HU Xueying;YU Liyan(Baoding Maternal and Child Health Care Hospital,Baoding 071000,China)

机构地区：[1]保定市妇幼保健院,河北保定071000 [2]河北省精神卫生中心

出　　处：《精神医学杂志》2024年第6期612-616,共5页Journal of Psychiatry

基　　金：河北省卫生健康委员会医学科研课题(编号:20240794)。

摘　　要：目的探索正念分娩疗法对伴快感缺失孕期抑郁障碍患者的干预效果。方法选取抑郁障碍伴快感缺失的孕妇80例,随机分为研究组(正念分娩疗法)和对照组(一般心理干预治疗)各40例,进行为期8周的心理干预。于干预前后,采用快感缺失量表(DARS)、17项汉密尔顿抑郁量表(HAMD-17)、汉密尔顿焦虑量表(HAMA)、匹茨堡睡眠质量指数(PSQI)进行评估。结果干预8周后,两组DARS总分及各因子分均较各自干预前升高(P<0.05);干预后研究组DARS总分及期待性快感、动机性快感因子分均高于对照组(P<0.05)。两组干预前后DARS总分及期待性快感、动机性快感因子分差值比较,差异均有统计学意义(P<0.05)。干预后,两组HAMD-17、HAMA评分均较各自干预前降低(P<0.05);干预后,研究组HAMD-17、HAMA评分均低于对照组(P<0.05)。两组HAMD-17、HAMA评分干预前后差值比较,差异均有统计学意义(P<0.05)。干预后两组PSQI总分及睡眠质量、入睡时间、睡眠时间、日间功能因子均较干预前降低(P<0.05),研究组睡眠效率、睡眠障碍因子分均较干预前降低(P<0.05);干预后研究组PSQI总分及睡眠质量、入睡时间、睡眠时间、睡眠障碍、日间功能因子分均低于对照组(P<0.05)。两组PSQI总分及各睡眠质量、日间功能因子分干预前后差值比较,差异均有统计学意义(P<0.05)。结论正念分娩疗法有助于提高伴快感缺失孕期抑郁障碍患者期待性和动机性快感,调节抑郁、焦虑情绪和睡眠质量。Objective To explore the effect of mindfulness-based childbirth therapy on depressed pregnant women with anhedonia.Methods A total of 80 pregnant women with depressive disorder and anhedonia were selected and randomly divided into study group(mindfulness delivery therapy)and control group(general psychological intervention treatment),with 40 cases in each group,for 8-week psychological intervention.Before and after intervention,they were all assessed with Dimentional Anhedonia Rating Scale(DARS),17-item Hamilton Depression Scale(HAMD-17),Hamilton Anxiety Scale(HAMA),and Pittsburgh Sleep Quality Index(PSQI).Results After intervention,the total score and all factor scores of DARS in both groups increased significantly compared with those before intervention(P<0.05);and the total score as well as factor scores of anticipatory pleasure and motivational pleasure of DARS in study group were higher than those in control group(P<0.05).After intervention,total scores of HAMD-17 and HAMA in both groups decreased compared with those before treatment(P<0.05),and the total scores of HAMD-17 and HAMA in study group were lower than those in control group(P<0.05).After intervention,the total score and factor scores of sleep quality,falling asleep time,sleep duration and daytime function of PSQI in both groups decreased significantly compared with those before intervention(P<0.05),and factor scores of sleep efficiency and sleep disorder in study group decreased significantly compared with those before intervention(P<0.05).After intervention,study group showed lower total score and factor scores of sleep quality,falling asleep time,sleep duration,sleep disorder and daytime function of PSQI than control group(P<0.05).There existed significant differences between two groups in differences of total scores and factor scores of anticipatory pleasure and motivational pleasure of DARS,total scores of HAMD-17 and HAMA,as well as total scores and factor scores of sleep quality and daytime function of PSQI before and after intervention(P<0.

关 键 词：正念分娩 孕妇 快感缺失 抑郁 焦虑 睡眠 

分 类 号：R749.4[医药卫生—神经病学与精神病学]