産後うつ病を予防するための介入:米国予防サービスタスクフォースのための証拠報告と体系的なレビュー
Elizabeth O'Connor1, Caitlyn A Senger1, Michelle L Henninger1
1Kaiser Permanente Research Affiliates Evidence-Based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon.
JAMA
|February 13, 2019
まとめ
カウンセリングの介入は 産後うつ病を効果的に予防します 特にリスクの高い個人にです 他のアプローチは有望ですが,母親と子供の幸福のためにその有効性と安全性を確立するには,より多くの研究が必要です.
科学分野:
- 生後期の精神的健康
- 予防医療戦略
- 根拠に基づいた医療
背景:
- 産後うつ病は 母親と乳児に影響を及ぼし 効果的な予防策が必要になります
- 妊産婦のうつ病を特定し 管理するにあたって 医療従事者の主な役割は
研究 の 目的:
- 生後うつ病の予防のための介入の利益と害を体系的に検討する.
- 予防サービス・タスク・フォースの勧告を参考にする.
主な方法:
- ランダム化臨床試験 (RCT) と非ランダム化制御介入試験の体系的レビュー
- MEDLINE,PsycINFO,Cochrane Centralなど 大手データベースで検索しました
- 介入の恩恵を推定するために使用されるメタ分析.
主要な成果:
- 22385人の参加者を含む50件の研究が含まれていた.
- カウンセリングによる介入は,胎内うつ病の確率を著しく低下させました (RR,0.61).
- 保健システムへの介入は潜在的利益を示したが,統計的に有意ではなかった.抗うつ薬の使用は再発と有害な影響に関して異なった結果を示した.
結論:
- カウンセリングの介入は,特にリスクの高い集団において,胎内うつ病を予防するのに有効です.
- 他の介入には可能性はあるが 徹底した研究が必要である.
- 生後期の精神保健のプライマリケアに 予防戦略を組み込むことを 支持する証拠があります
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