母亲抑郁症和儿童精神病理学的缓解:一个STAR*D儿童报告
Myrna M Weissman1, Daniel J Pilowsky, Priya J Wickramaratne
1Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, New York 10032, USA. mmw3@columbia.edu
JAMA
|March 23, 2006
概括
治疗母亲抑郁症有效地减少了儿童的精神病诊断和症状. 未经治疗的孕产妇抑郁症与儿童疾病率的增加有关,这凸显了需要及时的孕产妇心理健康护理的需要.
科学领域:
- 儿童和青少年精神病学 儿童和青少年精神病学
- 孕产妇心理健康 孕产妇心理健康
- 临床心理学 临床心理学
背景情况:
- 患有严重抑郁症的母亲的孩子表现出高率的早期发病,持久性和损害焦虑,破坏性和抑郁障碍.
- 这些童年障碍往往持续到成年期,显著影响整体功能.
研究的目的:
- 调查有效治疗母亲抑郁症的药物治疗与减少孩子的症状和诊断之间的关联.
- 评估母亲抑郁症缓解对儿童精神病治疗结果的影响.
主要方法:
- 利用了来自测序治疗替代方法缓解抑郁症 (STAR*D) 试验的数据,该试验涉及151对母亲和孩子 (7至17岁的儿童).
- 儿童由独立评估人员使用标准化仪器进行评估 (儿童情绪障碍和精神分裂症表,儿童行为检查清单,儿童全球评估量表).
- 孕产妇抑郁症缓解是根据汉密尔顿抑郁症评分尺度定义的,在3个月的药物治疗后,抑郁症得分≤7.
主要成果:
- 母亲抑郁症的缓解与儿童诊断和症状的减少有显著联系 (11%的减少与8%的增加对比).
- 实现缓解的母亲的孩子显示出33%的诊断缓解率,而没有缓解的母亲的孩子则为12%.
- 孕产妇的治疗反应与儿童的治疗结果呈正相关性,至少需要50%的孕产妇反应才能显著改善儿童的治疗结果.
结论:
- 母亲抑郁症的缓解对母亲和孩子的福祉都有积极的影响.
- 仍然抑郁的母亲与孩子患精神疾病的比例增加有关.
- 积极治疗母亲抑郁症至关重要,抑郁母亲的孩子需要仔细评估,特别是如果母亲的症状持续下去.
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