预防围产期抑郁症的干预措施:美国预防服务工作组的证据报告和系统审查
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
概括
辅导干预有效防止产周抑郁症,特别是在高危人群中. 虽然其他方法看起来有前途,但仍需要更多的研究来确定它们对母亲和儿童健康的有效性和安全性.
科学领域:
- 围产期心理健康
- 预防性医疗保健战略
- 基于证据的医学
背景情况:
- 围产期抑郁症影响到母亲和婴儿, 需要有效的预防策略.
- 在发现和治疗围产期抑郁症方面, 初级护理起着至关重要的作用.
研究的目的:
- 系统地审查预防围产期抑郁症的干预措施的益处和危害.
- 根据美国预防服务工作组的建议.
主要方法:
- 随机临床试验 (RCT) 和非随机控制干预研究的系统审查.
- 搜索了主要的数据库,包括MEDLINE,PsycINFO和Cochrane中央.
- 用于估计干预效益的元分析.
主要成果:
- 包括50项涉及22385名参与者的研究.
- 辅导干预显著降低了围产期抑郁症的可能性 (RR,0.61).
- 医疗系统的干预显示了潜在的益处,但没有统计学意义;抗抑郁药的使用在复发和不良影响方面产生了混合的结果.
结论:
- 咨询干预措施在预防围产期抑郁症方面是有效的,特别是在风险人群中.
- 其他干预措施有潜力,但需要进一步的研究.
- 证据支持将预防策略纳入围产期心理健康的初级护理.
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