综合心理干预对产后抑郁患者的疗效评价
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摘要
目的:探讨综合心理干预对改善产后抑郁患者的负性心理情绪及疗效评价。方法:选取2016年12月至2017年12月于我院分娩的80例产妇产后合并抑郁患者的临床资料,采用随机数字表法将患者随机分为干预组和对照组,给予对照组实施单纯心理干预治疗,干预组给予综合心理干预治疗,观察并比较两组患者治疗前和治疗8周后汉密尔顿焦虑量表评分(HAMA)、汉密尔顿抑郁量表评分(HAMD)、爱丁堡产后抑郁量表(Edinburgh postnatal depression scale,EPDS)评分情况,比较两组患者治疗前和治疗8周后血雌二醇和孕酮水平变化情况。结果:比较两组患者治疗前HAMA评分和HAMD评分,差异均无统计学意义(P>0.05);治疗后干预组HAMA评分和HAMD评分均显著低于对照组治疗后水平,差异具有统计学意义(t=-5.706,-4.748;P<0.05);比较两组患者治疗前EPDS评分,差异无统计学意义(P>0.05);治疗后干预组患者EPDS评分低于对照组治疗后水平,差异具有统计学意义(t=-11.26,P<0.05);比较两组患者治疗前血雌二醇和孕酮水平,差异均无统计学差异(P>0.05);治疗后观察组血雌二醇和孕酮水平均低于对照组治疗后水平,差异比较具有统计学差异(t=-12.19,-7.404;P<0.05)。结论:综合心理干预对治疗产后抑郁疗效显著,并且能够促进产妇恢复激素水平。
Objective:To explore the effect of comprehensive psychological intervention on improvement of the negative psychological mood and efficacy evaluation of postpartum depression patients in order to provide reference for clinical diagnosis and treatment.Methods:The clinical data of 80 patients with postpartum depression and postpartum depression admitted to our hospital from December 2016 to December 2017 were selected and divided into intervention group and control group by random number table method.The control group was given simple psychological intervention treatment,and the control group was given comprehensive psychotherapy.Scores of observe and compare Hamilton anxiety rating scale(HAMA),Hamilton depression rating scale(HAMD)and the Edinburgh postnatal depression scale(Edinburgh postnatal 'scale,EPDS)of the two groups of patients before and after 8 weeks treatment were compared.We also compared the changes in serum estradiol and progesterone levels between the two groups before and after 8 weeks of treatment.Results:The scores of HAMA,HAMD and EPDS were significantly lower than those of the pre-treatment level(P<0.05)after 8 weeks of treatment.After 8 weeks of observation group,HAMA(t=-5.706,P<0.001),HAMD(t=-4.748,P<0.001),EPDS(t=-11.26,P<0.001)were all lower than the control group.The estradiol and progesterone levels of the two groups of patients after treatment were lower than before treatment(P<0.05),and the estradiol(t=-12.19,P<0.001)and progesterone(t=-7.404,P<0.001)levels of the observation group of patients after treatment were lower than those of the control group.Conclusion:Comprehensive psychological intervention is effective in the treatment of postpartum depression and can promote maternal recovery hormone level.
Objective:To explore the effect of comprehensive psychological intervention on improvement of the negative psychological mood and efficacy evaluation of postpartum depression patients in order to provide reference for clinical diagnosis and treatment.Methods:The clinical data of 80 patients with postpartum depression and postpartum depression admitted to our hospital from December 2016 to December 2017 were selected and divided into intervention group and control group by random number table method.The control group was given simple psychological intervention treatment,and the control group was given comprehensive psychotherapy.Scores of observe and compare Hamilton anxiety rating scale(HAMA),Hamilton depression rating scale(HAMD)and the Edinburgh postnatal depression scale(Edinburgh postnatal 'scale,EPDS)of the two groups of patients before and after 8 weeks treatment were compared.We also compared the changes in serum estradiol and progesterone levels between the two groups before and after 8 weeks of treatment.Results:The scores of HAMA,HAMD and EPDS were significantly lower than those of the pre-treatment level(P<0.05)after 8 weeks of treatment.After 8 weeks of observation group,HAMA(t=-5.706,P<0.001),HAMD(t=-4.748,P<0.001),EPDS(t=-11.26,P<0.001)were all lower than the control group.The estradiol and progesterone levels of the two groups of patients after treatment were lower than before treatment(P<0.05),and the estradiol(t=-12.19,P<0.001)and progesterone(t=-7.404,P<0.001)levels of the observation group of patients after treatment were lower than those of the control group.Conclusion:Comprehensive psychological intervention is effective in the treatment of postpartum depression and can promote maternal recovery hormone level.
引文
[1]李密密,唐青峰,张国琴,等.我国产后抑郁评估量表的应用现状[J].中国心理卫生杂志,2016,30(6):418-423
[2]张凤凤.心理干预联合放松训练对产后抑郁患者心理健康和自我效能的影响研究[J].中国妇幼保健,2015,30(26):4440-4443
[3]Stephens S,Ford E,Paudyal P,et al.Effectiveness of psychological interventions for postnatal depression in primary care:A meta-analysis[J].Ann Fam Med,2016,14(5):463-472
[4]Milgrom J,Negri L M,Gemmill A W,et al.A randomized controlled trial of psychological interventions for postnatal depression[J].Br J Clin Psychol,2005,44(4):529-542
[5]汤月芬,施慎逊,陆雯,等.孕期心理干预对产后焦虑、抑郁的影响[J].中国心理卫生杂志,2009,23(2):83-89
[6]骆琴,彭树花,孟雪梅,等.孕期心理健康教育联合护理干预对产后抑郁的预防效果观察[J].国际精神病学杂志,2016,43(3):532-535
[7]武士敏,张洁,美丽班·哈盼,等.早期及时的心理疏导对产后抑郁患者生活质量的影响[J].中国健康心理学杂志,2017,25(8):1145-1148
[8]刘艳青.产后抑郁的发病机制及其护理干预进展[J].护理实践与研究,2016,13(15):25-27
[9]彭敏,李文堃,陈燕桢,等.心理治疗辅助帕罗西汀对产后抑郁症患者临床疗效的影响[J].实用医院临床杂志,2017,14(1):65-68
[10]段丽平.人性化护理用于产后抑郁症的效果分析[J].临床医药文献电子杂志,2016,3(3):531-531
[11]高宝娟,严雪霏.心理护理联合健康教育对产后抑郁的干预作用[J].中国妇幼保健,2017,32(13):2841-2843
[12]刘乐,陈静,蔡亦蕴,等.音乐治疗合并心理干预对高危孕妇孕期和产后焦虑抑郁情绪的影响[J].临床精神医学杂志,2017,27(1):9-11
[13]齐国娥,任平伟,李占敏,等.个性化心理干预在产后抑郁患者中实施的效果评价[J].护理实践与研究,2010,7(3):1-3
[14]O'Hara M W.Psychosocial and psychological interventions reduce the risk of postnatal depression compared with standard care[J].Evid Based Nurs,2014,17(2):38-39
[15]Morrell C J,Warner R,Slade P,et al.Psychological interventions for postnatal depression:Cluster randomised trial and economic evaluation[J].The PoNDER trial.Health Technol Assess,2009,13(30):1-153
[16]冯琼,蔡茵,周义文,等.分段心理干预对产后抑郁的影响[J].中国妇幼保健,2012,27(5):676-678
[17]黎学华,谢震渊.产后抑郁症的综合性心理干预及疗效评价[J].湖南师范大学学报(医学版),2010,7(3):23-26
[2]张凤凤.心理干预联合放松训练对产后抑郁患者心理健康和自我效能的影响研究[J].中国妇幼保健,2015,30(26):4440-4443
[3]Stephens S,Ford E,Paudyal P,et al.Effectiveness of psychological interventions for postnatal depression in primary care:A meta-analysis[J].Ann Fam Med,2016,14(5):463-472
[4]Milgrom J,Negri L M,Gemmill A W,et al.A randomized controlled trial of psychological interventions for postnatal depression[J].Br J Clin Psychol,2005,44(4):529-542
[5]汤月芬,施慎逊,陆雯,等.孕期心理干预对产后焦虑、抑郁的影响[J].中国心理卫生杂志,2009,23(2):83-89
[6]骆琴,彭树花,孟雪梅,等.孕期心理健康教育联合护理干预对产后抑郁的预防效果观察[J].国际精神病学杂志,2016,43(3):532-535
[7]武士敏,张洁,美丽班·哈盼,等.早期及时的心理疏导对产后抑郁患者生活质量的影响[J].中国健康心理学杂志,2017,25(8):1145-1148
[8]刘艳青.产后抑郁的发病机制及其护理干预进展[J].护理实践与研究,2016,13(15):25-27
[9]彭敏,李文堃,陈燕桢,等.心理治疗辅助帕罗西汀对产后抑郁症患者临床疗效的影响[J].实用医院临床杂志,2017,14(1):65-68
[10]段丽平.人性化护理用于产后抑郁症的效果分析[J].临床医药文献电子杂志,2016,3(3):531-531
[11]高宝娟,严雪霏.心理护理联合健康教育对产后抑郁的干预作用[J].中国妇幼保健,2017,32(13):2841-2843
[12]刘乐,陈静,蔡亦蕴,等.音乐治疗合并心理干预对高危孕妇孕期和产后焦虑抑郁情绪的影响[J].临床精神医学杂志,2017,27(1):9-11
[13]齐国娥,任平伟,李占敏,等.个性化心理干预在产后抑郁患者中实施的效果评价[J].护理实践与研究,2010,7(3):1-3
[14]O'Hara M W.Psychosocial and psychological interventions reduce the risk of postnatal depression compared with standard care[J].Evid Based Nurs,2014,17(2):38-39
[15]Morrell C J,Warner R,Slade P,et al.Psychological interventions for postnatal depression:Cluster randomised trial and economic evaluation[J].The PoNDER trial.Health Technol Assess,2009,13(30):1-153
[16]冯琼,蔡茵,周义文,等.分段心理干预对产后抑郁的影响[J].中国妇幼保健,2012,27(5):676-678
[17]黎学华,谢震渊.产后抑郁症的综合性心理干预及疗效评价[J].湖南师范大学学报(医学版),2010,7(3):23-26