心理干预对产后抑郁症疗效的影响-毛庆娟

毛庆娟①　张　富【】　　探讨心理干预对产后抑郁症疗效的影响。　将产后抑郁症患者随机分为心理干预组和对照组,治疗6周,分别给予心理干预配合药物治疗和单独使用药物治疗,采用汉密尔顿抑郁量表(HAMD)和临床疗效总评量表对病情严重程度(CGI-SI)评定疗效。　①治疗第6周末心理干预组有效率优于对照组,差异有显著性(i2=5.455,P=0.020);②两组治疗后各周末HAMD评分较治疗前均极显著降低(P0.01);两组间比较,治疗后2周开始心理干预组HAMD评分明显低于对照组,差异有显著性(P0.05);③治疗第6周末两组病情严重程度(CGI-SI)均较治疗前有极显著改善(t=14.46及14.42,均为P0.01);治疗后心理干预组CGI-SI评分低于对照组,差异有显著性(t=2.50,P=0.015)。　心理干预可显著改善产后抑郁症患者的抑郁症状,提高其生活质量。【】　抑郁症;心理干预;产后;汉密尔顿抑郁量表EffectofPsychologicalInterventionontheEfficacyofPostpartumDepression(PPD).MaoQingjuan,ZhangFu.ShalingziHos-pitalofZhangjiakouCity,Zhangjiakou075131,P.R.China【Abstract】　Objective　ToexploretheEffectofpsychologicalinterventionontheefficacyofpostpartumdepression.Methods　Atotalof60patientswithpostpartumdepressionweredividedintopsychologicalinterventiongroupandcontrolgroupfor6weeks.HAMD,CGI-SIwereusedtoevaluatetheefficacybeforeandafterthetreatment.Results　①Attheendof6weeks,theeffectiverateofthepsychologicalinterventiongroupwassignificantlyhigherthanthatofincontrolgroupwithstatisticalsignificance(i2=5.455,P=0.020).②TheHAMDscoresintwogroupsdecreasedsignificantlyaftertreatmentineveryweek(P0.01).TheHAMDscoresofthepsychologicalinterventiongroupwassignificantlylowerthanthatofcontrolgroupwithstatisticalsignificance(P0.05).③TheCGI-SIscoresintwogroupsdecreasedsignificantlyin6weekaftertreatment(t=14.46or14.42,P0.01).TheCGI-SIscoresofthepsychologicalinterventiongroupwassignificantlylowerthanthatofcontrolgroupwithstatisticalsignif-icance(t=2.50,P=0.015).Conclusion　Treatmentwithpsychologicalinterventioncanobviouslyrelievedepressivesymptomsofpostpartumdepressionandimprovetheirlifequality.【Keywords】　Depression;Psychologicalintervention;Postpartum;HAMD　　,、,1～2[1]。O'Hara[2],(PPD),13%;5.51%[3]～25.8%[4],。。1　1.1　　,,CCMD-3,HAMD17≥18,,,。60,。30,25.83±3.23,124,2(2)6,18,12;30,26.36±3.63,122,2(2)8,16,14;(P0.05)。1.2　　1.2.1　　10mg/d,220～40mg/d,。(P0.05)。6。HAMD17[5]、(CGI-SI)1、2、4、61。HAMD25%,25%～50%,51%～75%,75%。、,、。。1.2.2　1.2.2.1　,　、、,;,,,,。,,,、、,。1.2.2.2　　,,,、、、,,,,,,。,,,,·520·　2010185　　ChinaJournalofHealthPsychology　2010,Vol18,No.5　①.　075131　E-mail:[e-mail]:10.13342/j.cnki.cjhp.2010.05.020、、。,、,,、、,,。1.2.2.3　,　,,,,,,;、、;,、、、,,,、。1.2.2.4　,　,,,,,、、,。,.,,,。1.2.2.5　　,,,、,,,,,,,,。1.2.2.6　　,,,,。,,,,,,,。1.2.3　　SPSS11.5ti2。2　　2.1　　18,9,1,2,93.3%;10,10,1,9,70%。(i2=5.455,P=0.020)。1　HAMD(n=30,x-±s)　tP24.57±2.9924.83±2.800.3560.05120.03±3.98*21.17±3.31*1.1990.05214.93±5.34*17.50±4.17*2.0750.0549.70±5.65*12.90±5.93*2.1410.0567.40±4.89*10.33±5.50*2.1840.05　:*P0.01,2.2　HAMDCGI-SI　12。　　1,HAMD(P0.01);1HAMD(P0.05),2HAMD,(P0.05)。2　CGI-SI(n=30,x-±s)　tP3.60±0.893.76±0.900.7200.4741.27±0.50*1.70±0.84*2.4990.015　　2,(CGI-SI),t=14.4614.42,P0.01;:CGI-SI(P0.05);CGI-SI,(P=0.015)。3　　,、,[6],,,。,4.5[7],、、,,。,,。:HAMD、CGI-SI,,,,。,,。4　[1]陈燕杰,钟友彬.产后抑郁症[J].实用妇产科杂志,2000,16(1):13-15[2]O′HaraMW,SwainAM.Ratesandriskofpostpartumdepression:ametaanalysis[J].IntRevPsychiatry,1996,8:37-54[3]齐国娥.任平伟.李占敏,等.产后抑郁症的社区调查分析[J].中国健康心理学杂志,2009,17(10):29-31[4]王馨.袁野.刘建安.产后抑郁水平及其影响因素[J].中国健康心理学杂志,2009,17(1):91-93[5]张明园.精神科评定量表手册[M].长沙:湖南科学技术出版社,1993,122-127[6]张新艳.段椒芳.产后临床与心理初步分析[J].中国心理卫生杂志,1999,13(3):119[7]汤月芬.王立伟.施慎逊.产后抑郁症生物学病因及评估的研究进展[J].中华精神科杂志,2005,38(2):126-128(收稿时间:2009-12-18)·521·　2010185　　ChinaJournalofHealthPsychology　2010,Vol18,No.5