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首页> 外文期刊>The British journal of psychiatry : >Telephone-based nurse-delivered interpersonal psychotherapy for postpartum depression: nationwide randomised controlled trial
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Telephone-based nurse-delivered interpersonal psychotherapy for postpartum depression: nationwide randomised controlled trial

机译：基于电话的护士 - 产后抑郁症的人际心理治疗：全国随机对照试验

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Background Postpartum depression and anxiety are under-addressed public health problems with numerous treatment access barriers, including insufficiently available mental health specialist providers. Aims To examine the effectiveness of nurse-delivered telephone interpersonal psychotherapy (IPT) for postpartum depression. Trial registration ISRCTN88987377. Method Postpartum women (n = 241) with major depression (on the Structured Clinical Interview for DSM-IV (SCID-I)) from 36 Canadian public health regions in rural and urban settings were randomly assigned to 12 weekly 60 min nurse-delivered telephone-IPT sessions or standard locally available care. The primary outcome was the proportion of women clinically depressed at 12 weeks post-randomisation, with masked intention-to-treat analysis. Secondary outcomes examined included comorbid anxiety, self-reported attachment and partner relationship quality. Results At 12 weeks, 10.6% of women in the IPT group (11/104) and 35% in the control group (35/100) remained depressed (OR = 0.22, 95% CI 0.10-0.46), with the IPT group 4.5 times less likely to be clinically depressed (SCID); 21.2% in the IPT group and 51% in the control group had an Edinburgh Postnatal Depression Scale (EPDS) score >12 (OR = 0.26, 95% CI 0.14-0.48), and attachment avoidance decreased more in the IPT group than in the control group (P = 0.02). Significant differences favoured the IPT group for comorbid anxiety and partner relationship quality at all time points, with no differences in health service or antidepressant use. None of the IPT responders relapsed by 36 weeks. Between-group SCID differences were sustained at 24 weeks, but not at 36 weeks. Conclusions Nurse-delivered telephone IPT is an effective treatment for diverse urban and rural women with postpartum depression and anxiety that can improve treatment access disparities.
机译：背景后产后抑郁和焦虑是涉及众多治疗访问障碍的公共卫生问题，包括可用的心理健康专家提供者。旨在审查护士交付的电话人际关系心理治疗（IPT）对产后抑郁症的有效性。试验登记ISRCTN88987377。方法产后女性（n = 241）与主要抑郁症（关于DSM-IV（SCID-I）的结构化临床访谈）从农村和城市环境中的36个公共卫生地区随机分配到12周60分钟的护士交付电话 - 符合会话或标准的本地可用护理。主要结果是在随机后12周临床抑郁的妇女比例，具有掩盖意向治疗分析。检查的二次结果包括合并焦虑，自我报告的依恋和合作伙伴关系质量。结果在12周内，IPT集团（35/100）中的10.6％的IPT组（11/104）和35％的妇女持续抑制（或= 0.22,95％CI 0.10.46），有IPT组4.5临床抑郁的可能性不太可能（SCID）; IPT组中21.2％，对照组51％有爱丁堡后期抑郁尺度（EPD）得分> 12（或= 0.26,95％CI 0.14-0.48），而且IPT组的附着避免比在对照组（P = 0.02）。显着差异赞成IPT组在所有时间点的合并焦虑和合作伙伴关系质量，卫生服务没有差异或抗抑郁用途。 IPT响应者都没有复发36周。组间SCID差异在24周持续，但不在36周内进行。结论护士交付电话IPT对不同的城市和农村妇女进行后级抑郁和焦虑的有效待遇，可以改善治疗访问差异。

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