Miniati Mario, Callari Antonio, Calugi Simona, Rucci Paola, Savino Mario, Mauri Mauro, Dell'Osso Liliana
Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Via Roma, 67, 56100, Pisa, Italy,
Arch Womens Ment Health. 2014 Aug;17(4):257-68. doi: 10.1007/s00737-014-0442-7. Epub 2014 Jun 24.
Interpersonal psychotherapy (IPT) is a dynamically informed and present-focused psychotherapy originally conceived for patients with unipolar depression and subsequently modified for other disorders, including postpartum depression (PPD). The aim of this paper is to review the evidence on the efficacy of IPT for PPD. We conducted a systematic review of studies published between 1995 and April 2013 assessing the efficacy of IPT for PPD using PubMed and PsycINFO. We included the following: (i) articles that presented a combination of at least two of the established terms in the abstract, namely, interpersonal [all fields] and ("psychotherapy" [MeSH terms] or psychotherapy [all fields]) and (perinatal [all fields] or postpartum [all fields]) and ("depressive disorder" [MeSH terms] or ("depressive" [all fields] and "disorder" [all fields]) or depressive disorder [all fields] or "depression" [all fields] or depression [MeSH terms]); (ii) manuscripts in English; (iii) original articles; and (iv) prospective or retrospective observational studies (analytical or descriptive), experimental, or quasi-experimental. Exclusion criteria were as follows: (i) other study designs, such as case reports, case series, and reviews; (ii) non-original studies including editorials, book reviews, and letters to the editor; and (iii) studies not specifically designed and focused on IPT. We identified 11 clinical primary trials assessing the efficacy of IPT for PPD, including 3 trials with group interventions (G-IPT) and one that required the presence of the partner (PA-IPT). We also identified six studies interpersonal-psychotherapy-oriented preventive interventions for use in pregnancy. IPT studies showed overall clinical improvement in the most commonly used depression measures in postpartum depressed women (EPDS, HDRS, BDI) and often-full recovery in several cases of treated patients. Evidence from clinical trials indicates that, when administered in monotherapy (or in combination with antidepressants), IPT may shorten the time to recovery from PPD and prolong the time spent in clinical remission.
人际心理治疗(IPT)是一种基于动态信息且聚焦当下的心理治疗方法,最初是为单相抑郁症患者设计的,后来也被用于包括产后抑郁症(PPD)在内的其他疾病。本文旨在综述关于IPT治疗PPD疗效的证据。我们使用PubMed和PsycINFO对1995年至2013年4月期间发表的评估IPT治疗PPD疗效的研究进行了系统综述。我们纳入了以下研究:(i)在摘要中呈现至少两个既定术语组合的文章,即人际[所有字段]和(“心理治疗”[医学主题词]或心理治疗[所有字段])以及围产期[所有字段]或产后[所有字段]以及(“抑郁障碍”[医学主题词]或(“抑郁的”[所有字段]和“障碍”[所有字段])或抑郁障碍[所有字段]或“抑郁症”[所有字段]或抑郁症[医学主题词]);(ii)英文手稿;(iii)原创文章;以及(iv)前瞻性或回顾性观察性研究(分析性或描述性)、实验性或准实验性研究。排除标准如下:(i)其他研究设计,如病例报告、病例系列和综述;(ii)非原创研究,包括社论、书评和给编辑的信;以及(iii)未专门设计且聚焦于IPT的研究。我们确定了11项评估IPT治疗PPD疗效的临床初级试验,包括3项团体干预试验(G-IPT)和1项需要伴侣参与的试验(PA-IPT)。我们还确定了6项以人际心理治疗为导向的孕期预防性干预研究。IPT研究表明,产后抑郁女性最常用的抑郁量表(爱丁堡产后抑郁量表、汉密尔顿抑郁量表、贝克抑郁量表)总体上有临床改善,且在一些接受治疗的患者中常有完全康复的情况。临床试验证据表明,当IPT作为单一疗法(或与抗抑郁药联合使用)时,可能会缩短从PPD康复的时间,并延长临床缓解的时间。