دانلود مقاله روان درمانی روانپویشی برای افسردگی پس از زایمان
خلاصه
معرفی
روش
نتایج
بحث
نتیجه گیری
اعلامیه ها
منابع
Abstract
Introduction
Method
Results
Discussion
Conclusions
Declarations
References
چکیده
اهداف
شیوع افسردگی پس از زایمان در زنان بین 5 تا 26 درصد تخمین زده می شود و اثرات نامطلوبی بر مادر، نوزاد و شریک زندگی او دارد. ثابت شده است که درمان‌های روانشناختی برای زنان با علائم خفیف تا متوسط مؤثر است. در حالی که چندین مرور سیستماتیک اثرات مداخلات روانشناختی مختلف را برای افسردگی پس از زایمان، مانند درمان شناختی-رفتاری یا درمان بین فردی ارزیابی کرده اند، هیچ مروری برای ارزیابی روان پویشی درمانی انجام نشده است. یک مرور سیستماتیک برای ارزیابی اثربخشی درمان روان پویشی برای افسردگی پس از زایمان انجام شد.
مواد و روش ها
مطالعات با استفاده از پایگاه‌های داده زیر شناسایی شدند: PsycINFO، Psycarticles و Pubmed در ژانویه 2023. الزامات مطالعات به شرح زیر بود: آنها باید کمی باشند، به زبان انگلیسی در دسترس باشند، از جمله یک مداخله روان‌دینامیک با هدف درمان یا پیشگیری از افسردگی پس از زایمان که در طی آن شروع می‌شود. بارداری یا در 12 ماه اول پس از زایمان. مطالعات موردی، مطالعات کیفی یا مطالعات متمرکز بر بهبود روابط والدین و نوزاد یا پیامد نوزاد از این تحقیق حذف شدند.
نتایج
هفت کارآزمایی شامل 521 زن معیارهای ورود را داشتند. به طور خلاصه، سه کارآزمایی تصادفی‌سازی و کنترل‌شده و چهار مطالعه طولی پیدا شد. پرکاربردترین ابزار ارزیابی EPDS، پنج مداخله فردی و دو مورد دیگر مداخلات گروهی بود.
بحث
همه مطالعات اثربخشی مداخلات روان پویشی را برای افسردگی پس از زایمان، هم در محیط های خانگی و بالینی و هم در قالب گروهی و فردی گزارش کردند. تعداد محدود کارآزمایی، حجم نمونه کوچک و نبود گروه های کنترل مناسب محدودیت های اصلی بودند.
نتیجه گیری
برای عمل، درمان روان پویایی احتمالاً مداخله مؤثری برای افسردگی پس از زایمان است. تحقیقات آتی با طرح های روش شناختی قوی برای تایید این یافته ها مورد نیاز است.
Abstract
Objectives
Postpartum depression estimated prevalence in women is between 5 and 26% and it has adverse effects both on the mother, infant and her partner. Psychological treatments have proved to be effective for women with mild-to-moderate symptoms. Whereas several systematic reviews have assessed the effects of different psychological interventions for postpartum depression, such as cognitive-behavioural therapy or interpersonal therapy, no review assessing psychodynamic therapy has been carried out. A systematic review was conducted to evaluate the efficacy of psychodynamic therapy for postpartum depression.
Methods
Studies were identified using the following databases: PsycINFO, Psycarticles and Pubmed over January 2023. The requirements for the studies were the following: they had to be quantitative, available in English, including a psychodynamic intervention targeting treatment or prevention of postpartum depression which starts during pregnancy or within the first 12 months after giving birth. Case studies, qualitative studies or studies focused on improving parent-infant relationship or infant outcome were excluded from this research.
Results
Seven trials including 521 women met the inclusion criteria. In summary, three randomized controlled trials and four longitudinal studies were found. The most frequently used assessment tool was EPDS, five were individual interventions and the other two were group interventions.
Discussion
All studies reported the efficacy of psychodynamic interventions for postpartum depression, both in home and clinical settings and both in group and individual format. The limited number of trials, small sample sizes and lack of appropriate control groups were the main limitations.
Conclusions for practice
Psychodynamic therapy is probably efficient intervention for postpartum depression. Future research with strong methodological designs is needed to confirm these findings.
Significance
What is already known on this subject? Several systematic reviews have assessed the effects of different psychological interventions for postpartum depression, but no review assessing psychodynamic therapy has been carried out. What this study adds? A systematic review was conducted to evaluate the efficacy of psychodynamic therapy for postpartumdepression. This makes the systematic review a unique contribution to the literature.
Introduction
Historically parent’s mental health during the perinatal period has been overlooked, as it was conceived as a time of joy and emotional stability. Only in 1950’s some authors started to write about maternity blues, postpartum depression, and puerperal psychosis (Besser et al., 2008). Studies have generally targeted mothers and their psychological wellbeing. On the contrary, paternal mental health remains under-investigated even though non-gestational parents may also suffer from mental disorders in the peripartum period.
Postpartum depression encompasses a depression disorder occurring within the 12 months following childbirth (Branquinho et al., 2021) and the disorder can be compared to a major depressive episode in any moment of a woman’s life. However, symptoms such as anxiety, anhedonia, aggressive obsessional thoughts, restlessness or concentration and decision-making difficulties are more frequent or severe in the immediate postpartum (Batt et al., 2020). Postpartum depression has adverse effects on the woman and, therefore, on the infant as the disorder is closely related to difficulty to carry out different parenting tasks, such as breastfeeding, sleeping, or responding to the infant’s needs (Branquinho et al., 2021; Nanzer et al., 2012). It is also the strongest predictor of paternal depression during the perinatal period (Kaźmierczak et al., 2020). In addition, it is one of the main causes of maternal deaths in the first year after childbirth as the mother may develop suicidal thoughts and intentions. (Al-Halabí et al., 2021). The estimated prevalence of postpartum depression in women varies across countries, assessment criteria or time frame ranging from 5 to 26% (Liu et al., 2022).
Conclusions
Psychodynamic approach still plays a minor role in the mainstream theory, research, and treatment for postpartum depression, even though the amount of data has kept growing for the last decade. BDP is probably efficient intervention for postpartum depression. Therefore, it is suggested that research should be continued to assess the effectiveness of psychodynamic interventions in postpartum depression compared to other effective treatments.