社区干预在产后抑郁症康复中的意义

目的:探讨社区干预在产后抑郁症康复中的意义。方法:通过我院的访视员对2008年2月～2009年2月来我院足月分娩的2 394例产妇在产妇产后第7天和第28天进行家庭访视,发放抑郁自评量表及调查问卷表。将确诊的产后抑郁症患者按照是否愿意接受干预治疗分为治疗组和未治疗组进行对比,治疗组给予社区访视了解产妇的心理变化,实行有针对性的疏导、家庭干预与认知行为治疗等,必要时给予药物治疗。未治疗组每(1～2)周电话或家访直至痊愈,电话或家访期间未行任何干预,主要观察患者抑郁症状的变化。评估两组患者在疾病的转归和症状持续时间上的差异。结果:产后抑郁症的发病与产妇文化程度有密切关系,经统计学处理高中以上的产妇与高中以下产妇的发病率有明显差异(P<0.05);2 386名产妇中有明确产后抑郁症状的319例,发生率13.37%;行转诊的抑郁症患者和未进行治疗的抑郁症患者在疾病的转归和症状消失时间上存在明显的差异(P<0.05)。结论:产后抑郁症严重影响产妇身心健康和婴儿生长发育,社区干预是降低产后抑郁症发病率的重要手段。

The Significance of Community Intervention on the Recovery of Postpartum Depression

Objective:To investigate the significance of Community intervention on the recovery of postpartum depression.Methods:2 394 cases from February of 2008 to February of 2009 were home visited by our visitors on the seventh day and twenty-eighth day.They were tested by SDS and questionnaires.The cases who were diagnosed postpartum depression were assigned randomly to two groups:the treatment group and the non-treatment group according to whether accepting the Community intervention and the treatment.the treatment group was given community visition to study the postpartum mentality change,and then was given individualized psychological counseling、family intervention and the treatment of cognitive behavior.And even gixen drug treatment if necessary。the non-treatment group was only given telephone interview or family intervention every 1-2 week.And in this time they were not given any treatment,and we only observed the change on the symptoms of postpartum depression of the patients.The rehabilitation and duration of the symptom were observed.Results:There exicted intimate connection between the postpartum depression and literacy.The morbidity was lower in the person who had finished senior school than those were not(P<0.05);There were 319 cases postpartum depression in 2386 cases,and the morbidity rate was 13.37%;The treatment group was significantly improved compared with the non- treatment group on the rehabilitation and duration of the symptom(P<0.05),the curative effect of the treating group is better than those the non-treatment group.Conclusion:Postpartum depression severely affected by maternal health and infant growth and development,community intervention is to reduce the incidence of postpartum depression,an important means.