産後うつ病の妊娠期予防的介入におけるシステマティック・レビュー  [in Japanese] A systematic review : The effects of preventive interventions during gestation on postpartum depression  [in Japanese]

本研究では,産後うつ病に対する妊娠期の予防的介入の効果についてシステマティック・レビューを行い,その効果を検討した。研究方法は,PubMed, CINAHL, CCRCTなどの5つのデータベースを使用し,2004年12月までの文献について,キーワードは"depression" and "postpartum" "patient education" "primary prevention" "prevention and control"とし,妊娠期介入のrandomized controlled trialまたはcontrolled clinical trialで検索した。その結果11件が抽出され,介入方法論別に『情報提供』『心理療法』『保健相談』の3つに分類された。なお,介入効果が認められたのは,心理療法3件,情報提供1件であり,その介入内容は,産後うつ病の危険因子をもつ妊婦への母親役割の葛藤と対処方法,社会支援を得る方法,産後の過ごし方などをテーマとした心理療法であった。以上のことから,産後うつ病の妊娠期予防的介入は,産後うつ病の危険因子をもつ者を対象に,産後うつ病の特徴に焦点をあて,心理療法に基づいて展開することで効果が得られる可能性があることが傍証された。

A systematic review was performed to evaluate the effects of preventive intervention during gestation on postpartum depression (PPD). We searched for references published until December, 2004 by 5 search engines such as PubMed, CINAHL, and CCRCT using "depression postpartum", "patient education", "primary prevention", and "prevention and control" as key words and found 69 cases. Eleven cases of randomized controlled trials or controlled clinical trials were analyzed. The intervention methods were classified into "provision of information", "psychotherapy" and "interviews". The effects of intervention were observed in 4 of the 11 cases. The effects of "provision of information" were observed in 1 of 4 cases, those of "psychotherapy" in 3 of 5 cases. The contents include the intervention methods that engaged and measured various aspects of a mother's role, procedures to obtain social support, and efforts expended after giving birth in pregnant women having a risk factor for PPD. It is suggested that an effort is made to provide pregnant women who have a risk factor for PPD and developing a program in psychotherapy that has an assigned focus based on the characteristics of PPD.