بررسی اثرات مداخله گروه پشتیبانی در زنان مبتلا به پریشانی بعد از تولد: یک مطالعه کنترل شده در تایوان

Objective: The symptoms of depression experienced by women during the postnatal period may have profound effects on the lifelong health of both the mother and the child. In this randomized controlled study, we systematically evaluated the effects of weekly supportive group meetings for women with postnatal distress. Methods: Sixty postnatally distressed women were randomly assigned to support (n=30) and control (n=30) groups. Women assigned to the support group participated in four supportive group sessions that comprised discussions concerning transition to motherhood, postnatal stress management, communication skills, and life planning. Results: Subjects who attended the support sessions had significantly decreased scores on the Beck Depression Inventory (BDI) and the Perceived Stress Scale (PSS), and significantly increased scores on the Interpersonal Support Evaluation List (ISEL) as evaluated at the end of the fourth weekly session. In contrast, no significant changes were observed in the control group during this period. Conclusion: This is the first controlled study to provide evidence that participation in support groups for postnatally distressed women provides quantifiable psychosocial benefits.

The birth of a baby signals major changes in a woman's life, and is frequently accompanied by strong emotions ranging from joy to despair [1]. There has been an abundance of research documenting the problems associated with postpartum depression. In Taiwan, a 40% prevalence of mild to severe postpartum depression has been reported at 6 weeks postpartum, as assessed with the Beck Depression Inventory (BDI) [2]. Postpartum depression can be a threat to the life of the mother and the infant, and can also have a significant negative impact on the infant–mother relationship. Only physically and mentally healthy postpartum women are able to find a balanced point between caring for themselves and for others [3]. Support group programs have been found to be effective in helping women to cope with postnatal depression [4], [5], [6], [7], [8], [9] and [10]. However, there have been few controlled studies that have actually measured postnatal distress parameters in women. Morgan et al. [11] reported on the use of an eight-session group program for postnatally distressed women and one session for the couple that employed psychotherapeutic and cognitive–behavioral strategies to assist them in dealing with postnatal concerns. They found that formal measures showed a decrease in maternal distress over time and an increase in the level of self-esteem. However, their study did not employ a control group. Another study that evaluated the effects of an eight-session social support intervention (n=44), a no intervention condition (n=83), and a group-by-mail intervention (n=15) found that the social support intervention group that mixed depressed and nondepressed mothers had no effect on new mothers' general affective mood, some negative effects on mothers' self-confidence, and apparently positive effects on infant–mother interaction [12]. Their results suggest that depressed mothers will not become more self-confident by being placed in a group in which most mothers are confident; in fact, it was found that this placement might have been detrimental to depressed mothers' self-confidence although it did increase the mothers' proximal attention to their infants. To our knowledge there have been no studies that have directly assessed the effect of support group sessions on the psychosocial parameters in new mothers. The purpose of this study was to investigate the psychosocial effects of a support group program on postnatally distressed mothers in Taiwan. The term distress is used to indicate that, although no diagnostic interview was undertaken, all of the women showed a nonspecific negative affectivity on self-report instruments such as the BDI [11] and [13].