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Journal of Zhejiang University SCIENCE B

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Dialectical behavior therapy-based psychological intervention for woman in late pregnancy and early postpartum suffering from COVID-19: a case report


Author(s):  Jin-Wen Huang, Xiao-Yi Zhou, Shao-Jia Lu, Yi Xu, Jian-Bo Hu, Man-Li Huang, Hua-Fen Wang, Chan-Chan Hu, Shu-Guang Li, Jing-Kai Chen, Zhong Wang, Shao-Hua Hu, Ning Wei

Affiliation(s):  Department of Psychiatry, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; more

Corresponding email(s):  dorhushaohua@zju.edu.cn, nwei2011@zju.edu.cn

Key Words:  Coronavirus disease 2019 (COVID-19); Pregnancy; Postpartum; Psychological intervention; Dialectical behavior therapy


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Jin-Wen Huang, Xiao-Yi Zhou, Shao-Jia Lu, Yi Xu, Jian-Bo Hu, Man-Li Huang, Hua-Fen Wang, Chan-Chan Hu, Shu-Guang Li, Jing-Kai Chen, Zhong Wang, Shao-Hua Hu, Ning Wei. Dialectical behavior therapy-based psychological intervention for woman in late pregnancy and early postpartum suffering from COVID-19: a case report[J]. Journal of Zhejiang University Science B,in press.Frontiers of Information Technology & Electronic Engineering,in press.https://doi.org/10.1631/jzus.B2010012

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Abstract: 
At the end of 2019, a new form of pneumonia disease known as the corona virus disease 2019 (COVID-19) rapidly spread throughout most provinces of China, and the total global number of COVID-19 cases has surpassed 500 000 by Mar. 27, 2020 (WHO, 2020). On Jan. 30, 2020, the World Health Organization (WHO) declared COVID-19 a global health emergency (WHO, 2020). COVID-19 causes most damage to the respiratory system, leading to pneumonia or breathing difficulties. The confirmed case fatality risk (cCFR) was estimated to be 5% to 8% (Jung et al., 2020). Besides physical pain, COVID-19 also induces psychological distress, with depression, anxiety, and stress affecting the general population, quarantined population, medical staff, and patients at different levels (Kang et al., 2020; Xiang et al., 2020). Previous research on patients in isolation wards highlighted the risk of depressed mood, fear, loneliness, frustration, excessive worries, and insomnia (Abad et al., 2010).

对围产期新冠肺炎患者开展辩证行为治疗为基础的心理治疗:案例报告

目的:孕产妇的心理健康风险较为突出,但尚未有文献说明何种心理干预方式对患有新冠肺炎的围产期孕妇有效.本文报告了一例确诊新冠肺炎的 35周2天孕妇在入住隔离病房后,使用辩证行为治疗(DBT)相关技术对其存在的抑郁和焦虑症状在围产期进行持续心理干预的案例,旨在探究以DBT为基础的短程心理治疗对围产期新冠肺炎患者的抑郁和焦虑症状的改善作用.
创新点:首例对确诊新冠肺炎的孕产妇进行产前及产后心理评估及干预的案例.也是首次报道在公共卫生危机事件的个体干预中使用了DBT相关技术.
方法:患者,女,30岁,孕35周+2天,干咳两天就诊,在当地医院进行新型冠状病毒核酸测验提示阳性后转入浙江大学医学院附属第一医院住院治疗.2020年2月8日行剖腹产,产后继续在隔离病房治疗.入院后精神科访谈及心理测量均提示存在抑郁和焦虑症状,于2月7日、10日、16日进行三次心理干预,主要使用DBT相关干预技术,包括放松训练、正念练习、情绪控制技巧训练、人际支持等.期间根据患者的需要及时调整干预策略.通过三次心理干预,患者的抑郁、焦虑症状得到改善,抑郁和焦虑量表评分与基线比显著下降.
结论:本报告显示了对确诊新冠肺炎的隔离病房患者及时进行心理干预的必要性.心理干预能有效改善患者的抑郁、焦虑症状,减少或避免了精神类药物的使用,为新冠肺炎的临床治疗提供了支持.此报告也为以DBT为基础的心理治疗在危机干预中的应用提供了临床证据.

关键词组:新冠肺炎;孕期;产后;心理干预;辨证行为治疗

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