When the cradle falls: the treatment of postnatal depression in a psychiatric day hospital compared with routine primary care.
BACKGROUND
Postnatal depression affects one in ten women within 6 months of childbirth. The most effective treatment strategy for postnatal depression is not clear.


METHODS
This prospective, naturalistic study of the treatment of postnatal depression compared 30 women treated at a specialised psychiatric day hospital with 30 women treated using routine primary care (RPC). Clinical, marital and social adjustment were assessed on three occasions over 6 months using: the Edinburgh Postnatal Depression Questionnaire (EPDS); the Clinical Interview schedule (CIS); the Anxiety Subscale of the Hospital Anxiety and Depression Scale; the Dyadic Adjustment Scale (DAS); and the Work Leisure and Family Life Questionnaire-Modified (WLFLQ-M).


RESULTS
There were no significant differences between the two groups at baseline. However, there were significant differences in outcome at 3 and 6 months follow-up for all outcome measures except the DAS. At 6 month follow-up 21 of the PBDU group were no longer depressed compared with 7 of the RPC group.


CONCLUSIONS
A specialised day hospital is a more effective treatment setting for postnatal depression than routine primary care.


CONCLUSIONS
The study is not an RCT, so systematic bias is possible. The sample size is relatively small and the duration of follow-up relatively short.
Boath
E
E
Keele University, Stoke-on-Trent, UK.
Cox
J
J
Lewis
M
M
Jones
P
P
Pryce
A
A
D000293:Adolescent; D000328:Adult; D003631:Day Care, Medical; D019052:Depression, Postpartum / Q000175:diagnosis / Q000534:rehabilitation*; D004739:England; D005260:Female; D005500:Follow-Up Studies; D006778:Hospitals, Psychiatric; D006801:Humans; D011320:Primary Health Care; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy; D011795:Surveys and Questionnaires; D016896:Treatment Outcome