Controlled trial of the short- and long-term effect of psychological treatment of post-partum depression. I. Impact on maternal mood.
BACKGROUND
Psychological interventions for postnatal depression can be beneficial in the short term but their longer-term impact is unknown.


OBJECTIVE
To evaluate the long-term effect on maternal mood of three psychological treatments in relation to routine primary care.


METHODS
Women with post-partum depression (n=193) were assigned randomly to one of four conditions: routine primary care, non-directive counselling, cognitive-behavioural therapy or psychodynamic therapy. They were assessed immediately after the treatment phase (at 4.5 months) and at 9, 18 and 60 months post-partum.


RESULTS
Compared with the control, all three treatments had a significant impact at 4.5 months on maternal mood (Edinburgh Postnatal Depression Scale, EPDS). Only psychodynamic therapy produced a rate of reduction in depression (Structured Clinical Interview for DSM-III - R) significantly superior to that of the control. The benefit of treatment was no longer apparent by 9 months post-partum. Treatment did not reduce subsequent episodes of post-partum depression.


CONCLUSIONS
Psychological intervention for post-partum depression improves maternal mood (EPDS) in the short term. However, this benefit is not superior to spontaneous remission in the long term.
Winnicott Research Unit, Department of Psychology, University of Reading, UK.
Peter J
PJ
Cooper
Lynne
L
Murray
Anji
A
Wilson
Helena
H
Romaniuk
D000293:Adolescent; D000328:Adult; D000339:Affect; D000465:Algorithms; D019052:Depression, Postpartum / Q000628:therapy*; D005260:Female; D006801:Humans; D010342:Patient Acceptance of Health Care; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods*; D012044:Regression Analysis; D013997:Time Factors; D016896:Treatment Outcome