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.
Cooper
Peter J
PJ
Winnicott Research Unit, Department of Psychology, University of Reading, UK.
Murray
Lynne
L
Wilson
Anji
A
Romaniuk
Helena
H
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