Controlled trial of the short- and long-term effect of psychological treatment of post-partum depression: 2. Impact on the mother-child relationship and child outcome.
BACKGROUND
Postnatal depression is associated with adverse child cognitive and socio-emotional outcome. It is not known whether psychological treatment affects the quality of the mother-child relationship and child outcome.


OBJECTIVE
To evaluate the effect of three psychological treatments on the mother-child relationship and child outcome.


METHODS
Women with post-partum depression (n=193) were assigned randomly to routine primary care, non-directive counselling, cognitive-behavioural therapy or psychodynamic therapy. The women and their children were assessed at 4.5, 18 and 60 months post-partum.


RESULTS
Indications of a positive benefit were limited. All three treatments had a significant benefit on maternal reports of early difficulties in relationships with the infants; counselling gave better infant emotional and behaviour ratings at 18 months and more sensitive early mother-infant interactions. The treatments had no significant impact on maternal management of early infant behaviour problems, security of infant-mother attachment, infant cognitive development or any child outcome at 5 years.


CONCLUSIONS
Early intervention was of short-term benefit to the mother-child relationship and infant behaviour problems. More-prolonged intervention may be needed. Health visitors could deliver this.
Winnicott Research Unit, Department of Psychology, The University of Reading, UK.
Lynne
L
Murray
Peter J
PJ
Cooper
Anji
A
Wilson
Helena
H
Romaniuk
D000328:Adult; D002657:Child Development; D002675:Child, Preschool; D019052:Depression, Postpartum / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016014:Linear Models; D008425:Maternal Behavior / Q000523:psychology; D009034:Mother-Child Relations; D009769:Object Attachment; D011613:Psychotherapy / Q000379:methods*; D016896:Treatment Outcome