Patient preference for counselling predicts postpartum depression: a prospective 1-year follow up study in high-risk women.
BACKGROUND
Patient preferences have been associated with a positive effect of depression treatment. Little is known about patient preferences in at-risk samples. The aim of this study was to examine the role of patient preference for counselling in the occurrence of postpartum depression in high-risk women.


METHODS
We conducted a prospective 1-year follow up study in two hospitals and four midwifery practices in The Netherlands. Participants were 90 pregnant women at high risk for postpartum depression: 45 high-risk women who preferred no counselling, 45 high-risk women who preferred counselling. Both groups received care as usual. The main outcome measure was clinical depression (Research Diagnostic Criteria) at 3, 6, and 12 months postpartum.


RESULTS
Point-prevalence rates of clinical depression were significantly higher in high-risk women who preferred counselling compared with high-risk women who did not prefer counselling (24% versus 9%, P=0.048; 19% versus 5%, P=0.048, at 3 and 6 months postpartum, respectively). No significant difference was found at 12 months postpartum. Across the first-year postpartum, high-risk women who preferred counselling were at seven-fold increased risk for clinical depression (OR=7.7, 95% CI 1.7-33.8, P=0.007).


CONCLUSIONS
Patient preference for counselling is an important predictor of postpartum depression in pregnant women at high risk for postpartum depression. Patient preferences may reflect validly a perceived need for intervention in high-risk women. This finding emphasises the need to take patient preference for counselling into account as an important variable to identify a high-risk population.
Verkerk
Gerda J M
GJ
Department of Psychology and Health, Tilburg University, P.O. Box 90156, 5000 LE Tilburg, The Netherlands. g.j.m.verkerk@zonnet.nl
Denollet
Johan
J
Van Heck
Guus L
GL
Van Son
Maarten J M
MJ
Pop
Victor J M
VJ
D000328:Adult; D001294:Attitude to Health; D003376:Counseling; D019052:Depression, Postpartum / Q000523:psychology*; D005260:Female; D006801:Humans; D017060:Patient Satisfaction; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors