title: Patient choice of treatment for postpartum depression: a pilot study.
abstract: OBJECTIVE
  The lack of systematic efficacy research makes the selection of optimal treatment for postpartum depression (PPD) difficult. Moreover, the treatment decisions for women with PPD who are breastfeeding are heavily influenced by their concerns about infant exposure to antidepressant medication. The objective of this pilot trial was to examine the clinical characteristics of women with PPD associated with treatment selection.
  
  
  METHODS
  This open pilot trial offered 23 women with PPD one of 3 treatment options: sertraline, interpersonal psychotherapy (IPT), or their combination administered in an outpatient mental health setting over 12 weeks. Baseline and treatment outcome measures included the Hamilton Rating Scale for Depression (HRSD), the Beck Depression Inventory (BDI) and the Edinburgh Postnatal Depression Scale (EPDS).
  
  
  RESULTS
  Completers across all 3 treatment groups (n = 18) experienced significant clinical improvement with each of the 3 treatment modalities on the HRSD (p < 0.001), BDI (p < 0.001) and EPDS (p < 0.001). There were trends for women with a prior depression to more frequently choose sertraline as a treatment (alone or with IPT, p = 0.07), and for women who were breastfeeding to choose sertraline (alone or with IPT, p = 0.10) less frequently.
  
  
  CONCLUSIONS
  In this small sample of women with PPD, most women chose IPT with or without sertraline. A larger randomized study could further confirm the suggested predictors of treatment selection identified in this study: previous depression and breastfeeding status.
authors.affiliation: Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI 02905, USA. teri_pearlstein@brown.edu
authors.forename: T B
authors.initials: TB
authors.lastname: Pearlstein
authors.forename: C
authors.initials: C
authors.lastname: Zlotnick
authors.forename: C L
authors.initials: CL
authors.lastname: Battle
authors.forename: S
authors.initials: S
authors.lastname: Stuart
authors.forename: M W
authors.initials: MW
authors.lastname: O'Hara
authors.forename: A B
authors.initials: AB
authors.lastname: Price
authors.forename: M A
authors.initials: MA
authors.lastname: Grause
authors.forename: M
authors.initials: M
authors.lastname: Howard
mesh_terms: D000328:Adult; D002755:Choice Behavior; D019052:Depression, Postpartum / Q000188:drug therapy* / Q000628:therapy*; D005260:Female; D006801:Humans; D010358:Patient Participation; D010865:Pilot Projects; D012237:Rhode Island; D014481:United States; D016387:Women's Health