Long-term effects of a home-visiting intervention for depressed mothers and their infants.
BACKGROUND
Whereas preventive interventions for depressed mothers and their infants have yielded positive short-term outcomes, few studies have examined their long-term effectiveness. The present follow-up of a randomised controlled trial (RCT) is one of the first to examine the longer-term effects of an intervention for mothers with postpartum depression and their infants at school-age. In early infancy, the intervention was found effective in improving mother-infant interaction and the child's attachment to its mother.


METHODS
Twenty-nine mother-child pairs who completed the intervention are compared with 29 untreated mother-child dyads as to the quality of maternal interactive behaviour and the child outcomes of attachment security to the mother, self-esteem, ego-resiliency, verbal intelligence, prosocial behaviour, school adjustment, and behaviour problems at age 5 (M=68 months).


RESULTS
In the total sample no lasting treatment benefits were found, but in families reporting a higher number of stressful life events, children in the intervention group had fewer externalising behaviour problems as rated by their mothers than children in the control group.


CONCLUSIONS
In the context of multiple stressful life events the intervention served as a buffer by preventing the development of externalising problems in the child. The results warrant cautious interpretation because of the relatively small sample size and differential attrition revealing the mothers that completed the follow-up assessment to have improved less on maternal sensitivity following the intervention than the mothers who did not participate in the follow-up.
Kersten-Alvarez
Laura E
LE
Behavioural Science Institute, Radboud University Nijmegen, The Netherlands. l.kersten@psych.ru.nl
Hosman
Clemens M H
CM
Riksen-Walraven
J Marianne
JM
Van Doesum
Karin T M
KT
Hoefnagels
Cees
C
D000328:Adult; D002652:Child Behavior / Q000523:psychology*; D002675:Child, Preschool; D019052:Depression, Postpartum / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006792:House Calls; D006801:Humans; D007223:Infant; D018730:Infant Behavior / Q000523:psychology; D007360:Intelligence; D008297:Male; D008425:Maternal Behavior / Q000523:psychology*; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*; D012649:Self Concept; D012919:Social Behavior; D016896:Treatment Outcome