title: Six-month outcomes from a randomized controlled trial to prevent perinatal depression in low-income home visiting clients.
abstract: Perinatal depression (PD) has negative consequences for mothers and children and is more prevalent among women of low socioeconomic status. Home visitation programs serve low-income pregnant women at risk for PD. This study tested the efficacy of a group-based cognitive behavioral intervention (Mothers and Babies Course; MB) in reducing depressive symptoms and preventing the onset of perinatal depression among low-income women enrolled in home visitation. A randomized controlled trial was conducted. Seventy-eight women who were pregnant or had a child less than 6 months of age and who were assessed as at risk for PD were randomized to the MB intervention or usual home visiting services. Depressive symptoms were assessed at baseline and 1-week, 3- and 6-months post-intervention; depressive episodes were assessed with a clinical interview at the 6-month follow-up. Depressive symptoms declined at a significantly greater rate for intervention participants than usual care participants between baseline and 1-week, 3 and 6 months post-intervention. At the 6-month follow-up, 15 % of women who received the MB intervention had experienced a major depressive episode as compared with 32 % of women receiving usual care. Integrating mental health interventions into home visitation appears to be a promising approach for preventing PD. Cognitive behavioral techniques can be effective in preventing depression in perinatal populations and treating it.
authors.affiliation: Department of Pediatrics, Johns Hopkins University School of Medicine, 200 North Wolfe Street, Baltimore, MD, 21287, USA, standon@jhmi.edu.
authors.forename: S Darius
authors.initials: SD
authors.lastname: Tandon
authors.forename: Julie A
authors.initials: JA
authors.lastname: Leis
authors.forename: Tamar
authors.initials: T
authors.lastname: Mendelson
authors.forename: Deborah F
authors.initials: DF
authors.lastname: Perry
authors.forename: Karen
authors.initials: K
authors.lastname: Kemp
mesh_terms: D000293:Adolescent; D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D019052:Depression, Postpartum / Q000503:physiopathology / Q000517:prevention & control* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D018574:Home Care Agencies / Q000706:statistics & numerical data; D006792:House Calls / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016014:Linear Models; D008297:Male; D008423:Maternal Age; D011181:Postnatal Care / Q000379:methods*; D011203:Poverty; D011247:Pregnancy; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014505:Urban Population; D055815:Young Adult