title: The impact of supportive counselling on women's psychological wellbeing after miscarriage--a randomised controlled trial.
abstract: OBJECTIVE
  To assess the effectiveness of supportive counselling after miscarriage.
  
  
  METHODS
  Randomised controlled trial.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Two hundred and eighty women with miscarriage.
  
  
  METHODS
  Women were randomised to receive supportive counselling from a nurse (at diagnosis and 2 weeks later) or routine care. Psychological wellbeing was measured with the General Health Questionnaire (GHQ-12) and Beck Depression Inventory (BDI).
  
  
  METHODS
  Primary outcome measured the proportion of women suffering psychological distress (GHQ-12 score ≥4) at 3 months after miscarriage. Secondary outcomes were GHQ-12 and BDI scores at 6 weeks, 3 and 6 months.
  
  
  RESULTS
  There was no difference in the proportion of women suffering psychological distress at 3 months after miscarriage (17.1% in counselling group versus 24.4% in control group; 95% CI -0.034 to 0.177; P = 0.19). However, for the subgroup of women (n = 152) with high baseline GHQ-12 scores, the median GHQ-12 score in the counselling group was significantly lower than the control group at 6 weeks (median score 3 versus 4.5 in counselling and control groups; P = 0.04) and 3 months (median score 1 versus 2.5 in counselling and control groups; P = 0.03). Similarly, for women with high baseline BDI scores (BDI > 12), the proportion for women continuing to score high was significantly lower in the counselling group 6 weeks after miscarriage (33.3 versus 61.1% in counselling group and control group; P = 0.03).
  
  
  CONCLUSIONS
  Although the results of current study do not justify routine counselling of all women following miscarriage, a supportive counselling programme for selected women with high levels of psychological distress is promising and merits further investigation.
authors.affiliation: Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
authors.forename: G W S
authors.initials: GW
authors.lastname: Kong
authors.forename: T K H
authors.initials: TK
authors.lastname: Chung
authors.forename: I H
authors.initials: IH
authors.lastname: Lok
mesh_terms: D000022:Abortion, Spontaneous / Q000523:psychology*; D003376:Counseling / Q000379:methods*; D005260:Female; D006801:Humans; D011247:Pregnancy; D013315:Stress, Psychological / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D016387:Women's Health; D014932:Women's Health Services
keywords: Counselling; miscarriage; psychological