title: Perinatal Dyadic Psychotherapy for postpartum depression: a randomized controlled pilot trial.
abstract: An integrated approach addressing maternal depression and associated mother-infant relationship dysfunction may improve outcomes. This study tested Perinatal Dyadic Psychotherapy (PDP), a dual-focused mother-infant intervention to prevent/decrease maternal postpartum depression and improve aspects of the mother-infant relationship related to child development. Women recruited from hospital postpartum units were screened using a three-stage process. Forty-two depressed first-time mothers and their 6-week-old infants were enrolled and randomized to receive the PDP intervention or usual care plus depression monitoring by phone. The intervention consisted of eight home-based, nurse-delivered mother-infant sessions consisting of (a) supportive, relationship-based, mother-infant psychotherapy, and (b) a developmentally based infant-oriented component focused on promoting positive mother-infant interactions. Data collected at baseline, post-intervention, and three-month follow-up included measures of maternal depression, anxiety, maternal self-esteem, parenting stress, and mother-infant interaction. Depression and anxiety symptoms and diagnoses decreased significantly, and maternal self-esteem increased significantly across the study time frame with no between-group differences. There were no significant differences between groups on parenting stress or mother-infant interaction at post-intervention and follow-up. No participants developed onset of postpartum depression during the course of the study. PDP holds potential for treating depression in the context of the mother-infant relationship; however, usual care plus depression monitoring showed equal benefit. Further research is needed to explore using low-intensity interventions as a first step in a stepped care approach and to determine what subset of at-risk or depressed postpartum mothers might benefit most from the PDP intervention.
authors.affiliation: School of Nursing, MGH Institute of Health Professions, 36 1st Ave, Boston, MA, 02129, USA, jgoodman@mghihp.edu.
authors.forename: Janice H
authors.initials: JH
authors.lastname: Goodman
authors.forename: Joanna
authors.initials: J
authors.lastname: Prager
authors.forename: Richard
authors.initials: R
authors.lastname: Goldstein
authors.forename: Marlene
authors.initials: M
authors.lastname: Freeman
mesh_terms: D019052:Depression, Postpartum / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D009034:Mother-Child Relations; D009769:Object Attachment; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales; D011614:Psychotherapy, Brief / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome