title: Randomized Trial of Psychological Interventions to Preventing Postpartum Depression among Iranian First-time Mothers.
abstract: BACKGROUND
  The current study was conducted to examine the effect of cognitive behavior therapy on the reduction postpartum mood disorder and increasing the self-esteem of at-risk Iranian mothers.
  
  
  METHODS
  In this quasi-experimental study, 135 at-risk mothers were selected from the population by means of cluster sampling and randomly assigned into one of two groups: Intervention (n = 64), or control (n = 71). The control group received usual medical care, and the intervention group received an eight sessions' cognitive behavior program during pregnancy. Assessments were administered at two time points (pretest at the beginning of the third trimester and posttest at 2 weeks postpartum). Beck anxiety, beck depression, Edinburgh postpartum depression, (PPD) Coopersmith self-esteem, and religious attitude questionnaire were used to collect data.
  
  
  RESULTS
  The mean age of participants was 25.8 ± 3.7 years. One-third of them had either bachelor or higher degrees in education (33%). About two-third of participants were unemployment with similar distribution in both the groups (intervention = 80%, control = 83%). The majority (70%) of the participants had cesarean section deliveries. There were no statistically significant differences respects to sociodemographic characteristics between the control and intervention groups (P > 0.05). The multivariate analysis of covariance results showed that the average scores of PPD were reduced significantly in the intervention group (P < 0.001). Also while the mean score of anxiety in the intervention group decreased from 23.31 (standard error [SE] =12.11) to 16.64 (SE = 8.33) and self-esteem increased from 29.09 (SE = 3.51) to 31.81 (SE = 2.76), no change was statistically significant in comparison to the control group.
  
  
  CONCLUSIONS
  According to the findings of the present study, cognitive behavior intervention is effective in reducing PPD in at-risk mothers.
authors.affiliation: Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Fathi-Ashtiani
authors.affiliation: Department of Psychology, Faculty of Psychology and Education, Tehran University, Tehran, Iran.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Ahmadi
authors.affiliation: Department of Psychology, Faculty of Psychology and Education, Tehran University, Tehran, Iran.
authors.forename: Bagher
authors.initials: B
authors.lastname: Ghobari-Bonab
authors.affiliation: Department of Psychology, Faculty of Psychology and Education, Tehran University, Tehran, Iran.
authors.forename: Mohammed Parsa
authors.initials: MP
authors.lastname: Azizi
authors.affiliation: Department of Midwifery, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran.
authors.forename: Sayeh Moosavi
authors.initials: SM
authors.lastname: Saheb-Alzamani
keywords: Anxiety; cognitive behavior intervention; postpartum depression