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BackgroundDysthimia in adults is a chronic depression disorder which is characterized by a mild depression for at least 2 years. Remarkable psycho-social involvements, greater disturbances in psycho-social functions compared to other forms of depression and lack of definite findings about preferred treatment for this disorder led us to evaluate the effectiveness of Mindfulness based cognitive therapy (MBCT) method adjunct to pharmacotherapy compared with pharmachothrapy alone in treating dysthymia in this thesis.ObjectivesThis study aimed to evaluate the effectiveness of mindfulness-based cognitive therapy on a chronic type of depression disorder called dysthymiaPatients and MethodsThis study is a clinical trial of an interventional method which was carried out on dysthymic and double depressed patients who had referred to psychiatric clinics of Shiraz University of Medical Sciences, Shiraz, Iran. In doing so, 50 patients above the age of 18 were selected through convenience sampling and assigned into intervention and control groups. The control group only received medications while the intervention group in addition to receiving medication, participated in 8 sessions of a mindfulness based cognitive therapy course which was held once a week and each session lasted for 2 to 2.5 hours. All the participants filled out Beck Depression Inventory II and five facet mindfulness questionnaire. The data were analyzed using the SPSS statistical software (version 16) and univariate covariance and independent t test statistical methods.ResultsIn this study, no statistically significant differences were found between the two groups regarding the demographic characteristics. The mean difference between the two groups was statistically significant for the variables in post-test considering the pre-test. The experimental group participants showed significant improvement in terms of the defined variables; a trend which was not observed in the control group participants.ConclusionThe results of this study show that adding MBCT to pharmacotherapy in treatment of dysthymic patients can cause significant improvement in depression symptoms and mindfulness skills in patients compared to pharmacotherapy alone.

Objective: Several studies have explored the correlation between postpartum depression and a weak mother-infant bond; however, fewer studies have analyzed how other postpartum mental health conditions, such as childbirth-related post-traumatic stress disorder (PTSD), or important personal characteristics, including adult attachment styles, affect the quality of the mother-infant bond. This study aims to examine the association between attachment styles and postpartum bonding in mothers, considering the mediating influence of postpartum depression and childbirth-related PTSD. Methods: A total of 150 mothers, 4 to 12 weeks postpartum, completed a demographic questionnaire, the Edinburgh postpartum depression questionnaire, the posttraumatic stress questionnaire related to the birth of a child, the mother-child bonding questionnaire, and the attachment style questionnaire. The posttraumatic stress related to the birth of a child questionnaire was translated into Persian for the first time and was used after confirming its validity and reliability. The proposed model was examined by the structural equation modeling method. Results: The conceptual model’s results showed that the direct and standardized effect of anxious attachment style (β=0.49, P=0.001) and avoidant attachment style (β=0.47, P=0.001) on postpartum depression were significant. Also, the direct effect of anxious attachment style (β=0.59, P=0.001) on postpartum PTSD was significant. However, the coefficient of avoidant attachment style (β=-0.04, P=0.581) was not significant for postpartum PTSD. Also, the coefficients were investigated from the direct effect of postpartum depression, postpartum PTSD, anxious attachment style, and avoidant attachment style. The obtained results showed that postpartum depression (β=0.27, P=0.001), postpartum PTSD (β=0.43, P=0.001), and anxious attachment style (β=0.39, P=0.001) could predict the mother-child bond. However, the avoidant attachment style (β=0.00, P=0.946) could not predict the mother-child bond. Conclusion: The findings of the study revealed that insecure attachment styles were linked to challenges in forming a strong mother-infant bond. Anxious attachment was also associated with bonding difficulties, which were influenced by symptoms of postpartum depression and childbirth-related PTSD. In contrast, a higher degree of avoidant attachment style was associated with more significant difficulties in bonding, which were mediated by symptoms of depression. Accordingly, if interventions aim to enhance the mother-infant bond, treatment should focus on addressing childbirth-related PTSD, PPD symptoms, and insecure attachment styles.

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