Efficacy of Interpersonal Psychotherapy for Postpartum Depression

O’Hara, Michael W.; Stuart, Scott; Gorman, Laura L.; Wenzel, Amy

doi:10.1001/archpsyc.57.11.1039

Cited by 566 publications

(309 citation statements)

References 36 publications

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“…The group effect may particularly facilitate the reporting of symptoms and gathering support from the partner/family and decreasing social isolation. Our results were consistent with findings from a study on interpersonal therapy [31] that identified skills to resolve marital disputes and major role transitions as important elements in treatment and with findings from epidemiological studies looking into predictors of PPD [32,33,34,35]. Companionship and belonging to a group of similar people may have a protective effect.…”

Section: Discussionsupporting

confidence: 91%

Can a Brief Antepartum Preventive Group Intervention Help Reduce Postpartum Depressive Symptomatology?

Kozinszky

Dudás

Devosa

et al. 2012

Psychother Psychosom

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Background: Psychosocial and psychological interventions are generally effective in reducing depressive symptomatology in the postpartum period. Our aim was to evaluate the effectiveness of a brief preventive group intervention for postpartum depression (PPD) in a naturalistic setting, and study the effect of this on social and psychological risk factors. Methods: We conducted a randomized controlled trial (n = 1,719) in south-eastern Hungary in 62 antepartum centers. Pregnant women (n = 710) underwent a 4-session preventive group intervention whereas a control group (n = 1,009) attended 4 sessions providing the same information given in usual care. Results: Our intervention appeared to significantly reduce the risk of PPD, as defined by Leverton Questionnaire total scores (OR = 0.69). It resulted in an absolute risk reduction of about 18% in those with antepartum depression and 0.5% in those with no depression at recruitment. A multiple logistic regression analysis revealed a much reduced risk in those with a perceived lack of partner support (OR = 0.4) in the treatment group. Unplanned pregnancy, an irreversible risk factor affecting every fifth woman, also seemed to have a reduced effect on PPD after our group intervention (OR = 0.81). Conclusions: A brief preventive antepartum group intervention focusing on psychoeducation, stress management, improving coping mechanisms, and the development of social support can be effective in reducing postpartum depressive symptomatology.

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Section: Discussionsupporting

confidence: 91%

Can a Brief Antepartum Preventive Group Intervention Help Reduce Postpartum Depressive Symptomatology?

Kozinszky

Dudás

Devosa

et al. 2012

Psychother Psychosom

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“…Interpersonal Psychotherapy (IPT; 16 sessions) has demonstrated efficacy in treating acute depression, 56,57,58 preventing depressive relapse through maintenance, 59,60 treating antenatal and postpartum depression, 38,45,61 and treating depression in primary care. 62 A brief version of IPT has been developed 63 and has received empirical support in a number of studies of pregnant and parenting women with depression.…”

Section: Methodsmentioning

confidence: 99%

Culturally relevant treatment services for perinatal depression in socio-economically disadvantaged women: The design of the MOMCare study

Grote

Katon

Lohr

et al. 2014

Contemporary Clinical Trials

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Background Depression during pregnancy has been demonstrated to be predictive of low birthweight, prematurity, and postpartum depression. These adverse outcomes potentially have lasting effects on maternal and child well-being. Socio-economically disadvantaged women are twice as likely as middle-class women to meet diagnostic criteria for antenatal major depression (MDD), but have proven difficult to engage and retain in treatment. Collaborative care treatment models for depression have not been evaluated for racially/ethnically diverse, pregnant women on Medicaid receiving care in a public health system. This paper describes the design, methodology, culturally relevant enhancements, and implementation of a randomized controlled trial of depression care management compared to public health Maternity Support Services(MSS). Methods Pregnant, public health patients, ≥18 years with a likely diagnosis of MDD or dysthymia, measured respectively by the Patient Health Questionnaire-9(PHQ-9) or the Mini-International Neuropsychiatric Interview(MINI), were randomized to the intervention or to public health MSS. The primary outcome was reduction in depression severity from baseline during pregnancy to 18-months post-baseline(one-year postpartum). Baseline Results 168 women with likely MDD (96.4%) and/or dysthymia (24.4%) were randomized. Average age was 27.6 years and gestational age was 22.4 weeks; 58.3% racial/ethnic minority; 71.4% unmarried; 22% no high school degree/GED; 65.3% unemployed; 42.1% making ≤$10,000 annually; 80.4% having recurrent depression; 64.6% PTSD, and 72% an unplanned pregnancy. Conclusions A collaborative care team, including a psychiatrist, psychologist, project manager, and 3 social workers, met weekly, collaborated with the patients' obstetrics providers, and monitored depression severity using an electronic tracking system. Potential sustainability of the intervention within a public health system requires further study.

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“…It has proven effective for PND in controlled trials with large sample sizes, different comparison groups, and individual and group settings (Grote et al, 2009;O'Hara, et al, 2000;Miniati et al, 2014;Spinelli, & Endicott, 2003). IPT is therefore a PND treatment which has the potential to directly address maternal sensitivity in a similar manner to the attachment-based therapies.…”

Section: Interpersonal Therapy Is a Relationship-focussed Pnd Treatmentmentioning

confidence: 99%

Addressing the mother–baby relationship in interpersonal psychotherapy for depression: an overview and case study

Deans

Reay

Buist

2016

Journal of Reproductive and Infant Psychology

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Objective: This article describes the development of an interpersonal psychotherapy group which has been adapted to address the mother-child relationship in the context of postnatal depression (PND).Background: When PND develops, the child of the sufferer is also at risk for deleterious outcomes. It is thought that this is because the mother-baby bonding process is interrupted, affected, or reduced in quality by the existence of depression in addition to genetics and biological effects of exposure to illness in utero. Past approaches to mitigating this risk have focussed on treating the depression as the primary issue and the mother-baby relationship as secondary. This article makes the argument that interpersonal psychotherapy has neglected this relationship despite the evidence that this is a key precipitating/perpetuating factor in postnatal depression, and that targeting this relationship has benefits for both mother and baby. Method: An interpersonal psychotherapy protocol was developed, modified to incorporate psychoeducation and practice of maternally sensitive interactions. A case study from a version of this group intervention is provided. Results: The case study outcomes on selfreport scales of depression suggest the modified protocol is as effective in treating PND as the original protocol. Self-report of maternal attachment and videotape measures of maternal sensitivity also improved, suggesting that the modified protocol can address the mother-baby relationship. Conclusion:The suitability of adapting interpersonal psychotherapy to address the mother-baby relationship appears promising. Further rigorous trials using this therapy are warranted to determine its effectiveness.Keywords: postnatal depression; interpersonal therapy; maternal sensitivity; mother-baby relationship; group therapy Word count: 4,098 words 3 Motherhood is a time of transformation across the spectrum of functioning for women. For most, motherhood is associated with greater wellbeing and satisfaction (Holton, Fisher, & Rowe, 2010). However, it can also be associated with challenges, one of the biggest being that of postnatal depression (PND). For some 7-16% of women (O'Hara & Swain, 1996), new motherhood is associated with the onset of PND. Whilst PND is not a distinct disorder from Major Depressive Episode, there are some clinical differences. The psychosocial stressors surrounding new motherhood, including sleep disturbance and breastfeeding pain, have been shown to increase inflammatory hormones associated with depression (Kendall-Tackett, 2007). There is a higher risk for PND in women with poor marital relationships, and those who develop PND report greater symptoms for a greater duration, and are more susceptible to later recurrence of depression relative to women with supportive relationships (Campbell, Cohn, Flanagan, Popper, & Meyers, 1992). Mothers can find it difficult to engage in depression treatments due to the demands of motherhood, reluctance to disclose their feelings, (Conners-Burrow et. al., 2015). A combination...

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Efficacy of Interpersonal Psychotherapy for Postpartum Depression

Abstract: These findings suggest that IPT is an efficacious treatment for postpartum depression. Interpersonal psychotherapy reduced depressive symptoms and improved social adjustment, and represents an alternative to pharmacotherapy, particularly for women who are breastfeeding.

Cited by 566 publications

References 36 publications

Can a Brief Antepartum Preventive Group Intervention Help Reduce Postpartum Depressive Symptomatology?

Can a Brief Antepartum Preventive Group Intervention Help Reduce Postpartum Depressive Symptomatology?

Culturally relevant treatment services for perinatal depression in socio-economically disadvantaged women: The design of the MOMCare study

Addressing the mother–baby relationship in interpersonal psychotherapy for depression: an overview and case study

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