Interventions for postnatal depression assessing the mother–infant relationship and child developmental outcomes: a systematic review

Abstract

Postnatal depression (PND) has negative effects on maternal well-being as well as implications for the mother–infant relationship, subsequent infant development, and family functioning. There is growing evidence demonstrating that PND impacts on a mother’s ability to interact with sensitivity and responsiveness as a caregiver, which may have implications for the infant’s development of self-regulatory skills, making the infant more vulnerable to later psychopathology. Given the possible intergenerational transmission of risk to the infant, the mother–infant relationship is a focus for treatment and research. However, few studies have assessed the effect of treatment on the mother–infant relationship and child developmental outcomes. The main aim of this paper was to conduct a systematic review and investigate effect sizes of interventions for PND, which assess the quality of the mother–infant dyad relationship and/or child outcomes in addition to maternal mood. Nineteen studies were selected for review, and their methodological quality was evaluated, where possible, effect sizes across maternal mood, quality of dyadic relationship, and child developmental outcomes were calculated. Finally, clinical implications in the treatment of PND are highlighted and recommendations made for further research.

Psychological Therapy for Postnatal Depression in UK Primary Care Mental Health Services: A Qualitative Investigation Using Framework Analysis

“…The extent to which CBT and other psychotherapies address parent-child aspects of PND has been questioned (O'Hara and McCabe 2013). In a systematic review of 19 studies, psychological therapies were not found to have a significant impact on mother-infant-relationships despite improvements in PND (Tsivos et al 2015). Mothers in the current study perceived some impact on confidence as a parent as with as relationships with their infants even if this was indirectly via improvements in mood.…”

“…Both individual and group-based psychological interventions have been shown to be effective in reducing symptoms of depression (Cuijpers et al 2008; Dennis and Hodnett 2007;Scope et al 2013). Historically, psychological therapies for PND have focused on depression symptoms and less on mother-infant outcomes, including the mother-infant-relationship or the infant's development (e.g., see Tsivos et al 2015). Evaluations of parent-child outcomes indicate that traditional psychosocial and psychological therapies for PND do not lead to significant improvements in these areas, even when symptoms of PND have improved (Cooper et al 2003;Cooper et al 2010;Tsivos et al 2015).…”

Mothers’ experiences learning and performing infant massage—A qualitative study

“…Education to vulnerable parents how to respond appropriately and optimally to their temperamentally reactive infants is claimed to be central to forming secure attachment (Tsivos, Calam, Sanders, & Wittkowski, 2015). Others studies have also illuminated the importance the instructor have in educating the parents (Oswalt et al, 2009;Underdown et al, 2013).…”

Prenatal Depression Risk Factors, Developmental Effects and Interventions: A Review

“…Prenatal depression was assessed by the Center for Epidemiological Studies-Depression (CES-D) scale and anxiety and anger were measured by the Spielberger state anxiety and state anger scales in this study [64,65]. Even though the peer support group had lower socioeconomic status and higher depression scores at the beginning of treatment as well as having shorter group sessions, the groups were equivalent on depression scores at the end of the treatment period.…”