Prevention and treatment of post-partum depression: a controlled randomized study on women at risk
Background. Research is needed to evaluate the efficacy of prevention and treatment for post-partum depression.
Method. Subjects were screened with the Edinburgh Post-natal Depression Scale (EPDS) at the obstetric clinic. Mothers at risk (N = 258) (EPDS scores [gt-or-equal, slanted]9) were randomly assigned to a prevention/treatment group or a control group. The prevention group received one cognitive-behavioural prevention session during hospitalization. At 4 to 6 weeks post-partum, subjects were screened again with the EPDS, after drop-out rates (refusals plus no return of the second EPDS) of 25.4% (33/130) in the intervention group and 10.9% (14/128) in the control group. Mothers with probable depression (EPDS scores [gt-or-equal, slanted]11) were assessed using the Hamilton Depression Rating Scale (HDRS) and the Beck Depression Inventory (BDI). Mothers with major depression continued in the treatment group (N = 18) or in the control group (N = 30). Treated subjects received a cognitive-behavioural programme of between five and eight weekly home-visits.
Results. Compared with the control group, women in the prevention group had significant reductions in the frequency of probable depression (30.2% v. 48.2%). Recovery rates based on HDRS scores of <7 and BDI scores of <4 were also significantly greater in the treated group than in the control group.
Conclusions. The study suggests that this programme for prevention and treatment of post-partum depression is reasonably well-accepted and efficacious.
c1 Address for correspondence: Dr Henri Chabrol, 21 rue des Cèdres, 31400 Toulouse, France.