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 postpartum depression. Method. Subjects were screened with the Edinburgh Post-natal Depression Scale (EPDS) at the obstetric clinic. Mothers at risk (N = 258) (EPDS scores greater than or equal to 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 greater than or equal to 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.