Group interpersonal psychotherapy for postnatal depression: a pilot study

SummaryWe conducted a pilot study to assess the potential effectiveness of group interpersonal psychotherapy (IPT-G) as a treatment for postnatal depression (PND). The study was also established to test a treatment manual for IPT-G, assess the acceptability of this format for participants and test a recruitment strategy for a randomised controlled trial. 18 mothers diagnosed with PND participated in 2 individual session and 8 sessions of group IPT. A two-hour psychoeducational session was also held for the partners of the participants. Measures of depressive symptomatology and social adjustment were administered by an independent clinician at baseline, 4 weeks, 8 weeks and 3 months post treatment. Patient satisfaction with the treatment was also evaluated. Severity scores on the BDI, EPDS and the HDRS decreased from pre- to post-treatment. This was maintained at three months follow up. No overall improvement in the Social Adjustment Scale-Self Report was noted, although there was improvement in their relationship with their significant other. The results confirm previous work that IPT-G may improve symptom severity for women suffering from postnatal depression. Limitations included the use of antidepressant therapy by 67% of subjects and the lack of a control group. There is a need for further randomised controlled trials of IPT-G with larger sample sizes to establish its effectiveness as treatment for PND.

[1]  C. Henshaw,et al.  The treatment of postnatal depression: A comprehensive literature review , 2001 .

[2]  X. Kostaras,et al.  The Impact of Partner Support in the Treatment of Postpartum Depression , 2000, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[3]  S D Imber,et al.  National Institute of Mental Health Treatment of Depression Collaborative Research Program. General effectiveness of treatments. , 1989, Archives of general psychiatry.

[4]  M. O’Hara,et al.  Prospective study of postpartum depression: prevalence, course, and predictive factors. , 1985, Journal of abnormal psychology.

[5]  J. Cox,et al.  Counselling in a general practice setting: controlled study of health visitor intervention in treatment of postnatal depression. , 1989, BMJ.

[6]  L. Appleby,et al.  44-2 A controlled study of fluoxetine and cognitive-behavioural counselling in the treatment of postnatal depression , 1997, Biological Psychiatry.

[7]  P. Cooper,et al.  Controlled trial of the short- and long-term effect of psychological treatment of post-partum depression , 2003, British Journal of Psychiatry.

[8]  D. Ellwood,et al.  To screen or not to screen — that is the question in perinatal depression , 2002 .

[9]  C. Dennis Influence of depressive symptomatology on maternal health service utilization and general health , 2004, Archives of Women’s Mental Health.

[10]  P J Cooper,et al.  EDITORIAL: Postpartum depression and child development , 1997, Psychological Medicine.

[11]  P. Cooper,et al.  Fortnightly review: Postnatal depression , 1998 .

[12]  J. Cox,et al.  Detection of Postnatal Depression , 1987, British Journal of Psychiatry.

[13]  S. Matthey,et al.  A group programme for postnatally distressed women and their partners. , 1997, Journal of advanced nursing.

[14]  C. Klier,et al.  Interpersonal psychotherapy adapted for the group setting in the treatment of postpartum depression. , 2001, Journal of Psychotherapy Practice and Research.

[15]  Janet B W Williams,et al.  A structured interview guide for the Hamilton Depression Rating Scale. , 1988, Archives of general psychiatry.

[16]  J. Reich The effect of Axis II disorders on the outcome of treatment of anxiety and unipolar depressive disorders: a review. , 2003, Journal of personality disorders.

[17]  D. Wilfley,et al.  Interpersonal Psychotherapy For Group , 2000 .

[18]  S. Stuart,et al.  The prevention and psychotherapeutic treatment of postpartum depression , 2003, Archives of Women’s Mental Health.

[19]  R. Steer,et al.  Self-reported depression and negative pregnancy outcomes. , 1992, Journal of clinical epidemiology.

[20]  A. Wenzel,et al.  Efficacy of interpersonal psychotherapy for postpartum depression. , 2000, Archives of general psychiatry.

[21]  M. Weissman,et al.  Comprehensive Guide To Interpersonal Psychotherapy , 2000 .

[22]  A. Beck,et al.  Internal consistencies of the original and revised Beck Depression Inventory. , 1984, Journal of clinical psychology.

[23]  S. Hollon,et al.  6 – Cognitive Therapy of Depression1 , 1979 .

[24]  J. Milgrom,et al.  Group Treatment for Postpartum Depression: A Pilot Study , 1996, The Australian and New Zealand journal of psychiatry.

[25]  A. Wenzel,et al.  Psychotherapy for postpartum depression: a preliminary report. , 2003, The American journal of orthopsychiatry.

[26]  M. Weissman,et al.  Assessment of social adjustment by patient self-report. , 1976, Archives of general psychiatry.

[27]  H. Bauchner,et al.  Maternal Depressive Symptoms during Pregnancy, and Newborn Irritability , 1990, Journal of developmental and behavioral pediatrics : JDBP.

[28]  P. Reebye,et al.  Relation between Prenatal Maternal Mood and Anxiety and Neonatal Health , 2004, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[29]  L. Appleby,et al.  Maternal thinking and the treatment of postnatal depression , 1996 .

[30]  R. Ray,et al.  Group-Based Interpersonal Psychotherapy for Posttraumatic Stress Disorder: Theoretical and Clinical Aspects , 2004, International journal of group psychotherapy.

[31]  M. O’Hara,et al.  Prospective study of postpartum depression: 4 1/2-year follow-up of women and children. , 1991, Journal of abnormal psychology.

[32]  Controlled trial of the short- and long-term effect of psychological treatment of post-partum depression , 2003, British Journal of Psychiatry.

[33]  L. Murray,et al.  The effects of postnatal depression on the infant. , 1989, Bailliere's clinical obstetrics and gynaecology.

[34]  C. Hammen,et al.  Severity, chronicity, and timing of maternal depression and risk for adolescent offspring diagnoses in a community sample. , 2003, Archives of general psychiatry.

[35]  K. Dobson,et al.  Cognitive therapy of depression: pretreatment patient predictors of outcome. , 2002, Clinical psychology review.