Promoting mental health after childbirth: A controlled trial of primary prevention of postnatal depression

• Published in: British journal of clinical psychology 2000-09, Vol.39 (3), p.223-241
• Main Authors: Elliott, Sandra A., Leverton, Teresa J., Sanjack, Marion, Turner, Helen, Cowmeadow, Pauline, Hopkins, Jane, Bushnell, Diane
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Birth; Clinical psychology; Depression; Depression, Postpartum - diagnosis; Depression, Postpartum - prevention & control; Female; Health care; Health Promotion; Humans; Labor, Obstetric; Medical sciences; Mental Health; Motherhood; Mothers; Postnatal depression; Pregnancy; Prevention. Health policy. Planification; Preventive mental health care; Prospective Studies; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Questionnaires; Social psychiatry. Ethnopsychiatry; Surveys and Questionnaires
• ISSN: 0144-6657; 2044-8260
• DOI: 10.1348/014466500163248

Objectives. To investigate the effectiveness of a psychosocial intervention for the prevention of postnatal depression. Design. A controlled trial. Method. Women expecting their first or second child and designated as ‘more vulnerable’ by the Leverton Questionnaire (LQ) or Crown Crisp Experiential Index (CCEI) were allocated to a preventive intervention (N = 47) or control group (N = 52) by expected date of delivery to provide groups expecting their babies around the same time. Women were assessed at 3 months postnatal. An additional group of women designated as ‘less vulnerable’ (N = 88) were assessed to confirm the validity of the LQ as a vulnerability measure. Results. Questionnaire measures of mood in first‐time mothers invited to the Preparation for Parenthood groups revealed significantly more positive mood than in the group receiving routine care. The median Edinburgh Postnatal Depression Scale (EPDS) score for those invited was 3, compared to 8 for those not invited (p < .005). The diagnosis of depression using the Present State Examination revealed differences for both groups, though it reached statistical significance only with the first‐time mothers. Only 19 of the ‘more vulnerable’ invited first‐time mothers were ‘borderline’ or ‘cases’ at any time in the first 3 months postnatally compared to 39 of those not invited. The Surviving Parenthood groups for second‐time mothers were not successful. Conclusion. Some depressions following childbirth can be prevented by brief interventions that can be incorporated with existing systems of antenatal classes and postnatal support groups.