From the Journals

Couples-based cognitive-behavioral therapy curbs postpartum depression



Postpartum women who participated in a couples-based cognitive-behavioral therapy program showed less postpartum depression than did women in a solo program, according to data from 388 couples.

Previous studies have shown that both men and women experience depression up to 1 year after the birth of a child, but “no studies have compared the relative effectiveness of couple-based and women-alone interventions on parental mental health,” wrote F-W Ngai of the Hong Kong Polytechnic University and colleagues.

In a study published in the BJOG: An International Journal of Obstetrics and Gynaecology, the researchers randomized 134 childbearing Chinese couples to a couples-based cognitive-behavioral intervention (CBI), 124 women to a women-only CBI, and 130 controls who did not receive CBI. The CBI consisted of one 3-hour antenatal group session and two 30-mintue postnatal telephone sessions. Depressive symptoms were assessed during pregnancy as a baseline, and at 6 weeks, 6 months, and 12 months post partum and measured using the Edinburgh Postnatal Depression Scale (EPDS). Demographic characteristics were similar among the groups.

Overall, mothers in the couples-based CBI group showed significant improvement in depressive symptoms at 6 weeks post partum, compared with women in the women-only group or the controls (average differences in scores on the EPDS of 1.46 and 1.71, respectively). In addition, the percentage of women who met criteria for postnatal depression with an EPDS score of at least 10 was significantly lower (17.8% difference) in the couples-based CBI group compared with controls at 6 weeks postpartum. However, the differences between the groups were no longer significant at 6 months and 12 months post partum, and no differences in depression scores were seen among fathers at any time point.

“The findings provide evidence for the effectiveness of the couple-based cognitive behavioral intervention in improving postnatal depression among mothers, but not fathers,” and additional research is needed to find interventions that protect new fathers from depression, the researchers said.

The study findings were limited by several factors including the use only of self-reports for postpartum assessment and the homogeneous nature of the study population (all were educated, first-time Chinese parents), the researchers noted. However, the results support those from previous studies and suggest that couples-based CBI is feasible for use in primary care to promote perinatal health, they concluded.

The researchers had no financial conflicts to disclose.

SOURCE: Ngai F-W et al. BJOG. 2019. doi: 10.1111/1471-0528.15862.

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