Effects of Individual and Group Psychotherapy on Postpartum Depression
| Study | Study design; n | Intervention | Outcome |
|---|---|---|---|
| Individual Therapy | |||
| Appleby et al, 199721 | Randomized controlled trial; n = 87 women with PPD | 4 treatment groups: fluoxetine or placebo, plus 1 or 6 sessions of counseling provided by trained health visitors and derived from cognitive behavioral therapy (included reassurance and practical advice about feelings of not coping, child care, and lack of enjoyable activities and practical support) | Six sessions of counseling were better than 1 (clinical interview schedule score difference = 38.7% at 12 weeks), and fluoxetine was better than placebo (score difference = 40.7% at 12 weeks). There was no advantage in combining fluoxetine and counseling |
| Cooper & Murray, 199780 | Randomized controlled trial; n = 194 primiparous women with PPD | 4 treatment groups: nondirective counseling (n = 48), cognitive-behavioral therapy (n = 42), dynamic psychotherapy (n = 48), and a control group (n = 54); therapy sessions occurred 1 hour/week for 10 weeks | Over the initial 10-week period, the 3 treatment groups showed greater improvement than the control group; however, by 9 months postpartum, there was no significant difference between groups |
| Holden et al, 198981 | Randomized controlled trial; n = 55 women with PPD | 8 weekly counseling visits by health visitors trained to provide nondirective counseling (listening to clients’ feelings, and encouraging them to make decisions based on their own judgment) | 69% of women in the counseling group versus 38% in the control group had recovered after 3 months. |
| O’Hara et al, 200082 | Randomized controlled trial; n = 120 women with PPD | 12 weekly individual counseling sessions led by experienced psychotherapists (discussed losses & and interpersonal conflicts and affirmed clients’ competence) | 43.8% of women in the counseling group versus 13.7% controls had recovered after 3 months. |
| Group Therapy | |||
| Chen et al, 200083 | Randomized controlled trial; n = 60 women with PPD | 4 weekly supportive group sessions comprising discussions about transition to motherhood, postpartum stress management, communication skills, life planning, and strategies for change | Intervention group members experienced significant declines in depression scores, whereas control group members did not (Beck Depression Inventory change: −6.14 versus −0.92, P < .01). |
| Fleming et al, 199284 | Non-randomized controlled trial; n = 76 depressed & 76 non-depressed mothers | 8 weekly unstructured support groups, facilitated by psychologists; mothers discussed childbirth experiences, mood, motherhood, changing spousal relationships, and returning to work versus staying home | While the entire sample showed an improvement in mood from 2 weeks to 5 months postpartum, there was no significant intervention effect. |
| Meager & Milgrom, 199685 | Randomized controlled trial; n = 20 mothers with PPD | 10-week group treatment program, included education (about PPD), cognitive-behavioral therapy, and homework for reinforcement | Depression scores dropped significantly in the experimental group (Edinburgh Postnatal Depression Scale difference: −9.0), but not in the control group (difference, 0.5). |