Table 3.

Effects of Individual and Group Psychotherapy on Postpartum Depression

StudyStudy design; nInterventionOutcome
Individual Therapy
 Appleby et al, 199721Randomized controlled trial; n = 87 women with PPD4 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, 199780Randomized controlled trial; n = 194 primiparous women with PPD4 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 weeksOver 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, 198981Randomized controlled trial; n = 55 women with PPD8 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, 200082Randomized controlled trial; n = 120 women with PPD12 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, 200083Randomized controlled trial; n = 60 women with PPD4 weekly supportive group sessions comprising discussions about transition to motherhood, postpartum stress management, communication skills, life planning, and strategies for changeIntervention 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, 199284Non-randomized controlled trial; n = 76 depressed & 76 non-depressed mothers8 weekly unstructured support groups, facilitated by psychologists; mothers discussed childbirth experiences, mood, motherhood, changing spousal relationships, and returning to work versus staying homeWhile the entire sample showed an improvement in mood from 2 weeks to 5 months postpartum, there was no significant intervention effect.
 Meager & Milgrom, 199685Randomized controlled trial; n = 20 mothers with PPD10-week group treatment program, included education (about PPD), cognitive-behavioral therapy, and homework for reinforcementDepression scores dropped significantly in the experimental group (Edinburgh Postnatal Depression Scale difference: −9.0), but not in the control group (difference, 0.5).