Psychological Intervention for Postpartum Depression

Summary： The postpartum depression outcome and the effect of psychological intervention were studied in order to reduce the occurrence and development of the postpartum depression. A survey of 4000 women within 4-6 weeks postpartum in 80 communities in Shenzhen, China was performed using random cluster sampling method. By employing Edinburgh Postnatal Depression Scale （EPDS） as a screening tool, the positive women （defined as EPDS 〉10） were randomly divided into intervention group and control group at a ratio of 1：2. The women in the intervention group were treated by means of mailing postpartum depression prevention and treatment knowledge manual, face-to-face counseling, and telephone psychological counseling interventions aiming at individual risk factors, while those in the control group were treated with conventional methods. EPDS scores were assessed in these two groups again at 6th month postpartum. Totally, 3907 valid questionnaires were obtained. All the 771 positive women were divided into two groups： 257 in the intervention group, and 514 in the control group. At 6th month postpartum, the EPDS scores in the intervention group were decreased significantly, from baseline stage （12.84±3.02） to end stage （3.05±2.93）, while EPDS scores in the control group were reduced from 12.44±2.78 to 6.94±4.02. There were significant differences in the EPDS scores at end stage between the two groups （t=13.059, P〈0.001）. Psychological intervention can reduce postpartum depression, with better maternal compliance. It is feasible and necessary to establish postpartum depression screening and psychological intervention model in community-hospital and include the postpartum depression screening, intervention, and follow-up into the conventional healthcare.

Identifying the factors associated with depressive symptoms among postpartum mothers in Kathmandu, Nepal

Purpose:This study aimed to identify the factors associated with depressive symptoms among postpartum mothers in Kathmandu,Nepal.Method:A hospital-based cross-sectional study that included 346 postpartum mothers at 4-14 weeks after delivery was carried out.Validated Nepalese version of Edinburgh Postnatal Depression Scale with cut-off value of≥12 was used to screen depressive symptoms and structured questionnaires were used to identify the associated factors.Possible factors associated with depressive symptoms were identified by logistic regression analysis.Result:The mean age of the mothers was 22.75(SD=4.51).The prevalence of depressive symptoms among postpartum mothers was 17.1%(95%CI=15.07-19.12).No significant association existed between postpartum depressive symptoms and socio demographic and economic characteristics.In multivariate analysis,risk factors for postpartum depressive symptoms were identified as follows:women without adequate rest during pregnancy(aOR=4.023,95%CI=1.294-12.501),abortion history(aOR=3.25,95%CI=1.208-9.065),poor relationship with husband(aOR=1.67,95%CI=1.073-8.384),marital dissatisfaction(aOR=4.053,95%CI=2.281-12.819)and stressful life events(aOR=3.89,95%CI=1.504-9.810).Conclusions:This study aids to draw attention on the incorporation of routine screening for basic support and intervention for identified risk factors in postpartum period.Policies can be formulated to encourage postpartum women to obtain adequate rest during pregnancy,support women with poor partner relationship,reduce marital dissatisfaction,help women adjust with stressful life events,and prevent and manage abortion appropriately.These policies may reduce harmful consequences of postpartum depressive symptoms for women,newborn and their family.

Psychosocial impact of mothers with perinatal loss and its contributing factors:an insight

Objective:To evaluate the psychosocial impact among mothers with perinatal loss and its contributing factors.Methods:A cross sectional study was conducted in University Kebangsaan Malaysia Medical Centre (UKMMC) from April 2008 to May 2009 using Edinburgh Postnatal Depression Scale (EPDS) and self administered questionnaire.Results:Sixty-two respondents were included and most of them were working mothers (77.4%).The mean age of the respondents was (31.0±5.6) years and a majority of the subjects aged between 20-34 years (77.4%).According to the EPDS score,53.2% of the respondents had a psychosocial impact with a total score of >9,out of 30.There was a significant relationship between psychosocial impact after perinatal loss and support from friends (P=0.019).However,there were no significant differences between psychosocial impact and history of previous perinatal loss,ethnicity,occupation,educational level,age or total income.Conclusion:Mothers with perinatal loss should be screened for psychosocial impact and offered support when needed.Family and friends should continue to provide emotional support.People who have experienced similar problem before will be able to provide better support than those who have not.