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Interpersonal therapy program may reduce postpartum depression

U. researchers examine effect of therapy on 205 pregnant women six and 12 months after giving birth

A team of University researchers recently found that interpersonal therapy — therapy that focuses on communicating with others — reduced the onset of postpartum depression among women during a six-month period after giving birth. The study detailing these findings was published online in the Journal of Affective Disorders Sept. 29.


Caron Zlotnick, professor of psychiatry and human behavior, obstetrics and gynecology and medicine, lead author of the study, has researched interpersonal therapy as a means of preventing postpartum depression for 15 years.


Zlotnick said she was inspired to conduct her latest research by her experience working at Women and Infants Hospital of Rhode Island, where she encountered many low-income mothers. In 2001 and 2006, she led pilot studies before starting to collect data in 2006 for the latest study.


The most recent study included 205 women who met the criteria of receiving public assistance and speaking English. To be included in the study, subjects also had to score 27 or higher on the Cooper Survey Questionnaire, which indicates high risk for postpartum depression, according to the study. The women were randomly assigned to either participate in interpersonal therapy or undergo usual treatment.


Six months after giving birth, the women in the two groups showed significant differences, with 31 percent of the women in the control group and 16 percent of the women in intervention group experiencing postpartum depression. But 12 months postpartum, there was only a “marginally significant” difference between the two groups, Zlotnick said.


The interpersonal therapy used in the study was known as the “Reach Out, Stand strong, Essentials for new mothers program” or ROSE program, and it included four 90-minute group sessions during pregnancy and one 50-minute individual session after delivery, according to the study. The women participated in role-playing exercises and learned communication skills in small groups, Zlotnick said.


Implementing prevention on a large scale can raise the issue of practicality, said Charles Debattista, professor of psychiatry and behavioral sciences at Stanford University Medical Center, who was not involved with the study. Performing this kind of intervention requires skilled therapists to meet with the women, he said. When postpartum depression does occur, psychotherapy or medications are effective treatments, he added.


“Postpartum blues can include symptoms many women experience,” Debattista said, adding that doctors can miss diagnoses because only some women with symptoms suffer from postpartum depression. “Anticipating it and identifying it when it comes up” are important steps, he said.


The Philadelphia Department of Public Health recently approached Zlotnick to expand the program in that city. The intervention is already in use at three sites in New York state, Zlotnick said.

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