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Br J Psychiatry. 2003 May;182:412-9.

Controlled trial of the short- and long-term effect of psychological treatment of post-partum depression. I. Impact on maternal mood.

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Winnicott Research Unit, Department of Psychology, University of Reading, UK.



Psychological interventions for postnatal depression can be beneficial in the short term but their longer-term impact is unknown.


To evaluate the long-term effect on maternal mood of three psychological treatments in relation to routine primary care.


Women with post-partum depression (n=193) were assigned randomly to one of four conditions: routine primary care, non-directive counselling, cognitive-behavioural therapy or psychodynamic therapy. They were assessed immediately after the treatment phase (at 4.5 months) and at 9, 18 and 60 months post-partum.


Compared with the control, all three treatments had a significant impact at 4.5 months on maternal mood (Edinburgh Postnatal Depression Scale, EPDS). Only psychodynamic therapy produced a rate of reduction in depression (Structured Clinical Interview for DSM-III - R) significantly superior to that of the control. The benefit of treatment was no longer apparent by 9 months post-partum. Treatment did not reduce subsequent episodes of post-partum depression.


Psychological intervention for post-partum depression improves maternal mood (EPDS) in the short term. However, this benefit is not superior to spontaneous remission in the long term.

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