Pamela Scorza1, Catherine Monk2, Seonjoo Lee3, Tianshu Feng3, Obianuju O Berry4, Elizabeth Werner5. 1. Departments of Obstetrics and Gynecology, Columbia University, New York, NY. Electronic address: pls2122@cumc.columbia.edu. 2. Departments of Obstetrics and Gynecology, Columbia University, New York, NY; Psychiatry, Columbia University, New York, NY; New York State Psychiatric Institute, New York, NY. 3. New York State Psychiatric Institute, New York, NY. 4. Psychiatry, Columbia University, New York, NY. 5. Departments of Obstetrics and Gynecology, Columbia University, New York, NY; Psychiatry, Columbia University, New York, NY.
Abstract
BACKGROUND: The United States Preventive Services Task Force recommends that clinicians provide or refer pregnant and postpartum women who are at an increased risk of perinatal depression to counseling interventions. However, this prevention goal requires effective interventions that reach women at risk of, but before, the development of a depressive disorder. OBJECTIVE: We describe a pilot efficacy trial of a novel dyadic intervention to prevent common maternal mental health disorders, that is, Practical Resources for Effective Postpartum Parenting, in a sample of women at risk of maternal mental health disorders based on poverty status. We hypothesized that Practical Resources for Effective Postpartum Parenting compared with enhanced treatment as usual would reduce symptoms of maternal mental health disorders after birth. STUDY DESIGN: A total of 60 pregnant women who were recruited from obstetrical practices at Columbia University Irving Medical Center were randomized to the Practical Resources for Effective Postpartum Parenting (n=30) or enhanced treatment as usual (n=30) intervention. The Edinburgh Postnatal Depression Scale, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, and Patient Health Questionnaire were used to compare maternal mood at 6 weeks, 10 weeks, and 16 weeks after delivery. RESULTS: At 6 weeks after delivery, women randomized to Practical Resources for Effective Postpartum Parenting had lower mean Edinburgh Postnatal Depression scores (P=.018), lower mean Hamilton Depression scores (P<.001), and lower mean Hamilton Anxiety scores (P=.041); however, the incidence of postpartum mental disorders did not differ by treatment group. CONCLUSION: The Practical Resources for Effective Postpartum Parenting, which is an intervention integrated within obstetrical care, improves subclinical symptomology for at-risk dyads at a crucial time in the early postpartum period; however, our study did not detect reductions in the incidence of postpartum mental disorders.
RCT Entities:
BACKGROUND: The United States Preventive Services Task Force recommends that clinicians provide or refer pregnant and postpartum women who are at an increased risk of perinatal depression to counseling interventions. However, this prevention goal requires effective interventions that reach women at risk of, but before, the development of a depressive disorder. OBJECTIVE: We describe a pilot efficacy trial of a novel dyadic intervention to prevent common maternal mental health disorders, that is, Practical Resources for Effective Postpartum Parenting, in a sample of women at risk of maternal mental health disorders based on poverty status. We hypothesized that Practical Resources for Effective Postpartum Parenting compared with enhanced treatment as usual would reduce symptoms of maternal mental health disorders after birth. STUDY DESIGN: A total of 60 pregnant women who were recruited from obstetrical practices at Columbia University Irving Medical Center were randomized to the Practical Resources for Effective Postpartum Parenting (n=30) or enhanced treatment as usual (n=30) intervention. The Edinburgh Postnatal Depression Scale, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, and Patient Health Questionnaire were used to compare maternal mood at 6 weeks, 10 weeks, and 16 weeks after delivery. RESULTS: At 6 weeks after delivery, women randomized to Practical Resources for Effective Postpartum Parenting had lower mean Edinburgh Postnatal Depression scores (P=.018), lower mean Hamilton Depression scores (P<.001), and lower mean Hamilton Anxiety scores (P=.041); however, the incidence of postpartum mental disorders did not differ by treatment group. CONCLUSION: The Practical Resources for Effective Postpartum Parenting, which is an intervention integrated within obstetrical care, improves subclinical symptomology for at-risk dyads at a crucial time in the early postpartum period; however, our study did not detect reductions in the incidence of postpartum mental disorders.
Authors: Susan J Curry; Alex H Krist; Douglas K Owens; Michael J Barry; Aaron B Caughey; Karina W Davidson; Chyke A Doubeni; John W Epling; David C Grossman; Alex R Kemper; Martha Kubik; C Seth Landefeld; Carol M Mangione; Michael Silverstein; Melissa A Simon; Chien-Wen Tseng; John B Wong Journal: JAMA Date: 2019-02-12 Impact factor: 56.272
Authors: Christina Tragea; George P Chrousos; Evangelos C Alexopoulos; Christina Darviri Journal: Complement Ther Med Date: 2014-01-30 Impact factor: 2.446