Innovative psycho-educational program to prevent common postpartum mental disorders in primiparous women: a before and after controlled study

Fisher, Jane R. W.; Wynter, Karen H.; Rowe, Heather J.
January 2010
BMC Public Health;2010, Vol. 10 Issue 1, p432
Academic Journal
Background: Universal interventions to prevent postnatal mental disorders in women have had limited success, perhaps because they were insufficiently theorised, not gender-informed and overlooked relevant risk factors. This study aimed to determine whether an innovative brief psycho-educational program for mothers, fathers and first newborns, which addressed salient learning needs about infant behaviour management and adjustment tasks in the intimate partner relationship, prevented postpartum mental health problems in primiparous women. Methods: A before and after controlled study was conducted in primary care in seven local government areas in Victoria, Australia. English-speaking couples with one-week old infants were invited consecutively to participate by the maternal and child health nurse at the universal first home visit. Two groups were recruited and followed sequentially: both completed telephone interviews at four weeks and six months postpartum and received standard health care. Intervention group participants were also invited to attend a half-day program with up to five couples and one month old infants, facilitated by trained, supervised nurses. The main outcome was any Composite International Diagnostic Interview (CIDI) diagnosis of Depression or Anxiety or Adjustment Disorder with Depressed Mood, Anxiety, or Mixed Anxiety and Depressed Mood in the first six months postpartum. Factors associated with the outcome were established by logistic regression controlling for potential confounders and analysis was by intention to treat. Results: In total 399/646 (62%) women were recruited; 210 received only standard care and 189 were also offered the intervention; 364 (91%) were retained at follow up six months postpartum. In women without a psychiatric history (232/364; 64%), 36/125 (29%) were diagnosed with Depression or Anxiety or Adjustment Disorder with Depressed Mood, Anxiety, or Mixed Anxiety and Depressed Mood in the control group, compared with 16/107 (15%) in the intervention group. In those without a psychiatric history, the adjusted odds ratio for diagnosis of a common postpartum mental disorder was 0.43 (95% CI 0.21, 0.89) in the intervention group compared to the control group. Conclusions: A universal, brief psycho-educational group program for English-speaking first time parents and babies in primary care reduces de novo postpartum mental disorders in women. A universal approach supplemented by an additional program may improve effectiveness for women with a psychiatric history. Trial registration: ACTRN 12605000567628.


Related Articles

  • Consumers' views on the use of diagnostic labels to describe psychological distress in the postpartum: implications for health care. Oddy, Belinda; Rowe, Heather; Fisher, Jane // Australian Journal of Primary Health;Mar2009, Vol. 15 Issue 1, p9 

    Postpartum psychological distress is common and its detection is important in primary health care. Australia's residential early parenting centres admit mothers with their infants and treat both infant sleep and settling and maternal mental health. Many women have health problems but low uptake...

  • Exploring and enhancing engagement to the psychosocial intervention ‘Preparing for Parenthood’. Wheatley, S. L.; Brugha, T. S.; Shapiro, D. A. // Archives of Women's Mental Health;2003, Vol. 6 Issue 4, p275 

    Summary ¶Background: Poor compliance by participants consenting to be randomised to receive both physical and mental health promotion interventions represents a potentially serious threat to external and internal validity of those interventions. Quantitative and qualitative investigation of...

  • Detection of postpartum depression and anxiety in a large health plan. Coates, Ashley O.; Schaefer, Catherine A.; Alexander, Jeanne L. // Journal of Behavioral Health Services & Research;Apr-Jun2004, Vol. 31 Issue 2, p117 

    To determine the prevalence of diagnosed and/or treated postpartum depression and anxiety, records were extracted for 1 year after delivery from databases of outpatient diagnoses and prescriptions, for women in a health maintenance organization who had delivered a child from July 1997 through...

  • Do Antenatal Religious and Spiritual Factors Impact the Risk of Postpartum Depressive Symptoms? Mann, Joshua R.; McKeown, Robert E.; Bacon, Janice; Vesselinov, Roumen; Bush, Freda // Journal of Women's Health (15409996);Jun2008, Vol. 17 Issue 5, p745 

    Objectives: Previous research has identified an inverse relationship between religiosity/spirituality and depressive symptoms. However, prospective studies are needed. This study investigates the association between antenatal religiosity/spirituality and postpartum depression, controlling for...

  • Postpartum depression: risk-factors and treatments – Introduction. Glangeaud-Freudenthal, N.M.-C.; Boyce, P. // Archives of Women's Mental Health;2003 Supplement 2, Vol. 6, ps31 

    Provides an overview of papers on women's mental health featured in the April 2, 2003 issue of "Archives of Women's Mental Health." Origins of the Marcé Society; Article on postpartum blues; Review of the preventative studies and the studies on the treatment of postnatal depression;...

  • Abstracts 33rd Annual Meeting of the North American Society for Psychosocial Obstetrics and Gynecology February 9—11, 2006, Kohala Coast, Hawaii. Abstract // Archives of Women's Mental Health;May2006, Vol. 9 Issue 3, p161 

    Presents abstracts of studies on women's mental health presented at the 33rd Annual Meeting of the North American Society for Psychosocial Obstetrics and Gynecology held on February 9-11, 2006 at Kohala Coast, Hawaii. "The Women and Reproductive-Related Trauma," by Leslie Born, Claudio N....

  • PTSD and postpartum mental health in a sample of Caucasian, Asian, and Pacific Islander women. Onoye, Jane M.; Goebert, Deborah; Morland, Leslie; Matsu, Courtenay; Wright, Tricia // Archives of Women's Mental Health;2009, Vol. 12 Issue 6, p393 

    To better understand the role of posttraumatic stress disorder (PTSD) in postpartum health, this study investigates the relationship of PTSD and associated perinatal behavioral risk factors in a sample of Caucasian, Asian, and Pacific Islander women. As part of a larger longitudinal study, 54...

  • coming out of the dark.  // Fit Pregnancy;Aug/Sep2002, Vol. 9 Issue 3, p78 

    Details the experience of a woman who experienced postpartum depression after giving to a daughter.

  • Functioning and well-being at 24 weeks postpartum of women with postnatal depression. Boyce, P. M.; Johnstone, S. J.; Hickey, A. R.; Morris-Yates, A. D.; Harris, M. G.; Strachan, T. // Archives of Women's Mental Health;2000, Vol. 3 Issue 3, p91 

    Summary Background: Postnatal depression, an episode of major depression occurring within six months postpartum, occurs in 10-15% of mothers. Previous research has focussed on prevalence, risk factors, treatment, and impact, with little emphasis on assessment of functioning and well-being in...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics