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Perinatal Dyadic Psychotherapy for postpartum depression: a randomized controlled pilot trial

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Abstract

An integrated approach addressing maternal depression and associated mother-infant relationship dysfunction may improve outcomes. This study tested Perinatal Dyadic Psychotherapy (PDP), a dual-focused mother-infant intervention to prevent/decrease maternal postpartum depression and improve aspects of the mother-infant relationship related to child development. Women recruited from hospital postpartum units were screened using a three-stage process. Forty-two depressed first-time mothers and their 6-week-old infants were enrolled and randomized to receive the PDP intervention or usual care plus depression monitoring by phone. The intervention consisted of eight home-based, nurse-delivered mother-infant sessions consisting of (a) supportive, relationship-based, mother-infant psychotherapy, and (b) a developmentally based infant-oriented component focused on promoting positive mother-infant interactions. Data collected at baseline, post-intervention, and three-month follow-up included measures of maternal depression, anxiety, maternal self-esteem, parenting stress, and mother-infant interaction. Depression and anxiety symptoms and diagnoses decreased significantly, and maternal self-esteem increased significantly across the study time frame with no between-group differences. There were no significant differences between groups on parenting stress or mother-infant interaction at post-intervention and follow-up. No participants developed onset of postpartum depression during the course of the study. PDP holds potential for treating depression in the context of the mother-infant relationship; however, usual care plus depression monitoring showed equal benefit. Further research is needed to explore using low-intensity interventions as a first step in a stepped care approach and to determine what subset of at-risk or depressed postpartum mothers might benefit most from the PDP intervention.

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Acknowledgments

Support for this study was provided by grants to J. Goodman from the Robert Wood Johnson Foundation and from the National Institute of Child Health and Development (1R21HD065156-01). We wish to acknowledge the valuable contributions of our research team: Jennifer Bernard, Laura Betz, Melissa Burnett, Kayse Eichelberger, Mary Ellen Flanagan, Avery Forget, Christine Godbout, Carol Gordon, Deborah Koopman, Francesca Longo, Stephanie Lubin-Levy, Rebecca Petersen, Rachael Phillips, and Gabrielle Santangelo.

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Goodman, J.H., Prager, J., Goldstein, R. et al. Perinatal Dyadic Psychotherapy for postpartum depression: a randomized controlled pilot trial. Arch Womens Ment Health 18, 493–506 (2015). https://doi.org/10.1007/s00737-014-0483-y

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