Monday, April 24, 2023

Brief Interpersonal Therapy May Reduce Prenatal Depression

Pregnant individuals experiencing elevated levels of depression may benefit more from weekly interpersonal therapy (IPT) sessions than those who receive mental health counseling and maternity social services. These findings were published in JAMA Psychiatry.

“Approximately 17% of pregnant individuals meet criteria for major depressive disorder (MDD) diagnosis, and up to 37% report elevated symptoms during pregnancy,” wrote Benjamin L. Hankin, Ph.D., of the University of Illinois at Urbana-Champaign and colleagues. IPT “focuses on psychoeducation and interpersonal skill building to decrease interpersonal conflict and increase interpersonal support and competence.”

Hankin and colleagues recruited 234 individuals aged 18 to 45 who were no more than 25 weeks’ pregnant from obstetrics clinics in the Denver metropolitan area from 2017 to 2021. All participants reported elevated depressive symptoms—defined by the authors as a score of ≥10 on the Edinburgh Postnatal Depression Scale (EPDS) screening tool; about 37% had a diagnosis of MDD as determined by the Structured Clinical Interview for DSM-5.

The study participants were randomized to receive eight, 50-minute sessions of MomCare (described by the authors as “a culturally relevant, collaborative care intervention that provides brief IPT”) or enhanced usual care. Participants in the MomCare group were taught about the link between feelings and interpersonal interactions, as well as strategies to resolve interpersonal conflicts contributing to depression symptoms. Enhanced usual care combined mental health counseling and maternity social services, including information on housing and essential items. The participants were assessed using the EPDS and 20-item Symptom Checklist (SCL-20) for depression at baseline and throughout the pregnancy.

Over the course of pregnancy, individuals receiving MomCare experienced greater drops in depression symptoms, as assessed both by the EPDS and the SCL-20. “The benefit of IPT resulted in significant improvement observed relatively quickly [6 to 11 weeks],” Hankin and colleagues noted. In addition, just 6.1% of mothers receiving MomCare had a MDD diagnosis following birth, compared with 26.1% of the enhanced usual care group.

“Given our robust findings showing substantial improvements in maternal depression during pregnancy, future research from the Care Project will follow the neonates from birth through childhood to test rigorously whether reducing depression during pregnancy affects the development of infants’ risk mechanisms for later emerging depression, anxiety, and other health problems,” the authors wrote.

To read more about this topic, see the Psychiatric News article “Mood Symptoms in Pregnant Women May Not Be Fully Resolved by SSRIs.”

(Image: iStock/SDI Productions)

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