Postnatal depression (PND) is a serious and debilitating condition that disrupts
women's lives at a time when they are already under stress, adapting to the
substantial demands having a baby creates. PND is linked with adverse effects
on the development of the child and the family system, including poor marital
adjustment and elevated levels of depression in male partners. Implications, not
only for men's health, but also for the amount and quality of support men can
provide for their partners and children are far-reaching. Preventative programmes
for the treatment of PND have been widely advocated, but are rare in the
literature. Even fewer, are treatment programmes that include male partners.
This study compared the efficacy of a structured Cognitive Behavioural Therapy
(CBT) programme for the treatment of PND, delivered in 3 different ways, within
an Australian semi-rurallcoastal community. Thirty-nine women, diagnosed with
PND, completed 10 weeks of either 'individual' (n=9), 'group women only' (n=16)
or 'group partners involved' (n=14) intervention and were compared with a control
support group (n=7). Pre-intervention, women in the study reported the presence
of a number of psychosocial risk factors for PND and almost 20% of the men in
this sample were also depressed according to the BDI-II. Partners of the women
in the 'group partners involved' treatment completed a 6-week CBT group
programme especially designed for men (n=13). Partners of the women involved
in the other interventions acted as a control group (n=16). Depression, anxiety,
parenting stress, relationship adjustment and social support measures were
taken using standardized instruments at pre-intervention, post-test and at 3- and
6-month follow-up. Qualitative information about the experiences of PND and the
intervention programme was obtained through focus group interviews. The
intervention programme was evaluated by questionnaire by both participants and
their general practitioners or allied health professionals who had referred them to
the programme. Results indicated that, overall, the 10-week, structured CBT
programme was far more effective in treating PND than attending a support
group. Over time, group therapy outperformed individual therapy for depression
and anxiety. Including partners in intervention meant significantly improved
outcomes at 6-month follow-up for depression, anxiety and relationship
adjustment for women. When male partners were included, women's social
support levels were significantly higher at 3-month follow-up. Post-intervention
men who participated in the men's group were significantly less depressed and
stressed, and showed higher levels of social support than controls. The
intervention programme was rated highly by both participants and referrers for
effectiveness and acceptability, with the psychoeducational information and CBT
strategies rated as the most useful components. Participants viewed the
inclusion of male partners in PND treatment as fundamental and strongly
recommended increased community and professional awareness of PND and its
consequences. The important implications for clinical practice and resource
allocation raised by this study are addressed.
| Identifer | oai:union.ndltd.org:ADTP/221890 |
| Date | January 2002 |
| Creators | Sarah Jane Davey |
| Publisher | Murdoch University |
| Source Sets | Australiasian Digital Theses Program |
| Language | English |
| Detected Language | English |
| Rights | http://www.murdoch.edu.au/goto/CopyrightNotice, Copyright Sarah Jane Davey |
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