Efficacy of a brief cognitive-behavioral intervention on pregnant women to prevent postnatal depression

Abstract

BACKGROUND: Postnatal depression affects up to 19% women in the first three months after delivery. Cognitive-behavioural approach was consistently reported to be effective postnatal interventions. However, findings of preventive interventions during antenatal period were inconclusive although antenatal depressive symptom was consistently identified as significant predicators. AIM: The paper reports a longitudinal study to examine the efficacy of a 6-week antenatal intervention using group cognitive-behavioural approach on high risk women to prevent postnatal depression. The primary objective was to test whether the intervention group had significantly lower depressive symptoms and stress levels compared to control group after intervention. METHOD: Quasi-experimental design was used. Pregnant women at 14 to 30 weeks gestation were recruited from antenatal clinic of a public hospital. Those who scored 10 or above of the Edinburgh Postnatal Depression Scale were invited to participate (n¼143) in the intervention group or control group. A set of validated scales was administered at baseline measure at recruitment, 1-week after intervention, and at 6th postnatal week. The scales measured (1) depressive symptoms (EPDS); (2) anxiety and depression (HADS); (3) perceived stress (PSS); (4) dysfunctional attitudes (DAS); (5) satisfaction with family functioning (Family APGAR); (6) satisfaction in marital relationship (Dyadic Adjustment Scale); and (7) demographic information. Results: Repeated measure ANOVA showed the intervention group had significantly lower depressive symptoms and perceived stress levels as well as higher family functioning and marital satisfaction after intervention compared to control group. CONCLUSION: A brief antenatal intervention program using cognitive-behavioural approach was well-received by pregnant women and effective in reducing depressive symptoms and stress level.