Abstract
This study aims to examine the acceptability and effectiveness of an antenatal group intervention designed to reduce the severity of depression and anxiety symptoms and improve maternal attachment in pregnant women with current or emerging depression and anxiety. Women who participated in the program completed pre- and posttreatment measures of depression (Centre of Epidemiological Studies Depression Scale) and Edinburgh Postnatal Depression Scale), anxiety (State-Trait Anxiety Inventory) and maternal attachment (Condon Maternal Antenatal Attachment Scale). Participants also completed a satisfaction questionnaire and provided general feedback about the group intervention and experience. A total of 48 women (M = 26 weeks of gestation) commenced and 37 (77 %) completed at least 80 % of the six session group intervention. Significant improvements with moderate to large effect sizes were observed for depression as measured on the Centre of Epidemiological Studies Depression Scale (CES-D) (p < 0.001), Edinburgh Postnatal Depression Scale (EPDS) (p < 0.001), state anxiety (p < 0.001) and maternal attachment (p = 0.006). Improvements in posttreatment depression scores on the EPDS were maintained at 2 months postpartum. Participants reported that the program had met their expectations. Partners (n = 21) who completed evaluation forms indicated that their attendance had improved their awareness of their partner’s mental health issues and resources available to their family and would recommend the program to other fathers. These preliminary findings suggest that our antenatal group program is an effective and acceptable intervention for a clinical sample of women and partners. It is a feasible addition or alternative treatment option to perinatal mental health care. Future directions could involve more comprehensive randomised controlled trials (RCT) to examine the effectiveness of the group intervention.
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References
Ainsworth MDS, Blehar MC, Waters E, Wall S (1978) Pattern of attachment: a psychological study of the Strange Situation. Erlbaum, Hillsdale
Austin MP (2004) Antenatal screening and early intervention for “perinatal” distress, depression and anxiety: where to from here? Arch Womens Ment Health 7:1–6
Clatworthy J (2012) The effectiveness of antenatal interventions to prevent postnatal depression in high-risk women. J Affect Disord 137:25–34
Condon JT (1993) The assessment of antenatal emotional attachment: development of a questionnaire instrument. Br J Med Psychol 66:167–183
Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 150:782–786
Crockett K, Zlotnick C, Davis M, Payne N, Washington R (2008) A depression preventive intervention for rural low-income African-American pregnant women at risk for postpartum depression. Arch Womens Ment Health 11:319–325
Dunkel Schetter C, Tanner L (2012) Anxiety, depression and stress in pregnancy: implications for mothers, children, research, and practice. Curr Opin Psychiatr 25:141–148. doi:10.1097/YCO.0b013e3283503680
Glover V (2014) Maternal depression, anxiety and stress during pregnancy and child outcome: what needs to be done. Best Pract Res Clin Obstet Gynaecol 28:25–35. doi:10.1016/j.bpobgyn.2013.08.017
Goodman JH (2004) Paternal postpartum depression, its relationship to maternal postpartum depression, and implications for family health. J Adv Nurs 45:26–35
Goodman JH, Santangelo G (2011) Group treatment for postpartum depression: a systematic review. Arch Womens Ment Health 14:277–293
Heron J, O'Connor TG, Evans J, Golding J, Glover V (2004) The course of anxiety and depression through pregnancy and the postpartum in a community sample. J Affect Disord 80:65–73
Lara MA, Navarro C, Navarrete L (2010) Outcome results of a psycho-educational intervention in pregnancy to prevent PPD: a randomized control trial. J Affect Disord 122:109–117
Larsen DL, Attkisson CC, Hargreaves WA, Nguyen TD (1979) Assessment of client/patient satisfaction: development of a general scale. Eval Prog Plan 2:197–207
Lattimore KA, Donn SM, Kaciroti N, Kemper AR, Neal CR Jr, Vazquez DM (2005) Selective serotonin reuptake inhibitor (SSRI) use during pregnancy and effects on the fetus and newborn: a meta-analysis. J Perinatol 25:595–604
Lee AM, Lam SK, Sze Mun Lau SM, Chong CS, Chui HW, Fong DY (2007) Prevalence, course, and risk factors for antenatal anxiety and depression. Obstet Gynecol 110:1102–1112
Letourneau NL, Dennis CL, Benzies K, Duffett-Leger L, Stewart M, Tryphonopoulos PD, Este D, Watson W (2012) Postpartum depression is a family affair: addressing the impact on mothers, fathers, and children. Issues Mental Health Nurs 33:445–457. doi:10.3109/01612840.2012.673054
Lovestone S, Kumar R (1993) Postnatal psychiatric illness: the impact on partners. Br J Psychiatry 163:210–216
Paulson JF, Bazemore SD (2010) Prenatal and postpartum depression in fathers and its association with maternal depression: a meta-analysis. JAMA 303:1961–1969
Pearson RM, Melotti R, Heron J, Joinson C, Stein A, Ramchandani PG, Evans J (2012) Disruption to the development of maternal responsiveness? The impact of prenatal depression on mother-infant interactions. Infant Behav Dev 35:613–626
Post and Antenatal Depression Association (2012) The cost of perinatal depression in Australia. Deloitte Access Economics
Radloff LS (1977) The CES-D scale: a self report depression scale for research in the general population’. Appl Psychol Meas 1:385–401. doi:10.1007/Bf00289563
Spielberger CD, Gorssuch RL, Lushene PR, Vagg PR, Jacobs GA (1983) Manual for the State-Trait Anxiety Inventory. Consulting Psychologists, Palo Alto
Stamp GE, Williams AS, Crowther CA (1995) Evaluation of antenatal and postnatal support to overcome postnatal depression: a randomized, controlled trial. Birth 22:138–143
Stewart DE (2005) Depression during pregnancy. Can Fam Physician 51:1061–1063
Zlotnick C, Johnson SL, Miller IW, Pearlstein T, Howard M (2001) Postpartum depression in women receiving public assistance: pilot study of an interpersonal-therapy-oriented group intervention. Am J Psychiatry 158:638–640
Acknowledgments
We wish to acknowledge Dr Lia Laios for her contribution to the initial project development and design of the antenatal group program and Dr Jeanette Pine who assisted in the earlier development of the program content and co-facilitation of the group in 2011. We also acknowledge the contribution of Dr Susan Nicolson who redesigned the parent-infant attachment content of the program and co-facilitated three of the group programs with Dr Naomi Thomas. We also wish to thank Dagmar Voges who generously gave her time to assist co-facilitate a group program, and the women and partners whose participation, insights and feedback assisted in the ongoing development and revision of the program format and content. This pilot project was supported by the financial contribution from the Preston and Loui Geduld Trust in 2012. The Centre for Women’s Mental Health at the Royal Women’s Hospital is supported by the Pratt Foundation.
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Thomas, N., Komiti, A. & Judd, F. Pilot early intervention antenatal group program for pregnant women with anxiety and depression. Arch Womens Ment Health 17, 503–509 (2014). https://doi.org/10.1007/s00737-014-0447-2
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DOI: https://doi.org/10.1007/s00737-014-0447-2