Best Practice & Research Clinical Obstetrics & Gynaecology
9Psychosocial interventions for the treatment of perinatal depression
Introduction
The cause of postpartum depression is multifactorial ∗[1], ∗[2]; however, meta-analytic findings consistently highlight the importance of psychosocial variables, such as the lack of social support, marital conflict, and stressful life events. Analyses of social support variables in predictive studies clearly show a significant increase in the risk of postpartum depression in women who (1) do not have someone to talk openly with who has shared and understood a similar problem [3]; (2) lack an intimate confidant or friend [3], [4], [5], [6]; (3) do not receive support without having to ask for it [3]; and (4) feel socially isolated [7]. In addition, women who report marital difficulties have been found to be at risk of developing postpartum depression ∗[2], [8]. Depressed mothers are more likely to be dissatisfied with the support received from their partners [9], feel communication is poor [4], perceive their partner as uncaring [10], report a decline in the affection and cohesion in their relationship [11], and find a discrepancy between their expectations and later experiences of closeness to their partner [12], [13], [14]. Higher levels of postpartum depressive symptomatology have been linked to perceived stress during pregnancy [15], [16], childcare stressors [17], [18], [19], and the number of stressful life events since delivery [17], [20]. To address this issue, a variety of psychosocial interventions with the aim of enhancing the availability or perception of support have been developed to treat postpartum depression [21]. The purpose of this paper is to determine the current state of scientific knowledge related to the treatment of postpartum depression from a psychosocial perspective.
Section snippets
Theoretical underpinnings of psychosocial interventions
Social relationships and social support can affect mental health through several pathways. Members of a social network can exert a salutary influence on mental health by role modelling health-relevant behaviours [22]. Integration in a social network might also directly produce positive psychological states, including sense of purpose, belonging, and recognition of self-worth [23]. These positive states, in turn, might benefit mental health because of an increased motivation for self-care, as
Psychosocial treatment interventions
Several psychosocial treatment strategies have been evaluated for the treatment of postpartum depression based on the importance of psychosocial variables and the theoretical premise that supportive relationships during the perinatal period could reduce depressive symptoms and enhance a mother's feeling of wellbeing (Table 1).
Conclusion
Postpartum depression can be treated through several different psychosocial approaches, including peer support, partner support, non-directive counselling, home visits by mental health nurses, and collaborative models of care. Research has clearly shown that a lack of social support is a significant predictor of postpartum depression. As such, peer support interventions potentially have beneficial effects in treating women who have mild-to-moderate depression. Three studies have evaluated the
Research implications
This review clearly demonstrates postpartum depression research presents many special methodological complexities that need to be considered if scientific knowledge is to progress. First, particular difficulties exist in defining the target group to be studied, as diagnosis is much less concrete than in other areas where an initial assessment can be confirmed by physiological tests. Second, many of the treatments used are hard to define with clarity as psychosocial interventions often involve
Conflict of interest
None declared.
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Cited by (34)
Costs and benefits of scaling psychosocial interventions during the perinatal period in England: A simulation modelling study
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2021, Nursing for Women's HealthCitation Excerpt :Psychosocial interventions include prenatal and postpartum classes, home visits by mental health nurses, early postpartum follow-up, peer support, partner support, and non-directive counseling known as “listening visits”. Dennis (2014) reviewed 13 trials of psychosocial treatment interventions for PPD to determine their effectiveness. Treatment strategies in the included studies were peer support, partner support, non-directive counseling, and home visits by mental health nurses.
Perinatal Mood and Anxiety Disorders: Research and Implications for Nursing Care
2021, JOGNN - Journal of Obstetric, Gynecologic, and Neonatal NursingCitation Excerpt :Psychosocial interventions include prenatal and postpartum classes, home visits by mental health nurses, early postpartum follow-up, peer support, partner support, and non-directive counseling known as “listening visits”. Dennis (2014) reviewed 13 trials of psychosocial treatment interventions for PPD to determine their effectiveness. Treatment strategies in the included studies were peer support, partner support, non-directive counseling, and home visits by mental health nurses.
Social capital and antenatal depression among Chinese primiparas: A cross-sectional survey
2017, Psychiatry ResearchCitation Excerpt :Devoting attention to antenatal depression and taking appropriate preventive measures are key to prenatal care of women. Usually, psychosocial and psychological interventions are used to prevent perinatal depression (Dennis, 2014). But it is worth noting that research from the 1970s had shown that social environment has a direct benefit to mental health and could prevent diseases (Kim et al., 2014).