Counselling in a general practice setting: controlled study of health visitor intervention in treatment of postnatal depression.

OBJECTIVE

To determine whether counselling by health visitors is helpful in managing postnatal depression.

DESIGN

Controlled, random order trial.

SETTING

Health centres in Edinburgh and Livingston.

PATIENTS

Sixty women identified as depressed by screening at six weeks post partum and by psychiatric interview at about 13 weeks post partum. Five women did not wish to participate, and a further five did not complete the trial. Age, social and obstetric factors, and diagnosis were similar in women who completed the trial and those who withdrew.

INTERVENTION

Eight weekly counselling visits by health visitors who had been given a short training in counselling for postnatal depression.

END POINT

Reduction of depression. MEASUREMENTS and main results--Standardised psychiatric interviews and a 10 point self report scale were used to identify depression before and after intervention. The psychiatrist was not told to which group women were allocated. After three months 18 (69%) of the 26 women in the treatment group had fully recovered compared with nine (38%) of the 24 in the control group. The difference between the groups was thus 32% (95% confidence interval 5 to 58).

CONCLUSIONS

Counselling by health visitors is valuable in managing non-psychotic postnatal depression.