DR. SMCSI Medical College, Karakonam, Trivandrum, 695004, Kerala, India.
Department of Psychiatry, Dr. Somervell Memorial CSI Medical College, Karakonam, Kerala, India.
Asian J Psychiatr. 2020 Jan;47:101864. doi: 10.1016/j.ajp.2019.101864. Epub 2019 Nov 5.
Postnatal depression is a highly prevalent disorder with serious implications on maternal and child outcomes. There are few studies examining feasible interventions in low-middle-income community settings.
To assess the effectiveness of a low intensity group intervention led by lay workers during the antenatal period in reducing postnatal depression at 6-2 weeks postpartum.
A parallel group design with both positive and negative controls was employed. 1 community site was allocated to each of the 3 arms. The active intervention consisted of problem based sessions with cognitive behavioural components. The primary outcome was the presence of depression on CIS-R and secondary outcome measures where Global Assessment of Functioning (GAF) scores, EPNDS scores and participant perceptions.
69, 75 and 70 women received active, positive control and negative control interventions respectively. Post partum depression diagnosed with the CIS-R was present in 14.06% (C.I.- 5.55%-22.57%) and 22.62% (C.I.15.62%-29.63%) in the active arm and two control (combined) arms respectively. There was a 1/3 lower proportion of postpartum depression and impaired functioning in the intervention group, though statistical significance was not reached (p = 0.30). There were high levels of satisfaction reported for the active intervention.
There were trends for the possible effectiveness for this low intensity intervention and conclusions regarding its effectiveness can't be made as the sample size was small. There is a need to explore and develop locally relevant, innovative and feasible strategies for prevention of postnatal depression in resource constrained enviroments.
产后抑郁症是一种高发疾病，对母婴结局有严重影响。在中低收入社区环境中，很少有研究探讨可行的干预措施。
评估在产前期间由非专业人员领导的低强度小组干预在减少产后 6-2 周产后抑郁的效果。
采用平行组设计，同时设有阳性和阴性对照组。每个社区站点被分配到 3 个组臂之一。主动干预包括基于问题的认知行为成分课程。主要结果是使用 CIS-R 评估产后抑郁的存在，次要结果评估是全球功能评估（GAF）评分、EPNDS 评分和参与者感知。
69、75 和 70 名妇女分别接受了主动、阳性对照和阴性对照干预。使用 CIS-R 诊断产后抑郁症的发生率在主动组和两个对照组（合并）分别为 14.06%（置信区间 5.55%-22.57%）和 22.62%（置信区间 15.62%-29.63%）。干预组产后抑郁和功能障碍的比例降低了 1/3，但未达到统计学意义（p=0.30）。对主动干预的满意度报告很高。
这种低强度干预可能有一定的效果，但由于样本量小，不能得出其有效性的结论。在资源有限的环境中，需要探索和开发针对产后抑郁的具有创新性和可行性的本地相关策略。
