Hostname: page-component-7c8c6479df-995ml Total loading time: 0 Render date: 2024-03-28T11:37:29.250Z Has data issue: false hasContentIssue false

Treating maternal depression?

Published online by Cambridge University Press:  02 January 2018

P. J. McGrath
Affiliation:
Psychology, Department, Dalhousie University, Halifax, and IWK Health Centre, Halifax B3H 4JI, Nova Scotia, Canada
F. J. Elgar
Affiliation:
School of Social Sciences, Cardiff University, Cardiff, UK
C. Johnston
Affiliation:
Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
D. J. A. Dozois
Affiliation:
Department of Psychology, University of Western Ontario, London, Ontario, Canada
S. Reyno
Affiliation:
Dalhousie University, Halifax, Nova Scotia, Canada
Rights & Permissions [Opens in a new window]

Abstract

Type
Columns
Copyright
Copyright © Royal College of Psychiatrists, 2003 

Cooper et al (Reference Cooper, Murray and Wilson2003) reported a randomised trial with mothers with post-partum depression that compared routine primary care, non-directive counselling, cognitive–behavioural therapy (CBT) and psychodynamic therapy and found that psychological therapy improved maternal mood in the short term but the long-term effect was no better than spontaneous remission. The trial was generally well done and the procedures reasonably described. However, the researchers did not, from a cognitive–behavioural perspective, treat maternal depression. Cooper et al describe that treatment used cognitive–behavioural techniques but focused not on depression but on the management of mother–infant interactions.

Several randomised placebo-controlled trials have shown that CBT – when done properly – is an effective treatment for post-partum depression (Reference Holden, Sagovsky and CoxHolden et al, 1989; Reference Appleby, Warner and WhittonAppleby et al, 1997; Reference Chabrol, Teissedre and Saint-JeanChabrol et al, 2002) and for major depressive disorders (Reference Hollon, Haman, Brown, Gotlib and HammenHollon et al, 2002). There is an important relationship between post-partum depression and mother–infant interactions but it is not, by any means, the entirety or even the essence of post-partum depression. Although it is advisable to customise CBT to patients’ circumstances, exclusive use of one focus, such as mother–child interactions, is not a test of the therapy. If the goal is to change depression, one should treat depression. Thus, the title is inaccurate and the discussion of the lack of effect of CBT for maternal depression is misleading.

Footnotes

EDITED BY STANLEY ZAMMIT

References

Appleby, L., Warner, R., Whitton, A., et al (1997) A controlled study of fluoxetine and cognitive–behavioural counselling in the treatment of postnatal depression. BMJ, 314, 932936.Google Scholar
Chabrol, H., Teissedre, F., Saint-Jean, M., et al (2002) Prevention and treatment of post-partum depression: a controlled randomized study on women at risk. Psychological Medicine, 32, 10391047.Google Scholar
Cooper, P. J., Murray, L., Wilson, A., et al (2003) Controlled trial of the short-and long-term effect of psychological treatment of post-partum depression. I. Impact on maternal mood. British Journal of Psychiatry, 182, 412419.Google Scholar
Holden, J. M., Sagovsky, R. & Cox, J. L. (1989) Counselling in ageneral practice setting: controlled study of health visitor intervention in treatment of postnatal depression. BMJ, 298, 223226.Google Scholar
Hollon, S. D., Haman, K. L. & Brown, L. L. (2002) Cognitive–behavioral treatment of depression. In Handbook of Depression (eds Gotlib, I. H. & Hammen, C. L.), pp. 383403, New York: Guilford Press.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.