Maternal mental health
10 December 2009
The UK and Pakistani researchers, led by former Wellcome Trust Career Development Fellow in Tropical Health Professor Atif Rahman, trained ‘Lady Health Workers’ (who provide preventative healthcare to pregnant women and newborns) to identify symptoms of depression. Around 900 women were enrolled on the study, half of whom received a programme based on cognitive behavioural therapy for their depression, while the remainder received standard care.
The therapy included both sessions with the health workers and techniques that could be practised at home in between the sessions.
At both six months and a year after the start of therapy, the incidence of depression in the treatment group was half that of controls. The treatment also helped postnatal care: the mothers who underwent therapy were more likely to ensure their children were fully immunised, and their children had reduced rates of diarrhoea. These mothers were more likely to be using contraception, which decreases infant mortality by increasing the time between childbirth.
The team stresses the importance of “the development of an evidence-base for cost-effective interventions that can be scaled up in resource-poor settings”.
Image: Mother and child in Pakistan; N. Durrell McKenna/Wellcome Images
References
Rahman A et al. Cognitive behaviour therapy-based intervention by community health workers for mothers with depression and their infants in rural Pakistan: a cluster-randomised controlled trial. Lancet 2008;372:902-9.