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WESTPORT, CT (Reuters Health) Nov 16 - Interpersonal psychotherapy is an
effective alternative to pharmacotherapy in women with postpartum
depression, particularly those who are breast-feeding, researchers report
in the November issue of Archives of General Psychiatry.
"Although there is evidence that antidepressants are relatively safe for
nursing infants, the American Academy of Pediatrics classifies most
antidepressants as 'drugs whose effect on nursing infants in unknown but
may be of concern,' " Dr. Michael W. O'Hara and colleagues, from the
University of Iowa, in Iowa City, explain. For this reason, the
identification of effective, nonpharmacologic, alternatives for the
treatment of postpartum depression remains an important goal.
With this in mind, Dr. O'Hara and his team examined the efficacy of
interpersonal psychotherapy in a randomized, controlled study of 120
postpartum women with major depression. The women were assigned to either
interpersonal psychotherapy or a wait-list for 12 weeks. Ninety-nine women
completed the study.
At the end of 12 weeks, women who received psychotherapy had significantly
greater improvements on several measures of depression compared with
controls. Of the women in the psychotherapy group, 37.5% had reduced scores
on the Hamilton Rating Scale for Depression and 43.8% had reduced scores on
the Beck Depression Inventory. The corresponding recovery rates for women
in the control group were only 13.7% and 13.7%, respectively.
Absolute reductions in symptom severity were also significantly greater in
the women randomized to interpersonal psychotherapy compared with the
controls, according to the report. Treated women also had greater
improvements on measures of postpartum and social adjustment.
The low recovery rate in controls suggests that recovery from postpartum
depression occurs slowly without treatment, the investigators point out.
They therefore recommend that "women suffering from postpartum depression
should be treated as quickly as possible." These "findings should give
clinicians confidence that interpersonal psychotherapy is an effective and
acceptable treatment for postpartum depression."
Arch Gen Psychiatry 2000;57:1039-1045.
--Denny Rice, RN, IBCLC
--Dallas, Texas
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