Review of interventions to prevent or treat postnatal depression

Objective

The objective of this study was to examine evidence of the effectiveness of interventions, particularly by midwives, to prevent postnatal depression, or by Health Visitors to treat postnatal depression.

Methods

A literature search from 1966 to July 2005 covered health databases MEDLINE, CINAHL, EMBASE, and PsycINFO, and Evidence-Based databases in The Cochrane Library, covering the Cochrane Database of Systematic Reviews and the Cochrane Controlled Trials Register. Studies that evaluated maternal mood up to one year after delivery were reviewed.

Results

From the 37 published studies that involved an intervention to prevent postnatal depression, there was little evidence of effectiveness. Of 20 reviewed trials aiming to treat PND, there were encouraging outcomes, but many of the studies had methodological or reporting limitations. Of all the trials reviewed, The PoNDER Trial, a pragmatic cluster randomised trial (commissioned and funded by the NHS R&D Health Technology Assessment programme) was the largest, with the longest follow-up (to 18 months). This trial reported the cost-effectiveness of Health Visitors’ role in the detection of PND and offering a psychological intervention.

Conclusion

Among all the trials reviewed here, The PoNDER Trial has provided evidence of the cost-effectiveness of the HVs role in detecting PND and offering a psychological intervention.