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Influence of adjuvant detached mindfulness and stress management training compared to pharmacologic treatment in primiparae with postpartum depression

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Abstract

Ten to 15% of mothers experience postpartum depression (PPD). If untreated, PPD may negatively affect mothers’ and infants’ mental health in the long term. Accordingly, effective treatments are required. In the present study, we investigated the effect of detached mindfulness (DM) and stress management training (SMT) as adjuvants, compared to pharmacologic treatment only, on symptoms of depression in women with PPD. Forty-five primiparae (mean age: M = 24.5 years) with diagnosed PPD and treated with an SSRI (citalopram; CIT) took part in the study. At baseline, they completed questionnaires covering socio-demographic data and symptoms of depression. Experts rated also symptoms of depression. Next, participants were randomly assigned to one of the following study conditions: adjuvant detached mindfulness (CIT+DM); adjuvant stress management training (CIT+SMT); control condition (CIT). Self- and experts’ ratings were completed at the end of the study 8 weeks later, and again at 8 weeks follow-up. Symptoms of depression decreased significantly over time, but more so in the CIT+DM and CIT+SMT group, compared to the control condition. The pattern of results remained stable at follow-up. In primiparae with PPD and treated with a standard SSRI, adjuvant psychotherapeutic interventions led to significant and longer-lasting improvements.

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References

  • Abbott RA et al (2014) Effectiveness of mindfulness-based stress reduction and mindfulness based cognitive therapy in vascular disease: a systematic review and meta-analysis of randomised controlled trials. J Psychosom Res 76:341–351. doi:10.1016/j.jpsychores.2014.02.012

    Article  PubMed  Google Scholar 

  • Ahmadpanah M et al (2016a) Effects of psychotherapy in combination with pharmacotherapy, when compared to pharmacotherapy only on blood pressure, depression, and anxiety in female patients with hypertension. J Health Psychol 21:1216–1227. doi:10.1177/1359105314550350

    Article  PubMed  Google Scholar 

  • Ahmadpanah M et al (2016b) Validity and test-retest reliability of the Persian version of the Montgomery-Asberg Depression Rating Scale. Neuropsychiatr Dis Treat 12:603–607. doi:10.2147/NDT.S103869

    PubMed  PubMed Central  Google Scholar 

  • American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders 4th edition: DSM-IV-TR. American Psychiatric Association, Washington DC

    Google Scholar 

  • Apostolo J, Bobrowicz-Campos E, Rodrigues M, Castro I, Cardoso D (2016) The effectiveness of non-pharmacological interventions in older adults with depressive disorders: a systematic review. Int J Nurs Stud 58:59–70. doi:10.1016/j.ijnurstu.2016.02.006

    Article  PubMed  Google Scholar 

  • Bahadoran P, Foroushani S, Ehsanpour S, Abedi A (2008) A meta-analysis on studies about obstetric risk factors of postpartum depression in Iran within 1995–2005. Iranian Journal of nursing and midwifery research 13

  • Beck CT (2006) Postpartum depression: it isn’t just the blues. Am J Nurs 106:40–50 quiz 50-41

    Article  Google Scholar 

  • Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571

    Article  CAS  PubMed  Google Scholar 

  • Bloch M, Meiboom H, Lorberblatt M, Bluvstein I, Aharonov I, Schreiber S (2012) The effect of sertraline add-on to brief dynamic psychotherapy for the treatment of postpartum depression: a randomized, double-blind, placebo-controlled study. J Clin Psychiatry 73:235–241. doi:10.4088/JCP.11m07117

    Article  PubMed  Google Scholar 

  • Brand S, Holsboer-Trachsler E, Naranjo JR, Schmidt S (2012) Influence of mindfulness practice on cortisol and sleep in long-term and short-term meditators. Neuropsychobiology 65:109–118. doi:10.1159/000330362

    Article  CAS  PubMed  Google Scholar 

  • Brandon AR, Crowley SK, Gordon JL, Girdler SS (2014) Nonpharmacologic treatments for depression related to reproductive events. Current psychiatry reports 16:526. doi:10.1007/s11920-014-0526-0

    Article  PubMed  Google Scholar 

  • Chambers R, Gullone E, Allen NB (2009) Mindful emotion regulation: an integrative review. Clin Psychol Rev 29:560–572. doi:10.1016/j.cpr.2009.06.005

    Article  PubMed  Google Scholar 

  • Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. The British journal of psychiatry : the journal of mental science 150:782–786

    Article  CAS  Google Scholar 

  • Cuijpers P, Brannmark JG, van Straten A (2008) Psychological treatment of postpartum depression: a meta-analysis. J Clin Psychol 64:103–118. doi:10.1002/jclp.20432

    Article  PubMed  Google Scholar 

  • Dennis CL (2004) Treatment of postpartum depression, part 2: a critical review of nonbiological interventions. J Clin Psychiatry 65:1252–1265

    Article  PubMed  Google Scholar 

  • Dennis CL, Hodnett E (2007) Psychosocial and psychological interventions for treating postpartum depression The Cochrane database of systematic reviews:Cd006116 doi:10.1002/14651858.CD006116.pub2

  • Drury SS, Scaramella L, Zeanah CH (2016) The neurobiological impact of postpartum maternal depression: prevention and intervention approaches. Child Adolesc Psychiatr Clin N Am 25:179–200. doi:10.1016/j.chc.2015.11.001

    Article  PubMed  PubMed Central  Google Scholar 

  • Flynn HA, O'Mahen HA, Massey L, Marcus S (2006) The impact of a brief obstetrics clinic-based intervention on treatment use for perinatal depression. J Women’s Health 15(2002):1195–1204. doi:10.1089/jwh.2006.15.1195

    Article  Google Scholar 

  • Ghassemzadeh H, Mojtabai R, Karamghadiri N, Ebrahimkhani N (2005) Psychometric properties of a Persian-language version of the Beck Depression Inventory—second edition: BDI-II-PERSIAN. Depress Anxiety 21:185–192. doi:10.1002/da.20070

    Article  PubMed  Google Scholar 

  • Guille C, Newman R, Fryml LD, Lifton CK, Epperson CN (2013) Management of postpartum depression. Journal of midwifery & women's health 58:643–653. doi:10.1111/jmwh.12104

    Article  Google Scholar 

  • Hyde JS, Mezulis AH, Abramson LY (2008) The ABCs of depression: integrating affective, biological, and cognitive models to explain the emergence of the gender difference in depression. Psychol Rev 115:291–313. doi:10.1037/0033-295X.115.2.291

    Article  PubMed  Google Scholar 

  • Karyotaki E et al (2016) The long-term efficacy of acute-phase psychotherapy for depression: a meta-analysis of randomized trials. Depress Anxiety 33(5):370–383. doi:10.1002/da.22491

    Article  PubMed  Google Scholar 

  • Kheirabadi GR, Maracy MR (2010) Perinatal depression in a cohort study on Iranian women. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences 15:41–49

    Google Scholar 

  • Klier CM, Muzik M, Rosenblum KL, Lenz G (2001) Interpersonal psychotherapy adapted for the group setting in the treatment of postpartum depression. J Psychother Pract Res 10:124–131

    CAS  PubMed  PubMed Central  Google Scholar 

  • Matthews G, Wells A (2000) Attention, automaticity, and affective disorder. Behav Modif 24:69–93

    Article  CAS  PubMed  Google Scholar 

  • Norton AR, Abbott MJ, Norberg MM, Hunt C (2015) A systematic review of mindfulness and acceptance-based treatments for social anxiety disorder. J Clin Psychol 71:283–301. doi:10.1002/jclp.22144

    Article  PubMed  Google Scholar 

  • Pearlstein TB et al (2006) Patient choice of treatment for postpartum depression: a pilot study. Archives of women's mental health 9:303–308. doi:10.1007/s00737-006-0145-9

    Article  CAS  PubMed  Google Scholar 

  • Reck C, Stehle E, Reinig K, Mundt C (2009) Maternity blues as a predictor of DSM-IV depression and anxiety disorders in the first three months postpartum. J Affect Disord 113:77–87. doi:10.1016/j.jad.2008.05.003

    Article  PubMed  Google Scholar 

  • Sheehan DV et al (1998) The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 59(Suppl 20):22–33 quiz 34-57

    PubMed  Google Scholar 

  • Solem S, Thunes SS, Hjemdal O, Hagen R, Wells A (2015) A metacognitive perspective on mindfulness: an empirical investigation. BMC psychology 3:24. doi:10.1186/s40359-015-0081-4

    Article  PubMed  PubMed Central  Google Scholar 

  • Solem S, Hagen R, Wang CE, Hjemdal O, Waterloo K, Eisemann M, Halvorsen M (2017) Metacognitions and mindful attention awareness in depression: a comparison of currently depressed. Previously Depressed and Never Depressed Individuals Clinical psychology & psychotherapy 24:94–102. doi:10.1002/cpp.1983

    Article  Google Scholar 

  • Spada MM, Georgiou GA, Wells A (2010) The relationship among metacognitions, attentional control, and state anxiety. Cogn Behav Ther 39:64–71. doi:10.1080/16506070902991791

    Article  PubMed  Google Scholar 

  • Stein A et al (2014) Effects of perinatal mental disorders on the fetus and child. Lancet (London, England) 384:1800–1819. doi:10.1016/s0140-6736(14)61277-0

    Article  Google Scholar 

  • Stuart S, Koleva H (2014) Psychological treatments for perinatal depression best. Pract Res Clin Obstet Gynaecol 28:61–70. doi:10.1016/j.bpobgyn.2013.09.004

    Article  Google Scholar 

  • Stuart S, O'Hara MW, Gorman LL (2003) The prevention and psychotherapeutic treatment of postpartum depression. Archives of women's mental health 6(Suppl 2):S57–S69. doi:10.1007/s00737-003-0003-y

    Article  PubMed  Google Scholar 

  • Stuart-Parrigon K, Stuart S (2014) Perinatal depression: an update and overview. Current psychiatry reports 16:468. doi:10.1007/s11920-014-0468-6

    Article  PubMed  PubMed Central  Google Scholar 

  • Tannous L, Gigante LP, Fuchs SC, Busnello ED (2008) Postnatal depression in Southern Brazil: prevalence and its demographic and socioeconomic determinants. BMC Psychiatry 8:1. doi:10.1186/1471-244x-8-1

    Article  PubMed  PubMed Central  Google Scholar 

  • Veisani Y, Delpisheh A, Sayehmiri K, Rezaeian S (2013) Trends of postpartum depression in iran: a systematic review and meta-analysis. Depression research and treatment 2013:291029. doi:10.1155/2013/291029

    Article  PubMed  PubMed Central  Google Scholar 

  • Vigod SN, Stewart DE (2017) Postpartum depression. N Engl J Med 376:895. doi:10.1056/NEJMc1616547

    Article  PubMed  Google Scholar 

  • Wells A, Fisher P, Myers S, Wheatley J, Patel T, Brewin CR (2012) Metacognitive therapy in treatment-resistant depression: a platform trial. Behav Res Ther 50:367–373. doi:10.1016/j.brat.2012.02.004

    Article  PubMed  Google Scholar 

  • Wisner KL, Parry BL, Piontek CM (2002) Clinical practice postpartum depression. N Engl J Med 347:194–199. doi:10.1056/NEJMcp011542

    Article  PubMed  Google Scholar 

  • Yonkers KA, Lin H, Howell HB, Heath AC, Cohen LS (2008) Pharmacologic treatment of postpartum women with new-onset major depressive disorder: a randomized controlled trial with paroxetine. J Clin Psychiatry 69:659–665

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Yonkers KA, Smith MV, Lin H, Howell HB, Shao L, Rosenheck RA (2009) Depression screening of perinatal women: an evaluation of the healthy start depression initiative. Psychiatr Serv 60:322–328. doi:10.1176/appi.ps.60.3.322

    Article  PubMed  PubMed Central  Google Scholar 

  • Zlotnick C, Johnson SL, Miller IW, Pearlstein T, Howard M (2001) Postpartum depression in women receiving public assistance: pilot study of an interpersonal-therapy-oriented group intervention. Am J Psychiatry 158:638–640. doi:10.1176/appi.ajp.158.4.638

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medial Sciences, Hamadan, Iran

    Mohammad Ahmadpanah, Marzieh Nazaribadie, Ali Ghaleiha, Mohammad Haghighi & Leila Jahangard

  2. Department of Psychology, School of Human Sciences, Shahed University, Tehran, Iran

    Elham Aghaei

  3. Department of Psychology and Educational Sciences, University of Isfahan, Isfahan, Iran

    Azade Bakhtiari

  4. University of Basel, Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland

    Dena Sadeghi Bahmani, Edith Holsboer-Trachsler & Serge Brand

  5. Hamadan Educational Organization, Ministry of Education, Hamadan, Iran

    Amineh Akhondi

  6. Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran

    Hafez Bajoghli

  7. University of Basel, Department of Sport, Exercise, and Health; Division of Sport and Psychosocial Health, Basel, Switzerland

    Serge Brand

  8. Kermanshah University of Medical Sciences (KUMS), Psychiatry Department, Kermanshah, Iran

    Serge Brand

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  1. Mohammad Ahmadpanah
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  2. Marzieh Nazaribadie
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  11. Edith Holsboer-Trachsler
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  12. Serge Brand
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Corresponding author

Correspondence to Serge Brand.

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Funding

The entire study was performed without external funding.

Conflict of interest

All authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in the present study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Ahmadpanah, M., Nazaribadie, M., Aghaei, E. et al. Influence of adjuvant detached mindfulness and stress management training compared to pharmacologic treatment in primiparae with postpartum depression. Arch Womens Ment Health 21, 65–73 (2018). https://doi.org/10.1007/s00737-017-0753-6

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  • DOI: https://doi.org/10.1007/s00737-017-0753-6

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