In a study that just came out in Lancet, (as reported in Journal Watch, The New England Journal of Medicine), it was shown that effective intervention for postpartum depression in a low-resource, primary care setting is feasible. The groups of women (230 women from primary care clinics in Santiago, Chile who met criteria for postpartum depression) either received “usual care” (antidepressants, brief psychotherapeutic interventions, medical consultations, and external referral) or “multicomponent intervention “which included psychoeducational groups, treatment adherence support and pharmacotherapy if needed. Women in the intervention group did significantly better (EPDS scores) than the women receiving the usual care.
The authors cite the implication for clinical practice is that clinicians should remember that women who receive antidepressants to treat postpartum depression also need support in adhering to therapy.
I suspect most clinicians know this part. The physicians who are prescribing the meds should heed this advice. Treatment compliance is a tough obstacle, but one that we should all be alert to.
Rojas et al. Treatment of postnatal depression in low-income mothers in primary-care clinics in Santiago, Chile: A randomized controlled trial. Lancet 2007 Nov 10; 370:1629