Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Regular Article Psychother Psychosom 2012;81:98–107 DOI: 10.1159/000330035 Can a Brief Antepartum Preventive Group Intervention Help Reduce Postpartum Depressive Symptomatology? Zoltan Kozinszky a Robert B. Dudas b Iván Devosa c Sarolta Csatordai d Éva Tóth f Dávid Szabó e János Sikovanyecz e Katalin Barabás c Attila Pál e a Department of Obstetrics and Gynecology, Women and Children’s Division, Oslo University Hospital, Ullevaal, University of Oslo, Oslo, Norway; b Department of Psychiatry, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK; c Institute of Behavioral Science, d Faculty of Health Sciences and e Department of Obstetrics and Gynecology, University of Szeged, Szeged, and f Institute of Psychology, Faculty of Arts and Sciences, University of Pécs, Pécs, Hungary reduced risk in those with a perceived lack of partner sup- port (OR = 0.4) in the treatment group. Unplanned pregnan- cy, an irreversible risk factor affecting every fifth woman, also seemed to have a reduced effect on PPD after our group intervention (OR = 0.81). Conclusions: A brief preventive an- tepartum group intervention focusing on psychoeducation, stress management, improving coping mechanisms, and the development of social support can be effective in reducing postpartum depressive symptomatology. Copyright © 2012 S. Karger AG, Basel Introduction Although the importance of psychiatric conditions as- sociated with childbirth is increasingly being recognized, their current clinical management is largely restricted to pharmacological interventions. A recent Cochrane review preformed by Dennis and Hodnett [1] concluded that both psychosocial and psy- chological interventions were effective in treating post- partum depression (PPD). According to a recent meta- analysis on the prevention of PPD [2], although there was no overall statistically significant effect on the prevention Key Words Postpartum depression  Antepartum depression  Preventive group intervention  Psychosocial risk factors  Multiple logistic regression Abstract Background: Psychosocial and psychological interventions are generally effective in reducing depressive symptomatol- ogy in the postpartum period. Our aim was to evaluate the effectiveness of a brief preventive group intervention for postpartum depression (PPD) in a naturalistic setting, and study the effect of this on social and psychological risk fac- tors. Methods: We conducted a randomized controlled trial (n = 1,719) in south-eastern Hungary in 62 antepartum cen- ters. Pregnant women (n = 710) underwent a 4-session pre- ventive group intervention whereas a control group (n = 1,009) attended 4 sessions providing the same information given in usual care. Results: Our intervention appeared to significantly reduce the risk of PPD, as defined by Leverton Questionnaire total scores (OR = 0.69). It resulted in an abso- lute risk reduction of about 18% in those with antepartum depression and 0.5% in those with no depression at recruit- ment. A multiple logistic regression analysis revealed a much Received: February 5, 2010 Accepted after revision: June 16, 2011 Published online: January 18, 2012 Zoltan Kozinszky, MD, PhD Department of Obstetrics and Gynecology, University Hospital Ullevaal University of Oslo, Kirkeveien 166 NO–0407 Oslo (Norway) Tel. +47 4101 7564, E-Mail kozinszkyz  @  yahoo.com © 2012 S. Karger AG, Basel 0033–3190/12/0812–0098$38.00/0 Accessible online at: www.karger.com/pps Downloaded by: UCSF Library & CKM 169.230.243.252 - 3/10/2015 1:12:31 PM