ORIGINAL ARTICLE Influence of adjuvant detached mindfulness and stress management training compared to pharmacologic treatment in primiparae with postpartum depression Mohammad Ahmadpanah 1 & Marzieh Nazaribadie 1 & Elham Aghaei 2 & Ali Ghaleiha 1 & Azade Bakhtiari 3 & Mohammad Haghighi 1 & Dena Sadeghi Bahmani 4 & Amineh Akhondi 5 & Hafez Bajoghli 6 & Leila Jahangard 1 & Edith Holsboer-Trachsler 4 & Serge Brand 4,7,8 Received: 24 April 2017 /Accepted: 19 June 2017 # Springer-Verlag GmbH Austria 2017 Abstract Ten to 15% of mothers experience postpartum de- pression (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 symp- toms of depression. Next, participants were randomly assigned to one of the following study conditions: adjuvant detached mindfulness (CIT+DM); adjuvant stress manage- ment 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. Keywords Detached mindfulness . Stress management training . Postpartum depression . Standard SSRI treatment Introduction Pregnancy, childbirth, and caring for a newborn are challenging experiences, and some women might experience symptoms of depression. Such symptoms include low mood, hopelessness, helplessness, social withdrawal, poorer infant care (Reck et al., 2009), feelings of sadness, irritability, anger, and low self- esteem (Tannous et al., 2008). If symptoms appear within 4 weeks after delivery and persist at least for 2 weeks, the condition is classified as postpartum depression (PPD; now: perinatal depression; DSM 5). Prevalence rates of postpartum depressive symptoms range from 50 to 80% (Beck, 2006; Bahadoran et al., 2008)). Prevalence rates of PPD range from 1 to 5.9% during the first 12 months after birth, with peaks at the second and sixth months (cf. Beck, 2006; Wisner et al., 2002). In Iran, prevalence rates range from 20.1 (Kheirabadi and Maracy, 2010) to 25.3% (Veisani et al., 2013). * Serge Brand serge.brand@upkbs.ch 1 Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medial Sciences, Hamadan, Iran 2 Department of Psychology, School of Human Sciences, Shahed University, Tehran, Iran 3 Department of Psychology and Educational Sciences, University of Isfahan, Isfahan, Iran 4 University of Basel, Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland 5 Hamadan Educational Organization, Ministry of Education, Hamadan, Iran 6 Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran 7 University of Basel, Department of Sport, Exercise, and Health; Division of Sport and Psychosocial Health, Basel, Switzerland 8 Kermanshah University of Medical Sciences (KUMS), Psychiatry Department, Kermanshah, Iran Arch Womens Ment Health DOI 10.1007/s00737-017-0753-6