Objective: To minimize barriers to care, ameliorate antenatal depression, and prevent postpartum depression, we conducted a pilot study to assess the feasibility of providing brief interpersonal psychotherapy (IPT-B) to depressed, pregnant patients on low incomes in an obstetrics and gynecological (OB/GYN) clinic. Method: Twelve pregnant, depressed women were recruited as a convenience sample from the clinic and were offered a pretreatment engagement interview and eight sessions of IPT-B, followed by monthly maintenance IPT sessions up to 6-months postpartum. Results: Nine of these 12 patients (75%) completed eight sessions of IPT-B. Paired t tests showed that completers of IPT-B displayed significant improvement at posttreatment and 6-months postpartum on three measures of depression, a measure of anxiety, and some aspects of social functioning. Conclusions: These preliminary results suggest that providing depression screening and treatment to this sample in an OB/GYN clinic was feasible and accompanied by high rates of clinical and functional improvement.
Allister, I., Lester, B., Carr, S.,& Lui, J. (2001). The effects of maternal depression on fetal heart rate response to vibroacoustic stimulation. Developmental Neuropsychology, 20, 639-651.
2.
Alvidrez, J., & Azocar, F. (1999). Distressed women’s clinic patients: Preferences for mental health treatments and perceived obstacles. General Hospital Psychiatry, 21, 340-347.
3.
Anderson, C. M., Reiss, D. J., & Hogarty, G. E. (1986). Schizophrenia and the family: A practitioner’s guide to psychoeducation and management. New York: Guilford.
4.
Areias, M., Kumar, R., Barros, H., & Figueiredo, E. (1996). Correlates of postnatal depression in mothers and fathers. British Journal of Psychiatry, 169, 36-41.
5.
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893-897.
6.
Beck, A. T., & Steer, R. A. (1993). Manual for the Beck Depression Inventory. San Antonio, TX: Psychological Corporation.
7.
Belle, D. (1990). Poverty and women’s mental health. American Psychologist, 45, 385-389.
8.
Boyd-Franklin, N., & Lockwood, T. (1999). Spirituality and religion: Implications for psychotherapy with African American clients and families. In F. Walsh (Ed.), Spiritual resources in family therapy (pp. 90-103). New York: Guilford.
9.
Cowan, C., & Cowan, P. (2000). When partners become parents: The big life change for couples. Mahwah, NJ: Lawrence Erlbaum.
10.
Cox, J., Holden, J., & Sagovsky, R. (1987). Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 50, 782-786.
11.
Cunningham, M., & Zayas, L. (2002). Reducing depression during pregnancy: Designing multi-modal interventions. Social Work, 47, 114-123.
12.
Diamond, R., & Factor, R. (1994). Treatment-resistant patients or treatment-resistant systems?Hospital and Community Psychiatry, 45, 197-197.
13.
Field, T. (2000). Infants of depressed mothers. In S. Johnson & A. Hayes (Eds.), Stress, coping, and depression (pp. 3-22). Mahwah, NJ: Lawrence Erlbaum.
14.
Frank, E., Kupfer, D., Cornes, C., & Morris, S. (1993). Maintenance interpersonal psychotherapy for recurrent depression. In G. Klerman & M. Weissman (Eds.), New applications of interpersonal psychotherapy (pp. 75-102). Washington, DC: American Psychiatric Press.
15.
Frank, E., Kupfer, D. J., Perel, J. M., Cornes, C., Jarrett, D. B., Mallinger, A. G., et al. (1990). Three-year outcomes for maintenance therapies in recurrent depression. Archives of General Psychiatry, 47(12), 1093-1099.
16.
Gotlib, I., Whiffen, V., Wallace, P., & Mount, J. (1991). Prospective investigation of postpartum depression: Factors involved in onset and recovery. Journal of Abnormal Psychology, 100, 122-132.
17.
Greeno, C. G., Anderson, C. M., Shear, M. K., & Mike, G. (1999). Initial treatment engagement in a rural community mental health center. Psychiatric Services, 50(12), 1634-1636.
18.
Greeno, C. G., Anderson, C. M., Stork, E. M., Shear, M. K., Kellerher, K., & Mike, G. (2002). Return to treatment after assessment in a community child mental health clinic. Psychiatric Services, 53(5), 624-626.
19.
Grote, N. K., Bledsoe, S. E., Swartz, H., & Frank, E. (in press). Culturally relevant psychotherapy for perinatal depression. Clinical Social Work.
20.
Grote, N. K., & Frank, E. (2003). Difficult-to-treat depression: The role of contexts and co-morbidities. Biological Psychiatry, 53, 660-670.
21.
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 56-62.
22.
Hall, G. C. (2001). Psychotherapy research with ethnic minorities; Empirical, ethical, and conceptual issues. Journal of Consulting and Clinical Psychology, 69, 502-510.
23.
Heyl, B. S. (2001). Ethnographic interviewing. In P. Atkinson, A. Coffey, S. Delamont, J. Lofland, & L. Lofland (Eds.), Handbook of ethnography (pp. 369-383). London: Sage.
24.
Hobfoll, S., Ritter, C., Lavin, J., Hulszier, M., & Cameron, R. (1995). Depression prevalence and incidence among inner-city pregnant and postpartum women. Journal of Consulting and Clinical Psychology, 63, 445-453.
25.
Hunt, C., & Andrews, G. (1992). Drop-out rate as a performance indicator in psychotherapy. Acta Psychiatrica Scandinavica, 85, 275-278.
26.
Institute of Medicine. (1996). Fetal alcohol syndrome: Diagnosis, epidemiology, prevention, and treatment. Washington, DC: National Academy Press.
27.
Katon, W., & Ludman, E. (2003). Improving services for women with depression in primary care settings. Psychology of Women Quarterly, 27, 114-120.
28.
Katon, W., Robinson, P., Von Korff, M., Lin, E., Bush, T.Ludman, E., et al. (1996). A multi-faceted intervention to improve treatment of depression in primary care. Archives of General Psychiatry, 53, 924-932.
29.
Kazdin, A. E. (1998). Drawing valid inferences from case studies. In A. E. Kazdin (Ed.), Methodological issues and strategies in clinical research (pp. 403-417). Washington, DC: American Psychological Association.
30.
Klerman, G., Weissman, M., Rounsaville, B., & Chevron, E. (1984). Interpersonal psychotherapy of depression. London: Aronson.
31.
Kumar, R., & Robson, M. (1984). A prospective study of emotional disorders in childbearing women. British Journal of Psychiatry, 144, 35-47.
32.
Kupfer, D. (1991). Long-term treatment of depression. Journal of Clinical Psychiatry, 52, 28-34.
33.
Lundy, B., Jones, N., Field, T., Nearing, G., Davalos, M., Pietro, P., et al. (1999). Prenatal depression effects on neonates. Infant Behavior and Development, 22, 119-129.
34.
McKay, M., Nudelman, R., McCadam, K., & Gonzales, J. (1996). Evaluating a social work approach to involving inner city children and their families. Mental Health Care Research on Social Work Practice, 6, 462-472.
35.
Miranda, J., Chung, J., Green, B., Krupnick, J., Siddique, J., Revicki, D., et al. (2003). Treating depression in predominantly low-income young minority women: A randomized controlled trial. Journal of the American Medical Association, 290, 57-65.
36.
Miranda, J., & Dwyer, E. (1993). Cognitive behavioral therapy for disadvantaged medical patients. Behavior Therapist, 16, 226-228.
37.
Moore, G., Cohn, J., & Campbell, S. (2001). Infant affective responses to mother’s still face at 6 months differentially predict externalizing and internalizing behaviors at 18 months. Developmental Psychology, 37, 706-714.
38.
Murray, L., & Cooper, P. (Eds.). (1997). The role of infant and maternal factors in postpartum depression, mother-infant interactions, and infant outcome. In Postpartum depression and child development (pp. 11-135). New York: Guilford.
39.
O’Hara, M. (1994). Postpartum depression: Causes and consequences. New York: Springer-Verlag.
40.
O’Hara, M., Hoffman, J., Phillips, L., & Wright, E. (1992). Adjustment in postpartum women: The Postpartum Adjustment Questionnaire. Psychological Assessment, 4, 160-169.
41.
O’Hara, M., & Swain, A. (1996). Rates and risk of postpartum depression: A meta-analysis. International Review of Psychiatry, 8, 37-54.
42.
Pilkonis, P. A., Kim, Y., Proiette, J. M., & Barkham, M. (1996). Scales for personality disorders developed from the Inventory of Interpersonal Problems. Journal of Personality Disorders, 10, 355-369.
43.
Riley, D., & Eckenrode, J. (1986). Social ties: Subgroup differences in costs and benefits. Journal of Personality and Social Psychology, 51, 770-778.
44.
Robins, L. N., Cottler, L., & Bucholz, K. (1995). DIS for DSM-IV. St. Louis, MO: Washington University.
45.
Sandman, C., Wadwha, P. D., Dunkel-Schetter, C., Chicz-Demet, A., Belman, J., Porto, M., et al. (1994). Psychobiological influence of stress and HPA regulation on the human fetus and birth outcomes. Annals of the New York Academy of Science, 739, 198-210.
46.
Schulberg, H., Block, M., Madonia, M., Scott, C., Rodriguez, E., Imber, S., Perel, J., et al. (1996). Treating major depression in primary care practice: 8-month clinical outcomes. Archives of General Psychiatry, 53, 913-919.
47.
Sherbourne, C. D., & Stewart, A. L. (1991). The Medical Outcomes Study (MOS) Social Support Survey. Social Science and Medicine, 32, 705-714.
48.
Spinelli, M. (2001). Manual of interpersonal psychotherapy for antepartum depressed women (IPT-P). Unpublished manuscript, Columbia University Medical College, New York.
49.
Spinelli, M. G., & Endicott, J. (2003). Controlled clinical trial of inter-personal psychotherapy versus parent education for depressed pregnant women. American Journal of Psychiatry, 160, 555-562.
50.
Straus, M. A. (1979). Measuring intrafamily conflict and violence: The Conflict Tactics Scales. Journal of Marriage and the Family, 36, 13-29.
51.
Swartz, H. A., Frank, E., Shear, M. K., Thase, M. E., & Fleming, M. A. D. (2004). A pilot study of brief interpersonal psychotherapy for depression among women. Psychiatric Services, 55, 448-450.
52.
Swartz, H. A., Grote, N., Frank, E., Bledsoe, E., Fleming, D., & Shear, K. (2004). Brief interpersonal psychotherapy treatment manual. Unpublished manuscript, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, and University of Pittsburgh School of Social Work, Pittsburgh, PA.
53.
Swartz, H. A., & Markowitz, J. C. (1998). Interpersonal psychotherapy for the treatment of depression in HIV-positive men and women. In J. C. Markowitz (Ed.), Interpersonal psychotherapy: Review of psychiatry series (pp. 129-155). Washington, DC: American Psychiatric Press.
54.
Swartz, H. A., Shear, K., Frank, E., Cherry, C., Scholle, S., & Kupfer, D. (2002). A pilot study of community mental health care in a supermarket setting. Psychiatric Services, 53, 1132-1137.
55.
U.S. Department of Health and Human Services. (1999). Mental health: A report of the surgeon general. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General.
56.
U.S. Department of Health and Human Services. (2001). Mental health: culture, race and ethnicity: A supplement to mental health: A report of the surgeon general. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General.
57.
Wadwha, P. D., Sandman, C., Porto, M., Dunkel-Schetter, C., & Garite, T. (1993). The association between prenatal stress and infant birth weight and gestational age at birth: a prospective investigative investigation. American Journal of Obstetrics and Gynecology, 169, 858-865.
58.
Weissman, M., & Bothwell, S. (1976). Assessment of social adjustment by patient self-report. Archives of General Psychiatry, 33, 1111-1115.
59.
Weissman, M., Markowitz, J., & Klerman, G. (2000). A comprehensive guide to interpersonal psychotherapy. New York:Basic Books.
