IPT for Perinatal Depression

Michael W. O'Hara, Ph.D.

Pregnancy and childbirth are sometimes complicated by major or minor depression.  These depressions may reflect chronic conditions with which a woman has struggled for years or they may develop acutely.  As a group, these conditions are referred to as perinatal depression.  In addition to the personal suffering that women experience as a result of perinatal depression, a large literature documents its effects on the infant in utero and throughout development.  Perinatal depression also has a negative impact on the woman’s relationship with her partner and other children.  As a consequence, it is important to intervene early to reduce the negative sequelae of perinatal depression.

Several applications of Interpersonal Psychotherapy have been developed to address perinatal depression.  These applications have modified the typical structure ofIPTto varying degrees.  Modifications include offeringIPTin a briefer format – 12 sessions for postpartum major depression (O’Hara et al., 2000); 8 sessions for antenatal depression (Grote et al., 2004).  Problem areas have expanded and some have been reformulated. For example, Spinelli et al. (2003) included a new problem area to address the anxieties that depressed pregnant women may have about the development status of their fetus.  Another modification of IPT for perinatal depression is the group therapy format.  The group therapy format has been used in a variety of ways, including as a rather direct substitute for individual IPT during pregnancy or after delivery.  Group IPT has also been used as a preventive intervention for women at high risk for depression because of their mental health status or because of their social circumstances.

The evidence base for Interpersonal Psychotherapy for perinatal depression is relatively robust though there are only a few large scale studies (e.g., O’Hara et al., 2000).  Nevertheless, practitioners can confidently work with perinatal depressed women using a basic approach to IPT as long as they inform themselves of the special Postpartum mood disorders concerns and challenges that pregnant and postpartum women face as they cope with depression.

For more information, contact Michael W. O'Hara, PH.D, at mike-ohara@uiowa.edu

Bibliography

Crockett, K., Zlotnick, C.,Davis, M., Payne, N., & Washington, R. (2008). A depression preventive intervention for rural low-income African-American pregnant women at risk for postpartum depression. Archives of Women's Mental Health, 11, 319-325.

Grote, N. K., Swartz, H. A.; Geibel, S. L., Zuckoff, A., Houck, P., & Frank, E. (2009). A randomized controlled trial of culturally relevant, brief interpersonal psychotherapy for perinatal depression. Psychiatric Services, 60, 313-321.

O'Hara, M. W., Stuart, S., Gorman, L. L., & Wenzel, A. (2000). Efficacy of interpersonal psychotherapy for postpartum depression. Archives of General Psychiatry, 57, 1039-1045.

Reay, R., Fisher, Y., Robertson, M., Adams, E., & Owen, C. (2006). Group interpersonal psychotherapy for postnatal depression: A pilot study.  Archives of Women's Mental Health, 9, 31-39.

Segre, L. S.; Stuart, S., & O'Hara, M. W. (2004). Interpersonal Psychotherapy for Antenatal and Postpartum Depression.  Primary Psychiatry, 11, 52-56, 66.

Spinelli, M., Endicott, J. (2003). Controlled clinical trial of interpersonal psychotherapy versus parenting education program for depressed pregnant women.  The American Journal of Psychiatry, 160, 555-562.

Stuart, S. (1999). Miller, Laura J. (Ed), (1999). Interpersonal psychotherapy for postpartum depression. (pp. 143-162).Washington,DC: American Psychiatric Association.