When the cradle falls: the treatment of postnatal depression in a psychiatric day hospital compared with routine primary care

Background: Postnatal depression affects one in ten women within 6 months of childbirth. The most effective treatment strategy for postnatal depression is not clear. Methods: This prospective, naturalistic study of the treatment of postnatal depression compared 30 women treated at a specialised psychiatric day hospital with 30 women treated using routine primary care (RPC). Clinical, marital and social adjustment were assessed on three occasions over 6 months using: the Edinburgh Postnatal Depression Questionnaire (EPDS); the Clinical Interview schedule (CIS); the Anxiety Subscale of the Hospital Anxiety and Depression Scale; the Dyadic Adjustment Scale (DAS); and the Work Leisure and Family Life Questionnaire–Modified (WLFLQ–M). Results: There were no significant differences between the two groups at baseline. However, there were significant differences in outcome at 3 and 6 months follow-up for all outcome measures except the DAS. At 6 month follow-up 21 of the PBDU group were no longer depressed compared with 7 of the RPC group. Conclusions: A specialised day hospital is a more effective treatment setting for postnatal depression than routine primary care. Limitations of the study: The study is not an RCT, so systematic bias is possible. The sample size is relatively small and the duration of follow-up relatively short.