The effect of cognitive-behavioural and solution-focused counselling on prevention of postpartum depression in nulliparous pregnant women

Abstract

Objective: The aim of this study was to evaluate the effect of cognitive-behavioural approach and solution-focused counselling on prevention of postpartum depression in nulliparous pregnant women. Background: Maternity blues is a common disorder and postpartum depression is a serious disorder. Therefore, the use of preventive measures and timely intervention is of particular importance. Methods: In this randomised clinical trial, 85 nulliparous pregnant women at 30–35 weeks were randomly divided into three groups: cognitive-behavioural counselling (n = 25), solution-focused counselling (n = 25) and control (n = 35). Counselling meetings were held on a weekly basis. The cognitive-behavioural group received four sessions of counselling and the solution-focused group received three sessions of counselling. The control group received only routine pregnancy healthcare services. Maternity blues and postpartum depression were, respectively, measured on postpartum days 5 and 15 through the Austin Inventory and Edinburgh Postnatal Depression Scale. The mean scores of the three groups were compared using one-way ANOVA. Results: The results of this study showed that the maternity blues mean scores of the three groups of cognitive-behavioural counselling, solution-focused counselling and control groups were 6.1 ± 4.6, 4.2 ± 3.6 and 6.7 ± 4.9, respectively, and the difference between the scores was significant. The mean scores of postnatal depression on the 15th postpartum day in the three groups were 6.7 ± 5.3, 4.4 ± 4.4 and 10.4 ± 5.9, respectively. The results showed that cognitive-behavioural and solution-focused counselling significantly reduced the maternity blues and postpartum depression scores compared with the control group and no difference was observed between the scores of these two counselling methods. The odds ratio of being depressed in women with maternity blues was 7.6 (95% CI: 2.1–27.5). Conclusion: Integration of solution-focused and cognitive-behavioural counselling programmes in prenatal care can be effective for improving the mental health of pregnant women.