The Effectiveness of Psychotherapy in the Treatment of Postpartum Depression

ABSTRACT Background: Suicide is the second leading cause of death in postpartum women making it a major health priority. Lack of diagnosis, recognition of symptoms, and proactive treatment of postpartum depression (PPD) can lead to devastating effects on the mother and child such as harm or death. The intervention of psychotherapy is recommended as a first line treatment for PPD and is a means by which PPD can be reduced or avoided altogether. This integrative literature review seeks to discover if there is an opportune time in which to initiate psychotherapy interventions in order to reduce or prevent PPD development or progression. Methods: An integrative literature review was conducted to examine research and information regarding timing of implementation of psychotherapy on the pregnant and postpartum population. Databases such as PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete and Google were used to find relevant research articles and studies. Inclusion criteria included: publication date from 2006-2019, research articles written in English, research related to postpartum depression and screening, and research related to psychotherapy use in the pregnant and postpartum population. Exclusion criteria included: depression experienced by mothers who had intrauterine fetal demise (IUFD), psychological disorders unrelated to PPD, and research that evaluated treatment options other than psychotherapy. Results: Eight studies were found that focused on women and the use of psychotherapy treatment for PPD at various times throughout pregnancy. Studies were conducted in the US, Korea, Hungary, and Australia. Studies evaluated the effectiveness of psychotherapy during pregnancy, postpartum, or both and were evaluated to determine if there was an opportune time for intervention implementation in order to treat PPD. Three of the eight studies measured the effectiveness of psychotherapy interventions during pregnancy on at-risk mothers with results revealing that psychotherapy use during pregnancy was effective in treating depression with the added benefit of helping to prevent PPD occurrence. Two studies were found that evaluated psychotherapy use in pregnant and postpartum at-risk women. Results revealed that psychotherapy initiation during pregnancy and postpartum reduced PPD development and progression. Three studies were found that looked directly at psychotherapy and its effectiveness in women diagnosed with PPD during postpartum. Results revealed that psychotherapy was an effective treatment for PPD and helped decrease PPD symptoms postpartum. Conclusion: Findings from this integrative literature review reinforced the importance of self-care, the need for standard risk assessment development and implementation, and suggests there is an opportune time frame in which to initiate psychotherapy interventions for treatment and prevention of PPD. Findings reveal that psychotherapy initiation during pregnancy, and for the at-risk population, can halt progressive PPD symptoms and can reduce the likelihood of PPD diagnosis. Results from this literature review conclude that the opportune time to initiate psychotherapy interventions is during pregnancy due to its ability to provide prophylactic treatment. Prophylactic treatment of PPD during pregnancy for women who are determined to be at-risk can reduce PPD occurrence and numbers of PPD associated suicide