Identification and Therapy of Postpartum Depression
Identification and Therapy of Postpartum Depression
This study will evaluate the effectiveness of a telephone-based depression screening and care
 management program in treating depression in postpartum women.
Depression is a serious illness that can interfere with everyday life. Researchers believe
 that it is one of the most common complications during and after pregnancy. Depression after
 pregnancy is called postpartum depression and may be caused by a rapid change in hormone
 levels during and immediately after pregnancy. Postpartum depression can occur anytime within
 the first year after childbirth and can negatively affect both mothers and their children.
 Mothers with postpartum depression may experience low energy, difficulty concentrating,
 irritability, and inability to meet their children's needs for love and affection. As a
 result, women with postpartum depression may feel guilty and lose confidence in themselves as
 parents. Research shows that children of mothers with postpartum depression may have delays
 in language development, difficulty with emotional bonding to others, behavioral problems,
 lower activity levels, sleep problems, and distress. This study will evaluate the
 effectiveness of a telephone-based depression screening and care management program in
 treating depression in postpartum women.

 Participants in this single blind study will be randomly assigned to receive either enhanced
 treatment as usual or telephone-based care management for the first year postpartum. All
 participants will have a 90-minute in-home interview upon study entry to assess depressive
 symptoms, functional status, medical history, and post-pregnancy plans. Participants assigned
 to care management will receive two calls in the first month postpartum, followed by monthly
 calls for the remainder of the first postpartum year. During each 10- to 20-minute call,
 participants will be asked to provide information regarding current depressive symptoms,
 steps they have taken to seek depression-related care, and any barriers they have encountered
 in the process. In addition, a care manager will act as an advocate for the participants and
 assist in obtaining specialized services as necessary throughout the year. Participants
 assigned to receive enhanced treatment as usual will not receive monthly phone calls or
 tailored care management. All participants will receive follow-up calls at 3, 6, and 12
 months postpartum to assess outcome measures; these calls will last about 30 minutes.
Inclusion Criteria:

 -  4-6 weeks postpartum

 -  English-speaking

 -  Score of at least 10 on the Edinburgh Postnatal Depression Scale

 Exclusion Criteria:

 -  DSM-IV diagnosis of bipolar disorder or psychotic episode

 -  Active substance abuse within 6 months prior to study entry

 -  Has not received obstetrical care

 -  History of a suicide attempt within 6 months of study entry