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Six-month multicomponent intervention improves postnatal depression in low-income settings

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Professor Ricardo Araya

Correspondence to: Professor Ricardo Araya, Academic Unit of Psychiatry, Department of Community Based Medicine, University of Bristol, Cotham Hourse, Cotham Hill, Bristol BS6 6JL, UK; r.araya@bristol.ac.uk

QUESTION

Question:

What is the optimum way to improve treatment and recognition of postnatal depression in low-income settings?

Patients:

230 women who had given birth in the previous year, and who had unrecognised and untreated postnatal depression. 922 women were initially approached while they were waiting for health-related consultations and screened for depression using the Edinburgh postnatal depression scale (EPDS; maximum score 30, higher scores indicate more severe symptoms) on two separate occasions two weeks apart. Those with persistent depression (EPDS score ⩾10 on both occasions) were formally assessed and those with a clinical diagnosis of major depression (DSM-IV criteria assessed through Mini International Neuropsychiatry Interview) were included in the study. Exclusions: receiving treatment for depression, pregnancy, psychotic symptoms, suicide risk, or history of mania, alcohol or drug abuse.

Setting:

Three clinics in deprived urban areas of …

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