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Training health visitors to identify and treat depressive symptoms with psychological approaches reduces postnatal depression

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QUESTION

Question:

Can health visitors with special training to enhance psychological care reduce depressive symptoms in postnatal women?

Patients:

4084 women registered at participating general practices. Exclusions: <18 years old; unable to give informed consent; or severe mental health problems.

Setting:

101 general practices in 29 primary care trusts, Trent region, UK; recruitment April 2003 to March 2006.

Intervention:

Special training for health visitors, including training in either cognitive behavioural or person centred approaches to treatment (intervention, 89 health visitors at 63 general practitioner (GP) surgeries, 2749 women) or usual care (control, 49 health visitors at 38 GP surgeries, 1335 women). Intervention groups: health visitors were trained to identify symptoms of postnatal depression in women 6–8 weeks after giving birth (Edinburgh Postnatal Depression Scale (EPDS)) and to assess mood and deliver psychological interventions. The health visitors were randomly allocated to be trained in either cognitive behavioural or person centred approaches. Therapy was delivered for 1 h a week over 8 weeks. Usual care included routine contact with health visitors (who had not received the special training outlined above) at …

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