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CBT improves maternal perinatal depression in rural Pakistan

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Does a community health worker delivered cognitive behavioural therapy (CBT) based intervention improve the health of perinatally depressed women and their newborn infants in rural Pakistan?


903 married women, aged 16–45 years, in their third trimester of pregnancy and diagnosed with DSM-IV perinatal major depression (CBT based intervention, 463; control, 440). Exclusions for mothers: serious medical condition; pregnancy related illness; disability; psychosis; and serious illness, death or moved residence during the study. Exclusions for infants: born prematurely or with congenital defect; aborted or stillborn; died within first year of birth; and given up for adoption.


40 Union Councils (administrative units) in Gujar Khan and Kallar Syedan, rural Pakistan. Recruitment: April 2005 to March 2006.


CBT based intervention or enhanced routine care (control). Both groups received visits from local female health visitors every week during the last month of pregnancy, three times in the month after birth and then once a month for 9 months. The intervention group health workers were trained …

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