The effects of cognitive behavioral therapy on the improvement of the health of youth mothers with postpartum depression at the University Teaching Hospital of Lusaka,Zambia

Abstract

Postpartum Depression (PPD) is a major depressive episode during puerperium and affects 10% to 22% of mothers before the infant’s first birthday. Increase in number of youthful mothers and the influence of PPD on the maternal health of mothers has not been fully explored. Treatment of PPD has concentrated on pharmacotherapy while undermining the effect of psychotherapy. This study examined the effect of cognitive behavioural therapy (CBT) on the improvement of health of youth mothers with PPD at the University Teaching Hospital, Lusaka. The main objective which guided the study was to evaluate the effect of CBT on the improvement of the health status of youth mothers with PPD, and to evaluate whether there was a significant difference in PPD levels between youth mothers on CBT and those not on CBT besides them being on pharmacological treatment. The study also investigated common symptoms and risk factors of PPD, and levels of awareness of CBT among mothers and professional staff. The study was a randomised controlled trial among 64 youth mothers and 6 health professionals. Participants were purposively sampled and randomly put into two groups, 32 in the intervention (CBT) and 32 in the control (Non-CBT) groups. Both groups received pharmacotherapy while CBT was administered as additional therapy to the intervention group. Participants were interviewed using semi-structured interview guides for information on awareness. EPDS was administered to screen and assess mothers for PPD, which was used as a measure of the health status. Using ANOVA, results showed a statistically significant mean difference: F (1,51=8.72, p= 0.004) towards the intervention (CBT) group, on the improvement of health. Post-test reviewed a greater reduction difference in mean score for Intervention group than Control group, (that is 6.69 compared to 3.97). Among the specific symptoms, anxiety had the largest contribution: p= 0.001, and thoughts of self-harm: p= 0.03. Demographic variables had statistically insignificant influence except past history of depression: p= 0.043. Health professionals were aware of simple counselling, but had limited knowledge and skills about CBT. Mothers showed insignificant awareness of CBT and other psychotherapeutic services. There is need for improved screening, treatment and sensitisation on PPD. CBT has effect on treatment of PPD and is safe compared to just norm treatment with drugs. Therefore, the study recommended CBT as an additional treatment therapy to the traditional treatment of drugs.