BACKGROUND Postpartum depression and anxiety are under-addressed public health problems with numerous treatment access barriers, including insufficiently available mental health specialist providers. AIMS To examine the effectiveness of nurse-delivered telephone interpersonal psychotherapy (IPT) for postpartum depression. Trial registration ISRCTN88987377. METHOD Postpartum women (n = 241) with major depression (on the Structured Clinical Interview for DSM-IV (SCID-I)) from 36 Canadian public health regions in rural and urban settings were randomly assigned to 12 weekly 60 min nurse-delivered telephone-IPT sessions or standard locally available care. The primary outcome was the proportion of women clinically depressed at 12 weeks post-randomisation, with masked intention-to-treat analysis. Secondary outcomes examined included comorbid anxiety, self-reported attachment and partner relationship quality. RESULTS At 12 weeks, 10.6% of women in the IPT group (11/104) and 35% in the control group (35/100) remained depressed (OR = 0.22, 95% CI 0.10-0.46), with the IPT group 4.5 times less likely to be clinically depressed (SCID); 21.2% in the IPT group and 51% in the control group had an Edinburgh Postnatal Depression Scale (EPDS) score >12 (OR = 0.26, 95% CI 0.14-0.48), and attachment avoidance decreased more in the IPT group than in the control group (P = 0.02). Significant differences favoured the IPT group for comorbid anxiety and partner relationship quality at all time points, with no differences in health service or antidepressant use. None of the IPT responders relapsed by 36 weeks. Between-group SCID differences were sustained at 24 weeks, but not at 36 weeks. CONCLUSIONS Nurse-delivered telephone IPT is an effective treatment for diverse urban and rural women with postpartum depression and anxiety that can improve treatment access disparities.

中文翻译：

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基于电话的护士提供的产后抑郁人际心理治疗：全国随机对照试验

背景 产后抑郁和焦虑是未得到充分解决的公共卫生问题，存在许多治疗障碍，包括可用的心理健康专家提供者不足。目的 检验护士提供的电话人际心理治疗 (IPT) 对产后抑郁症的有效性。试用注册 ISRCTN88987377。方法 来自加拿大农村和城市环境中 36 个公共卫生区域的患有重度抑郁症的产后妇女（n = 241）（在 DSM-IV（SCID-I）的结构化临床访谈中）被随机分配到 12 个每周 60 分钟的护士提供的电话-IPT 会话或标准的本地可用护理。主要结果是随机分组后 12 周时临床抑郁的女性比例，并进行了隐蔽的意向治疗分析。检查的次要结果包括共病焦虑、自我报告的依恋和伴侣关系质量。结果 在第 12 周时，IPT 组中 10.6% (11/104) 和对照组中 35% (35/100) 的女性仍然抑郁（OR = 0.22，95% CI 0.10-0.46），IPT 组为 4.5临床抑郁症 (SCID) 的可能性要小几倍；IPT 组 21.2% 和对照组 51% 的爱丁堡产后抑郁量表 (EPDS) 得分 >12（OR = 0.26，95% CI 0.14-0.48），IPT 组的依恋回避比对照组（P = 0.02）。在所有时间点，IPT 组的共病焦虑和伴侣关系质量有显着差异，卫生服务或抗抑郁药的使用没有差异。到 36 周时，没有任何 IPT 响应者复发。组间 SCID 差异在 24 周时持续存在，但在 36 周时不存在。