Postnatal depression in British mothers of African and Caribbean origin: a randomised controlled trial of learning through play plus culturally adapted cognitive behaviour therapy compared with psychoeducation.

Journal: Frontiers in psychiatry

Volume: 15

Issue: 

Year of Publication: 

Affiliated Institutions:  Division of Psychology and Mental Health, The University of Manchester, Manchester, United Kingdom. School of Social Science, Humanity and Law (SSSHL), Department of Humanities and Social Sciences, Teesside University, Middlesbrough, United Kingdom. Nottingham Trent University, Nottingham, United Kingdom. Department of Sociology, Coal City University, Enugu, Nigeria. Department of Psychology, University of Jos, Jos, Nigeria.

Abstract summary 

One in every three women worldwide experiences postnatal depression after childbirth, with long-term negative consequences on their children. The mainstream mental healthcare provision for British mothers of African/Caribbean origin is mostly unsuccessful due to a lack of culturally appropriate care.The study adopts a mixed-methods randomised controlled trial (RCT) design. A 12-session (60 minutes each) of online Learning Through Play plus Culturally adapted Cognitive Behaviour Therapy (LTP+CaCBT) intervention was employed for treating postnatal depression in comparison with psychoeducation (PE). Participants aged 19-53 were screened for depression using the Patient Health Questionnaire (PHQ-9). N=130 participants who scored >5 on PHQ-9 were randomised into LTP+CaCBT (n=65) or PE (n=65) groups. N=12 focus groups (LTP+CaCBT, n=6; PE, n=6) and n=15 individual interviews (LTP+CaCBT, n=8; PE, n=7) were conducted, transcribed verbatim and analysed.Satisfaction with intervention (LTP+CaCBT, 72.9%; PE, 65.2%); retention rates (LTP+CaCBT, 91%; PE, 71%); reduction in postnatal depression was higher in LTP+CaCBT on PHQ-9 Md=1.00 with z= -4.046; compared to PE, Md=1.00 with z= -1.504. Both groups showed reduced levels of anxiety on GAD-7 with no significant difference. Emerging themes from the qualitative findings showed increased positive moods, reduced worries about parenting difficulties and the facilitative role of remote intervention.LTP+CaCBT intervention is culturally appropriate and acceptable and reduces postnatal depression in British mothers of African/Caribbean origin. A fully powered RCT is recommended to evaluate the clinical and cost-effectiveness of LTP+CaCBT, including the child's outcomes compared with routine treatment as usual.www.ClinicalTrials.gov, identifier NCT04820920.

Authors & Co-authors:  Jidong Dung Ezekiel DE Ike Tarela Juliet TJ Murshed Maisha M Francis Christopher C Mwankon Shadrack Bitrus SB Jidong John Ezekiel JE Pwajok Juliet Yop JY Nyam Pam Patrick PP Husain Nusrat N

Study Outcome 

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Statistics
Citations :  James SL, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, et al. . Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. (2018) 392:1789–858. doi: 10.1016/S0140-6736(18)32279-7
Authors :  9
Identifiers
Doi : 1383990
SSN : 1664-0640
Study Population
Female,Women,Mothers
Mesh Terms
Other Terms
British African Caribbean women;UK;cognitive behaviour therapy (CBT);cultural adaptation;learning through play;postnatal depression (PND)
Study Design
Study Approach
Qualitative
Country of Study
Publication Country
Switzerland