Exploratory RCT of a group psychological intervention for postnatal depression in British mothers of South Asian origin – ROSHNI-D

Abstract

Background: Postnatal depression (PND) is a global public health problem. There is a high prevalence of PND amongst ethnic minority women and major ethnic inequalities in mental health care in the U.K. Language and cultural barriers pose a significant challenge for access to timely treatment and interventions for British South Asian (BSA) women with PND. Methods: The study, carried out in Manchester and Lancashire, England, was a two-arm single-blind exploratory randomised controlled trial. BSA women (N = 83) having a baby <12 months were randomised either to the group receiving the culturally adapted Positive Health Programme (PHP) (n = 42) or to the group receiving treatment as usual (TAU) (n = 41). Follow-up assessments were at 3 months (end of intervention) and 6 months after randomisation. Results: Using an intention to treat analysis, there was no significant difference between PHP intervention and TAU groups in depression measured using Hamilton Depression Rating Scale both at 3 and 6 months follow up. Using modified intention to treat analysis, women who attended four or more sessions showed significant reduction in depression in the PHP group compared to the TAU group and the greater number of sessions attended was associated with greater reductions in depression scores. Limitations: The sample was relatively small and the study was conducted in one geographical area in Northwest England; hence, these results may not be generalizable to other regions and populations. Conclusion: The recruitment and trial retention figures highlighted the ability of the research team to engage with BSA women, having implications in planning services for this group. Trial registration: Clinicaltrials.gov NCT01838889.

Keywords

• Postnatal depression
• Cognitive-behavioural therapies
• Psychosocial intervention
• Ethnic minority
• Randomised controlled design