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Randomized Controlled Trial
. 2016 Jun;55(6):495-503.e2.
doi: 10.1016/j.jaac.2016.04.003. Epub 2016 Apr 7.

Brief Psychotherapy for Maternal Depression: Impact on Mothers and Children

Holly A Swartz  1 , Jill M Cyranowski  2 , Yu Cheng  3 , Allan Zuckoff  3 , David A Brent  4 , John C Markowitz  5 , Stacy Martin  4 , Marlissa C Amole  4 , Fiona Ritchey  4 , Ellen Frank  4
Affiliations
Randomized Controlled Trial

Brief Psychotherapy for Maternal Depression: Impact on Mothers and Children

Holly A Swartz et al. J Am Acad Child Adolesc Psychiatry. 2016 Jun.

Abstract

Objective: Two-generation studies demonstrate that treating maternal depression benefits school-age children. Although mothers prefer psychotherapy to medication, little is known about how psychotherapy for maternal depression affects offspring, especially in very high-risk families in which both mothers and children concurrently meet syndromal criteria for psychiatric disorders. This trial evaluated the effects of 2 brief psychotherapies for maternal depression on very high-risk families.

Method: Mothers with major depressive disorder were randomly assigned to 9 sessions of either brief interpersonal psychotherapy for mothers (IPT-MOMS; n = 85) or brief supportive psychotherapy (BSP; n = 83). Independent assessors evaluated mothers and their children, ages 7 to 18 years, diagnosed with at least 1 internalizing disorder, every 3 months over the course of 1 year.

Results: Symptoms and functioning of mothers and children improved significantly over time, with no between-group differences. However, children of mothers assigned to BSP had more outpatient mental health visits and were more likely to receive antidepressant medication. Mothers reported greater satisfaction with IPT-MOMS than BSP. Improvement in mothers' depressive symptoms was associated with improvement in child functioning in time-lagged fashion, with children improving 3 to 6 months after mothers improved. Antidepressant medication use and number of mental health visits received by children did not affect outcomes.

Conclusion: IPT-MOMS and BSP demonstrated comparable beneficial effects on maternal depression. Children's functioning improved following maternal improvement, independent of youths' treatment. Children of mothers randomized to IPT-MOMS, compared with BSP, achieved comparable outcomes despite less follow-up treatment. Observation of lagged association between maternal improvement and change in child functioning should influence treatment planning for families. Clinical trial registration information-Psychotherapy for Depressed Mothers of Psychiatrically Ill Children; http://clinicaltrials.gov/; NCT00919594.

Keywords: children; depression; interpersonal psychotherapy; mothers; psychotherapy; treatment.

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Figures

Figure 1
Figure 1
Consolidated standards of reporting (CONSORT) diagram. Note: BSP = brief supportive psychotherapy; IPT-MOMS = interpersonal psychotherapy for mothers.
Figure 2
Figure 2
Mean maternal depression scores over time by treatment assignment. Note: Unadjusted mean scores are shown with bars indicating standard error.
Figure 3
Figure 3
Mean child impairment scores over time by maternal treatment assignment. Note: Unadjusted mean scores are shown with bars indicating standard error.
See this image and copyright information in PMC

References

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