[Effectiveness of a manualized cognitive-behavioural intervention for postnatal depression]. / Efficacia di un intervento cognitivo-comportamentale manualizzato nella depressione post-partum.

AIM: Important guidelines recommend cognitive-behavioural interventions for postnatal depression but in the clinical practice they are not really diffused. This study describes the results and effectiveness of a structured cognitive-behavioural intervention implemented in a public mental health department. METHODS: The study involved 54 depressed women drawn from a community screening programme for postnatal depression in Bergamo province. Intervention was conducted on group and individual basis following a cognitive-behavioural programme of 10-15 weeks duration, including at least one partner session and adhered to a structured manual. Baseline and post intervention measures of depression and health were collected through validated rating scales. RESULTS: Following treatment, a significant improvement was demostrated on Edinburgh Post Natal Depression Scale, Beck Depression Inventory, Patient Health Questionnaire-9, Short Form-12. The improvements were manteined after a 12 mounths follow up. CONCLUSIONS: These results are encouraging and suggest that brief and structured cognitive behavioral interventions can be effective as a treatment for depression in postnatal period and routinely implemented in the clinical practice.

[Prevalence and risk factors of postnatal depression among women attending antenatal courses]. / Prevalenza e fattori di rischio della depressione post parto tra le donne che partecipano ai corsi pre parto.

AIMS: Postnatal depression, the most frequent complication occurring after pregnancy, is often not recognized. The prevalence of postnatal depression is currently considered to be 10-15% in western countries. A wide range of risk factors related to postnatal depression were researched in international studies. Our aim was to evaluate the risk factors and their frequency in a women population of Bergamo Province and compare the results with findings of international literature. METHODS: 595 women taking part to antenatal courses in three hospitals in Bergamo Province were screened for Postnatal Depression using EPDS and clinical interview. Prevalence and possible psychosocial risk factors data were collected and subsequently analysed and compared with literature findings. RESULTS: Thirty six (7.1%) women of our sample had postnatal depression. Depressed mood and depression during pregnancy, anxiety during pregnancy, poor social support, recent life events, a history of depression or other psychiatric history, presence of maternity blues were the strongest predictors of postnatal depression in our sample. CONCLUSIONS: The Psychosocial risk factors emerged from our study are substantially the same indicated by international studies, on the contrary prevalence is a little lower. This result may be explained considering that our women sample wasn't completely representative of general population.

[Effectiveness of cognitive-behavioral treatment in social phobia: a description of the results obtained in a public mental health service]. / Efficacia nella pratica clinica di un servizio pubblico del trattamento cognitivo-comportamentale della Fobia Sociale: descrizione dei risultati ottenuti.

OBJECTIVE: Cognitive Behavioural Therapy for the treatment of Social Phobia has proved effective through several controlled trials and meta-analyses. In spite of this the CBT has not spread in clinical field yet. Therefore our aim was to verify the effectiveness of the CBT in a public mental health service and to compare our results with those described by experimental research. DESIGN AND SETTING: Participants were 11 public mental health center clients, with a primary diagnosis of Social Phobia (according to DSM-IV criteria). The transportability of CBT to a common clinical setting was examined comparing treatment outcome data, at the end of the treatment and at a six months follow up, with results described in controlled efficacy studies. We employed self completion rating scales relating to both general health conditions and life satisfaction (SF36) and trend of symptoms (LSPS). Moreover we recorded the Clinical Global Impression (CGI) and Patient's Global Impression (PGI). RESULTS: Despite differences in setting, clients and treatment providers, both the magnitude of change from pre-treatment and maintenance of change at a six months follow up were comparable with the parallel findings in the efficacy studies. CONCLUSIONS: The results attest the effectiveness of CBT even in a public mental health center setting so, in consideration of the fact that social phobia is a very common disease and involve high degree of severity, chronicity and disability, we hope that this effectual and relatively cheap therapy will be routinely applied in public mental health services.