Effect of Problem‑Solving Therapy and Relaxation on the Severity of Postpartum Depressive Symptoms: A Randomized Controlled Trial

Background: Postpartum depression with high prevalence and unpleasantcomplications needs to be identified and treated. Objective: This study aimed tocompare the effect of problem‑solving therapy (PST) and relaxation on the severityof postpartum depressive symptoms. Methods: This randomized controlledtrial was performed in health‑care centers of Mashhad city, Iran, in women onthe 3rd postpartum week. A total of 120 women were selected conveniently andrandomly assigned to three groups (i.e., PST, relaxation, and control groups).The women completed Edinburgh Depression Scale and Beck DepressionInventory (BDI). Problem‑solving skills were educated during six weekly sessions.Progressive muscle relaxation exercises and guided imagery were performeddaily and once a week during 6 weeks, respectively. In the control group,women received usual postpartum care. All groups completed a daily checklistfor recording depression symptoms. The three groups completed the BDI onceagain a week after the end of the intervention. Data analysis was conducted usingChi‑square, paired t‑test, analysis of variance (ANOVA), and repeated measuresANOVA. Results: The mean difference of severity of depressive symptomswas significantly different between the three groups at 9 weeks after delivery(−14.86 ± 6.15 in PST group, −10.71 ± 5.23 in relaxation group, and −4.72 ± 4.51in the control group, P 0.001). The frequency of mild depression decreased from57.1% to 3.8% in PST group, from 65.4% to 23.1% in the relaxation group, andfrom 60.7% to 33.3% in the control group. Conclusion: Both PST and relaxationcan reduce the severity of depressive symptoms. However, the effects of PST weremore than those of relaxation.