At?f Rahman|Abid Malik|Siham Sikander|Christopher Roberts|Francis Creed
Cognitive behaviour therapy-based intervention by community health workers for mothers with depression and their infants in rural Pakistan: a cluster-randomised controlled trial
University of Liverpool|University of Sheffield|Human Development Research Foundation|Human Development Research Foundation|University of Manchester|University of Manchester
treatment perinatal depression publichealth priority high prevalence association disability poor infant development integrated cognitive behaviour therapybased intervention routine work communitybased primary health workers rural pakistan assessed effect intervention maternal depression infant outcomeswe randomly assigned 40 union council clusters rural rawalpindi pakistan equal numbers intervention control married women aged 1645 years third trimester pregnancy perinatal depression eligible participate intervention group primary health workers trained deliver psychological intervention whereas control group untrained health workers made equal number visits depressed mothers primary outcomes infant weight height 6 months 12 months secondary outcome maternal depression interviewers unaware group participants assigned analysis intention treat study registered isrctn65316374the number clusters per group 20 463 mothers intervention group 440 control group 6 months 97 23 418 211 53 400 mothers intervention control groups respectively met criteria major depression adjusted odds ratio 022 95 ci 014 036 p00001 effects sustained 12 months 111412 27 vs 226386 59 adjusted 023 95 ci 015 036 p00001 differences weightforage heightforage z scores infants two groups significant 6 months 083 vs 086 p07 203 vs 216 p03 respectively 12 months 064 vs 08 p03 110 vs 136 p007 respectivelythis psychological intervention delivered communitybased primary health workers potential integrated health systems resourcepoor settings