Perinatal Dyadic Psychotherapy for postpartum depression: a randomized controlled pilot trial

Probably not a substantial claim: may not pass S3 (load-bearing).

Effective treatments for depression exist.

“Effective treatments for depression exist (Claridge 2014; De Crescenzo et al. 2014; Sockol et al. 2011; Stuart and Koleva 2014)”

• cites Claridge 2014 sourceNot checked — no full text of the source
• cites De Crescenzo et al. 2014 sourceNot checked — no full text of the source
• cites Sockol et al. 2011 sourceSupported

May combine two claims.

Depressed mothers show fewer positive facial expressions and less sensitivity to their infants than non-depressed mothers.

“Compared to non-depressed mothers, they exhibit fewer positive facial expressions and show overall less sensitivity to their infants (Cohn et al. 1990; Field 1984; Herrera et al. 2004; Fleming et al. 1988).”

• cites Cohn et al. 1990 sourceNot checked — no full text of the source
• cites Field 1984 sourceNot checked — no full text of the source
• cites Herrera et al. 2004 sourcePartly supported

  The Introduction (page unavailable) describes a lack of facial emotional communication in depressed mothers, and the Discussion reports unresponsive behaviour and suggests that mothers with depressed mood may not respond to their infants’ changing demands. These passages support the general concern about responsiveness, but the paper does not establish that depressed mothers show fewer positive facial expressions or measure overall sensitivity. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

Antidepressants can effectively reduce postpartum depression symptoms.

“Antidepressants can effectively decrease PPD symptoms (e.g., Cohen et al. 2001; Wisner et al. 2002; Yonkers et al. 2008)”

• cites Cohen et al. 2001 sourceNot checked — no full text of the source
• cites Wisner et al. 2002 sourceNot checked — no full text of the source
• cites Yonkers et al. 2008 sourceSupported

May combine two claims.

Infants of depressed mothers alter their behavior, showing deficits in emotional and behavioral regulation, greater fussiness, and fewer positive and more negative facial expressions.

“In response, infants of depressed mothers alter their own behavior, leading to a broad range of infant deficits including poor emotional and behavioral state regulation, greater fussiness, and fewer positive and more negative facial expressions (Field et al. 1988; Field et al. 1990; Manian and Bornstein 2009).”

• cites Field et al. 1988 sourceNot checked — no full text of the source
• cites Field et al. 1990 sourceNot checked — no full text of the source
• cites Manian and Bornstein 2009 sourcePartly supported

  The Discussion (Maternal Depression and Infant ER; page unavailable) describes differences in how infants of depressed mothers regulate distress, supporting the regulation portion of the claim. But the Results (Infant Response to Still-Face Perturbation; page unavailable) found no group differences in infant states other than gaze aversion, and the Discussion says the groups did not differ in duration of negative states. This paper therefore does not support greater fussiness or fewer positive and more negative expressions in infants of depressed mothers. (LLM, conf=0.89)

  Experimental — accuracy not yet measured

May combine two claims.

Established risk factors for postpartum depression include elevated EPDS scores in early postpartum, history of depression, and past or current anxiety disorders.

“Established risk factors for PPD include elevated EPDS scores in the early postpartum, history of depression, and past or current anxiety disorders (Dennis et al., 2004; Milgrom et al 2008; Prenoveau et al. 2013; Robertson et al.2004).”

• cites Dennis et al., 2004 sourceNot checked — no full text of the source
• cites Milgrom et al 2008 sourceNot checked — no full text of the source
• cites Prenoveau et al. 2013 sourcePartly supported

  The Results (Diagnostic Stability and Associations; page unavailable) show that postpartum GAD was associated with subsequent co-occurring GAD and MDD, supporting current GAD as a possible risk factor. The Methods (Procedure; page unavailable) describe EPDS screening and the exclusion of women with psychiatric histories from the no-diagnosis group, but the paper does not establish elevated early EPDS scores, a history of depression, or past anxiety disorders as risk factors in the way the sentence states. Its anxiety finding is specific to postpartum GAD, not anxiety disorders generally. (LLM, conf=0.88)

  Experimental — accuracy not yet measured

May combine two claims.

Prior work demonstrated the feasibility, acceptability, safety, and preliminary efficacy of the PDP intervention with depressed postpartum women and their infants.

“Prior work has demonstrated the feasibility, acceptability, safety, and preliminary efficacy of the PDP intervention with depressed postpartum women and their infants (Goodman et al. 2013).”

• cites Goodman et al. 2013 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Before delivering the intervention, nurse interventionists completed a 10-day training and met a reliability criterion of at least 90% on an interventionist skills checklist during role play.

“Prior to providing the intervention, the nurse interventionists completed a 10-day training in the PDP intervention and met reliability criteria for providing the intervention based on attainment of at least 90% on interventionist skills checklist during role play evaluation (see Goodman et al. 2013 for details).”

• cites Goodman et al. 2013 sourceSupported

The quote only partly states this claim.

Usual care with depression monitoring may be an effective intervention.

“Our finding that usual care with depression monitoring may be an effective intervention is supported by a number of studies which have shown that low-intensity interventions, such as guided self-help via written materials, limited professional support, or internet-delivered interventions are effective in non-postpartum patients with MDD, even when depression is severe (Andrews et al. 2010; Bower”

• cites Andrews et al. 2010 sourcePartly supported

  The citation supports the sentence’s point that low-intensity internet-delivered CBT can be effective for people with major depressive disorder: the Discussion reports benefits from simple lessons with brief professional contact. It does not establish effectiveness specifically for severe depression or for usual care with depression monitoring; the latter is the citing authors’ own finding. (LLM, conf=0.83)

  Experimental — accuracy not yet measured
• cites Bower et al. 2013 sourcePartly supported

  In Box 2: Clinical scenario (page unavailable), the paper reports that low-intensity interventions provide clinically significant benefits over usual care, including for patients with more severe depression. But the Inclusion criteria for studies (page unavailable) also admit patients identified by symptom scores or self-assessment, including mixed depression and anxiety; the result is not established specifically for non-postpartum patients with diagnosed MDD. The sentence presents monitored usual care as the citing authors’ own finding, rather than a finding attributed to this source. (LLM, conf=0.83)

  Experimental — accuracy not yet measured
• cites Cuijpers et al. 2011 sourcePartly supported

  The Discussion (p. 7) reports a small, statistically significant effect of self-guided treatment on depressive symptoms, supporting the sentence’s broader point about low-intensity interventions. It explicitly says the analysis could not establish effectiveness for patients with diagnosed major depression, and it does not establish effectiveness when depression is severe. The citing authors’ finding about usual care with monitoring is their own framing, not a finding this source reports. (LLM, conf=0.88)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

Fifty-eight women met initial eligibility for study inclusion.

“Fifty-eight women met initial eligibility for study inclusion by meeting the following criteria:”

May combine two claims.

For PSI-SF, CIB-sensitivity, and CIB-reciprocity, neither time nor group was statistically significant.

“For PSI-SF, CIB-sensitivity, and CIB-reciprocity, neither time nor group was statistically significant.”

May combine two claims.

For CIB-involvement, time was statistically significant (p < 0.001) but group was not (p > 0.9).

“For CIB-involvement, time was statistically significant (p < 0.001) but group was not (p > 0.9).”

May combine two claims.

No control-group participants had any psychiatric diagnosis at follow-up, so traditional regression methods could not be used.

“Traditional (i.e., non-exact) methods could not be used because there were no participants in the control group who had any of these diagnoses at the follow-up period.”

May combine two claims.

17 women (40.5%) met criteria for one or more anxiety disorders at baseline, eight (19%) at post-intervention, and two (4.8%) at follow-up.

“In addition to depression diagnoses, 17 women (40.5%) met criteria for one or more anxiety disorders at baseline, eight (19%) at post-intervention, and two (4.8%) at follow-up.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Recruitment was labor intensive, mainly because the study screened the available general population of first-time postpartum women (n = 790) at three study hospitals.

“Recruitment of participants was labor intensive, mainly due to the fact that we screened the available general population of first-time postpartum women (n = 790) who delivered at the three study hospitals during our recruitment time period.”

May combine two claims.

Of 13 women with baseline major or minor depression, 10 no longer met criteria at post-intervention and 12 were without a depression diagnosis at follow-up.

“In sum, of the 13 women who met criteria for major or minor depression at baseline, 10 no longer met criteria at post-intervention and 12 were without a depression diagnosis at follow-up.”

May combine two claims.

Twenty-three women (54.8%) met criteria for major or minor depression and/or an anxiety disorder at baseline, nine (21.4%) at post-intervention, and three (7.1%) at follow-up.

“Twenty-three women (54.8%) met criteria for major or minor depression and/or an anxiety disorder at baseline, nine (21.4%) at post-intervention, and three (7.1%) at follow-up.”

Classified as probably not a substantial claim.

The study was a randomized controlled pilot trial comparing Perinatal Dyadic Psychotherapy with usual care plus depression monitoring for women with elevated postpartum depressive symptoms.

“A randomized controlled pilot trial was conducted to compare Perinatal Dyadic Psychotherapy (PDP) to usual care plus depression monitoring for women with elevated postpartum depressive symptoms.”

May combine two claims.

Many postpartum women have sub-threshold but clinically relevant depressive symptoms that may worsen if untreated.

“In addition to depression that meets diagnostic criteria for major depressive disorder (MDD), a high proportion of postpartum women experience sub-threshold yet clinically relevant levels of depressive symptoms that, if left untreated, may progress to more severe depression (Kessler et al. 2003).”

• cites Kessler et al. 2003 sourceNot checked — no full text of the source

May combine two claims.

Maternal anxiety, parenting stress, poor maternal self-esteem, and lack of confidence in the mothering role may impair mother-infant relationships and compromise child development.

“These include maternal anxiety (Heron et al. 2004; Ross and McLean 2006; Wenzel et al. 2005), parenting stress (Abindin 1995; Swendsen and Mazure 2000), poor maternal self-esteem (Weinberg et al. 2001), and lack of confidence in the mothering role (Weinberg et al. 2001).”

• cites Heron et al. 2004 sourceNot checked — no full text of the source
• cites Ross and McLean 2006 sourceNot checked — no full text of the source
• cites Wenzel et al. 2005 sourceNot checked — no full text of the source

May combine two claims.

Depressed mothers may be withdrawn and disengaged or intrusive and over-stimulating.

“Depressed mothers may be withdrawn and disengaged, or intrusive and over-stimulating (Beck 1995; Cohn et al. 1990; Field 1984).”

• cites Beck 1995 sourceNot checked — no full text of the source
• cites Cohn et al. 1990 sourceNot checked — no full text of the source
• cites Field 1984 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Postpartum depression affects about one in five women during the first year after delivery.

“Postpartum depression (PPD) affects approximately one in five women in the first year after delivery (Gavin et al. 2005).”

• cites Gavin et al. 2005 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Postpartum depression can become a chronic or recurring depressive course across a woman's life.

“PPD can lead to a chronic or recurring depressive course throughout a woman’s life (Cooper and Murray 1995; Goodman 2004).”

• cites Cooper and Murray 1995 sourceNot checked — no full text of the source
• cites Goodman 2004 sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

Mother-infant interaction videotapes were coded by two research assistants blind to participant group status.

“Mother-infant interaction videotapes were coded by two RAs (a clinical psychologist and a graduate psychology student) blind to participant group status.”

May combine two claims.

The CIB internal consistencies were .91, .85, and .87 for the maternal, infant, and dyadic constructs at post-intervention, and .93, .66, and .94 at follow-up.

“Internal consistencies were .91, .85, and .87 for the maternal, infant, and dyadic constructs respectively at post-intervention, and .93, .66, and .94 at follow-up.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

All diagnostic interviews were audio recorded, and the first 10 and then every fourth interview were reviewed by the principal investigator as a quality check.

“All diagnostic interviews with participants were audio recorded and the first 10, and then every fourth interview thereafter, were reviewed by the principal investigator as a quality check, with corrective action taken if needed.”

Classified as probably not a substantial claim.

First-time mothers were targeted to limit potential confounders such as older children.

“First-time mothers were targeted to limit potential confounders (i.e., older children), and because new mothers would likely derive the most benefit from the infant developmental aspects of the intervention.”

• AssumptionRests on an assumption: New mothers would likely derive the most benefit from the infant developmental aspects of the intervention.

Probably not a substantial claim: may not pass S3 (load-bearing).

A resource list of mental health providers and depression hotlines was given to all mothers who scored at least 20 on the EPDS and to any woman who requested depression help information.

“A resource list of mental health providers and depression hotlines was given to all mothers who scored ≥ 20 on the EPDS and to any woman who requested depression help information.”

May combine two claims.

In this study, all women except one improved over time, a rate unlikely to be accounted for by the effects of time alone.

“In this study, all women except one improved over time, a rate unlikely accountable to the effects of time alone.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The STAI Trait subscale measures more general, long-standing anxiety.

“The 20-item Trait subscale measures more general long-standing anxiety.”

• cites Spielberger et al. 1970Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

Chi-squared tests indicated no statistically significant baseline differences between groups on past history of MDD, depression diagnosis, lifetime anxiety disorder, current anxiety disorder, or depression/anxiety diagnosis.

“Results of the chi-squared tests indicated no statistically significant differences at baseline between the intervention and control groups on (a) past history of MDD, (b) depression diagnosis at baseline; (c) lifetime (past and/or current) anxiety disorder; (d) current anxiety disorder, or (e) depression and/or anxiety disorder diagnosis.”

May combine two claims.

The Edinburgh Postnatal Depression Scale has adequate sensitivity and specificity relative to DSM-IV-TR diagnoses of major and minor depression and is sensitive to changes in depression over time.

“The EPDS has adequate sensitivity and specificity when compared to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000) psychiatric diagnoses of major and minor depression and is sensitive to changes in depression over time.”

• cites Cox et al. 1987 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Research assistants who were blind to specific screening results collected baseline data.

“Research assistants blind to specific screening results collected baseline data at the initial home visit following collection of informed consent and final eligibility determination.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The MSRI internal consistencies were .96, .96, and .94 at baseline, post-intervention, and follow-up.

“Internal consistencies were .96, .96, and .94 at baseline, post-intervention, and follow-up respectively.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The PSI-SF is a 36-item self-report measure designed to identify potentially dysfunctional parent-child relationships and to measure the relative magnitude of stress in the relationship.

“The Parenting Stress Index-Short Form (PSI-SF; Abindin 1995) is a 36-item self-report measure developed to identify potentially dysfunctional parent-child relationships that place a child at risk for emotional disturbance, and to measure the relative magnitude of stress in the relationship.”

• cites Abindin 1995Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

All intervention sessions were videotaped, and fidelity was monitored by randomly selecting three sessions per participant for coding.

“All intervention sessions were videotaped and intervention fidelity was monitored by randomly selecting three sessions from each participant for fidelity coding: one from sessions 1 to 3, one from sessions 4 or 5, and one from sessions 6 to 8.”

May combine two claims.

Interventions that enhance the mother-infant relationship can reduce adverse effects of postpartum depression on infants but rarely reduce maternal depression.

“Although these interventions can effectively ameliorate the adverse effects of PPD on infants, they rarely result in decreased depression for the mothers (Kersten-Alvarez et al. 2011; Nylen et al. 2006).”

• cites Kersten-Alvarez et al. 2011 sourceNot checked — no full text of the source
• cites Nylen et al. 2006 sourceNot checked — no full text of the source

May combine two claims.

The CIB is a well-validated method for measuring parent-infant interactions that has demonstrated sensitivity to infant age, culture, biological and psychiatric risk, and intervention effects.

“Recordings were analyzed using the Coding Interactive Behavior manual (CIB; Feldman 1998), a well-validated method for measuring parent-infant interactions that has demonstrated sensitivity to infant age, culture, biological and psychiatric risk, and intervention effects (Feldman 2007; Feldman and Eidelman 2005; Feldman and Masalha 2007).”

• cites Feldman 2007Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Feldman and Eidelman 2005 sourceNot checked — no full text of the source
• cites Feldman and Masalha 2007 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Various interventions have been used to enhance the mother-infant relationship in the context of maternal depression.

“On the other hand, various interventions have been utilized to enhance the mother-infant relationship in the context of maternal depression (see Nylen et al. 2006 for review).”

• cites Nylen et al. 2006 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Twenty percent of all available videos were randomly assigned to be double coded.

“Twenty percent of all available videos were randomly assigned to be double coded.”

Classified as probably not a substantial claim.

Post-intervention and follow-up outcome data were collected by research assistants blind to psychiatric status and group assignment.

“Post-intervention and follow-up outcome data were collected at home visits by RAs blind to psychiatric status and group assignment.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In the 42 participants, the EPDS Cronbach's alpha was .53 at baseline, .80 at post-intervention, and .81 at follow-up.

“Cronbach alphas for the 42 participants at baseline, post-intervention, and follow-up were .53, .80 and .81 respectively.”

Probably not a substantial claim: may not pass S3 (load-bearing).

All study procedures were approved by the relevant institutional review boards before the study began.

“All study procedures were approved by the institutional review boards of the participant hospitals and the academic center prior to the start of the study.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The STAI State subscale measures transient or current anxiety and is sensitive to changes over time.

“The 20-item State subscale measures transient/current anxiety and is sensitive to changes over time.”

• cites Spielberger et al. 1970Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The PSI-SF internal consistencies were .93 at post-intervention and .89 at follow-up.

“Internal consistencies were .93, and .89 post-intervention and follow-up respectively.”

May combine two claims.

All randomly selected videos met intervention fidelity criteria of at least 85% for both adherence and competence, with most sessions scoring higher.

“All randomly selected videos met intervention fidelity criteria of at least 85% for both adherence and competence, most sessions scoring much higher.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Internal consistencies were .86 for trait anxiety at baseline and .92, .92, and .90 for state anxiety at baseline, post-intervention, and follow-up.

“Internal consistencies were .86 for trait anxiety at baseline and .92, .92, and .90 for state anxiety at baseline, post-intervention and follow-up respectively.”

Classified as probably not a substantial claim.

The SCID-I was administered at baseline, post-intervention, and follow-up to determine diagnoses of depressive and/or anxiety disorders.

“The Structured Clinical Interview for DSM-IV Axis I Disorders, Non-Patient Edition (SCID-I; First et al. 1996) was administered at baseline, post-intervention and follow-up to determine diagnoses of depressive disorders and/or anxiety disorders.”

• cites First et al. 1996Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Coders received extensive training and reached inter-rater reliability of at least 90% before independent coding.

“Coders received extensive training in the coding method and reached inter-rater reliability of ≥ 90% prior to independent coding.”

May combine two claims.

Perinatal Dyadic Psychotherapy offers promise as a feasible and effective intervention in a sample of depressed postpartum women.

“In this pilot RCT, we found that Perinatal Dyadic Psychotherapy offers promise as a feasible and effective intervention in a sample of depressed postpartum women.”

Classified as probably not a substantial claim.

Randomization used consecutively numbered, sealed, opaque envelopes containing randomly generated numbers.

“Mother-infant dyads were randomized to intervention or control groups by the study coordinator using consecutively numbered, sealed, opaque envelopes containing randomly generated numbers.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Inter-rater reliability of at least 90% was maintained throughout the study.

“Inter-rater reliability of at least 90% was maintained throughout the study duration.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Depression severity was monitored at recruitment and throughout the study using the EPDS at intervention visits for the intervention group, by telephone on a corresponding schedule for the control group, and at all data collection visits for both groups.

“Depression severity was monitored at recruitment and throughout the study using the EPDS at each intervention visit for the intervention group, via telephone on a corresponding schedule for the control group, and at all data collection visits for both groups.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Randomization occurred without the coordinator knowing or having access to baseline data.

“Randomization occurred without coordinator’s knowledge of or access to baseline data.”

May combine two claims.

Dyadic approaches to treating postpartum depression have the greatest potential to reduce maternal depression and to lessen the negative impact of depression on the infant through the impaired mother-infant relationship.

“Dyadic approaches to the treatment of PPD have the greatest potential to reduce maternal depression as well as to decrease the negative impact of depression on the infant due to the impaired mother-infant relationship.”

• AssumptionRests on an assumption: An integrated approach addressing both maternal depression and mother-infant relationship dysfunction simultaneously might produce synergistic effects.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

All research assistants were extensively trained in SCID-I administration and demonstrated acceptable reliability per SCID guidelines before conducting study interviews.

“All were extensively trained in SCID-I diagnostic interview administration and demonstrated acceptable reliability per SCID guidelines prior to conducting study interviews.”

May combine two claims.

Independent samples t-tests indicated no statistically significant baseline differences between groups on age, EPDS total, trait anxiety, and MSRI total; however, the intervention group had significantly higher baseline state anxiety than controls (p = .02).

“A series of independent samples t-test indicated no statistically significant differences between groups at baseline on age, EPDS total score, trait anxiety score, and MSRI total score; however, there was a statistically significant difference on state anxiety score, with the intervention group showing significantly higher baseline state anxiety than controls (p = .02).”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Per study protocol, if a participant scored at least 20 on the EPDS or indicated suicidal ideation, a research nurse or the principal investigator helped her access appropriate care and the principal investigator was notified.

“Per study protocol, if a participant scored ≥ 20 on the EPDS or indicated suicidal ideation, a research nurse or the PI assisted the participant in accessing the appropriate level of care (e.g., perinatal social worker located in the clinic, mental health provider, obstetric provider, or emergency care) and the principal investigator was notified.”

May combine two claims.

The CIB was the sole interaction outcome and may not have been sensitive enough to pick up on subtle group differences.

“The CIB was our sole interaction outcome and may not have been sensitive enough to pick up on subtle group differences in maternal sensitivity, infant engagement, and dyadic reciprocity.”

Classified as probably not a substantial claim. May combine two claims.

PDP holds potential for treating depression in the context of the mother-infant relationship, but further research with larger sample sizes is needed.

“PDP holds potential for treating depression in the context of the mother-infant relationship, but further research with larger sample sizes is needed to more fully examine the intervention.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Diagnostic interviews were used to determine depression diagnoses and the presence of anxiety disorders.

“We used diagnostic interviews to determine depression diagnoses, as well as the presence of anxiety disorders which are often comorbid and may complicate postpartum health and functioning.”

May combine two claims.

Outcome assessors were blind to group allocation and to prior depression results.

“Outcome assessors were blind to group allocation and to prior depression results.”

May combine two claims.

Depression monitoring by phone showed equal benefit and raises the possibility that it may provide an effective, less intensive intervention that could be used as a first step in a stepped care approach.

“Depression monitoring by phone showed equal benefit and raises the possibility that it may provide an effective, less intensive intervention that could be used as a first step in a stepped care approach to treatment.”

May combine two claims.

The EPDS Cronbach's alpha was adequate at post-intervention and follow-up but low at baseline.

“Although the EPDS Cronbach’s alpha for our sample was adequate at post-intervention and follow-up, it was low at baseline.”

May combine two claims.

Strict eligibility criteria required two positive EPDS scores one week apart, recruiting women with more persistent depressive symptoms.

“We required that potential participants have two positive EPDS scores one week apart, thus recruiting a sample of women for whom depressive symptoms were more persistent rather than temporary.”

May combine two claims.

No formal power calculations were carried out, and power to detect significant between-group differences was limited, possibly due to insufficient sample size or lower than expected effect sizes.

“As a pilot study, these results must be treated as preliminary and interpreted with caution as no formal power calculations were carried out and power to detect significant differences between groups on outcomes was limited, possibly due to insufficient sample size or to lower than expected effect sizes.”

May combine two claims.

All data, including mother-infant interaction data, were collected in participants' homes, enabling more naturalistic data collection.

“All data, including mother-infant interaction data was collected in participants’ homes, enabling more naturalistic data collection than what is typically collected in a lab setting.”

May combine two claims.

In a randomized controlled trial of supportive counseling by public health nurses, the majority of women (66%) had only one counseling session; these women showed depression scores comparable to women who received two to seven sessions, and significantly more improved compared to a control group.

“In a randomized controlled trial of a supportive counseling intervention provided by public health nurses to women with PPD (Glavin et al. 2010), the majority of women (66%) had only one counseling session -- constituting a non-intensive intervention. These women showed depression scores comparable to women who received two to seven sessions, and significantly more improved compared to a control”

• cites Glavin et al. 2010 sourceNot checked — no full text of the source

Classified as probably not a substantial claim. May combine two claims.

Intensive training of nurse interventionists and strict intervention fidelity monitoring were provided.

“We provided intensive training of nurse interventionists and utilized strict intervention fidelity monitoring.”

May combine two claims.

All participants completed the condition to which they were allocated and there was no attrition, enhancing the validity of the results.

“All participants completed the condition to which they were allocated and there was no attrition from the study, enhancing the validity of the results.”