Effectiveness of counseling for anxiety and depression in mothers of children ages 0-30 months by community workers in Karachi, Pakistan: a quasi experimental study
Open accessAbstract
Background: The prevalence of anxiety/depression is quite high during the perinatal period but unfortunately its detection and treatment have been less than satisfactory. Moreover, many women are reluctant to take pharmacotherapy for fear of excretion of drugs into their breast milk. This study assesses the effectiveness of counseling from minimally trained community health workers in reducing anxiety/depression, the rate of recurrence and the interval preceding recurrence in women during first two and a half years after childbirth. Methods: In a quasi-experimental study, community women from two under-privileged communities were trained in data gathering, teaching healthy child-rearing practices, basic counseling skills, and screening for anxiety/depression by using an indigenously developed questionnaire, the Aga Khan University Anxiety and Depression Scale (AKUADS). The diagnosis was further confirmed by a clinical psychologist using DSM IV criteria. After obtaining consent, 420 women were screened and 102 were identified as having anxiety/depression. Screening was carried out after 1, 2, 6, 12, 18, 24 and 30 months of a live birth. Only 62 out of 102 agreed to be counseled and received eight weekly sessions. AKUADS was re-administered at 4 weeks and 8 weeks after the beginning of counseling; this was followed by the clinical psychologist's interview for confirmation of response. After recovery, screening was continued every 3 months for detection of recurrence throughout the study period. Out of the women who had declined counseling 12 agreed to retake AKUADS after 4 and 8 weeks of diagnosis. Independent samples t-test, chi-square test, Repeated Measures ANOVA and Kaplan Meier technique were used for the analysis. Results: A significant decline in level of anxiety/depression was found in both the counseled and the non-counseled groups at 4 and 8 weeks (p-value < 0.001) but the counseled group fared better than the non-counseled for recovery, reduction in the rate of recurrence and increase in the duration before relapse. Conclusions: As our results cannot be generalized; further studies need to be carried out, to assess the benefit of incorporating minimal counseling skills in the training of community health workers.
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A few experimental studies from LMICs have shown positive mental health outcomes from peer-delivered interventions.
“A few experimental studies from LMICs have shown positive mental health outcomes from peer-delivered interventions [29–33].”
From Barefoot therapists: barriers and facilitators to delivering maternal mental health care through peer volunteers in Pakistan: a qualitative study (2016) · cites this paper as [30]
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- Gul A Ali BS The onset and benefit from counseling by minimally trained counselors on anxiety and depression in women J Pak Med Assoc 2004 54 11 549 552 15623179
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“A few experimental studies from LMICs have shown positive mental health outcomes from peer-delivered interventions [29–33].”
Background
- Authors
- Ali, N. S., Ali, B. S., Azam, I. S., & Khuwaja, A. K.
- Affiliations
- Aga Khan University (PK)
- Corresponding author
- Azam, Iqbal S
- ORCID
- Ali, Niloufer S
- Venue
- BMC Psychiatry
- Published
- 2010-07-19
- Volume
- 10
- Issue
- 1
- Pages
- 57-57
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC2912800
- OpenAlex
- W2042873220
- Cited by
- 36
- References
- 39
- Citations by year
- 2024: 2 · 2023: 3 · 2022: 2 · 2021: 4 · 2019: 3 · 2018: 4 · 2017: 2 · 2016: 4 · 2015: 1 · 2014: 2 · 2013: 7 · 2012: 1
- FWCI
- 2.85
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- eCommons - AKU (Aga Khan University) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Keywords
- maternal anxiety, maternal depression, postpartum mental health, community health workers, counseling intervention, perinatal mental health, depression recurrence, screening, child-rearing practices
- MeSH terms
- Anxiety Disorders, Child, Preschool, Community Health Workers, Counseling, Depressive Disorder, Female, Humans, Infant, Infant, Newborn, Mothers, Pakistan, Postoperative Complications, Pregnancy, Psychiatric Status Rating Scales, Puerperal Disorders, Surveys and Questionnaires, Prevalence, Treatment Outcome, Diagnostic and Statistical Manual of Mental Disorders, Secondary Prevention
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