Telephone based nurse-delivered interpersonal psychotherapy for postpartum depression: nationwide randomised controlled trial
Open accessAbstract
Background: Postpartum depression and anxiety are under-addressed public health problems with numerous treatment access barriers, including insufficiently available mental health specialist providers. Aims: To examine the effectiveness of nurse-delivered telephone interpersonal psychotherapy (IPT) for postpartum depression. Trial registration ISRCTN88987377. Method: Postpartum women ( n = 241) with major depression (on the Structured Clinical Interview for DSM-IV (SCID-I)) from 36 Canadian public health regions in rural and urban settings were randomly assigned to 12 weekly 60 min nurse-delivered telephone-IPT sessions or standard locally available care. The primary outcome was the proportion of women clinically depressed at 12 weeks post-randomisation, with masked intention-to-treat analysis. Secondary outcomes examined included comorbid anxiety, self-reported attachment and partner relationship quality. Results: At 12 weeks, 10.6% of women in the IPT group (11/104) and 35% in the control group (35/100) remained depressed (OR = 0.22, 95% CI 0.10–0.46), with the IPT group 4.5 times less likely to be clinically depressed (SCID); 21.2% in the IPT group and 51% in the control group had an Edinburgh Postnatal Depression Scale (EPDS) score >12 (OR = 0.26, 95% CI 0.14–0.48), and attachment avoidance decreased more in the IPT group than in the control group ( P = 0.02). Significant differences favoured the IPT group for comorbid anxiety and partner relationship quality at all time points, with no differences in health service or antidepressant use. None of the IPT responders relapsed by 36 weeks. Between-group SCID differences were sustained at 24 weeks, but not at 36 weeks. Conclusions: Nurse-delivered telephone IPT is an effective treatment for diverse urban and rural women with postpartum depression and anxiety that can improve treatment access disparities.
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Across mental health interventions, several RCTs and pre-post studies reported lower depressive symptom scores.
“The included studies reported improvements in depressive symptom scores, clinical recovery at selected time points, anxiety, worry, and childbirth-related trauma symptoms (Avignon et al., 2025; Dennis et al., 2020; Husain et al., 2024; ¨ Ozhüner and ¨ Ozerdo ˘ gan, 2025; Van Lieshout et al., 2022; Xiao et al., 2025).”
From Extending the continuum: Mapping post-6-week nurse/midwife-led interventions for postnatal women – A scoping review (2026) · cites this paper as Dennis et al., 2020
Across mental health interventions, several RCTs and pre-post studies reported reductions in anxiety, worry, or trauma symptoms.
“The included studies reported improvements in depressive symptom scores, clinical recovery at selected time points, anxiety, worry, and childbirth-related trauma symptoms (Avignon et al., 2025; Dennis et al., 2020; Husain et al., 2024; ¨ Ozhüner and ¨ Ozerdo ˘ gan, 2025; Van Lieshout et al., 2022; Xiao et al., 2025).”
From Extending the continuum: Mapping post-6-week nurse/midwife-led interventions for postnatal women – A scoping review (2026) · cites this paper as Dennis et al., 2020
Across mental health interventions, several RCTs and pre-post studies reported higher recovery at selected time points.
“The included studies reported improvements in depressive symptom scores, clinical recovery at selected time points, anxiety, worry, and childbirth-related trauma symptoms (Avignon et al., 2025; Dennis et al., 2020; Husain et al., 2024; ¨ Ozhüner and ¨ Ozerdo ˘ gan, 2025; Van Lieshout et al., 2022; Xiao et al., 2025).”
From Extending the continuum: Mapping post-6-week nurse/midwife-led interventions for postnatal women – A scoping review (2026) · cites this paper as Dennis et al., 2020
At 12 weeks, 10.6% of the telephone-IPT group versus 35% of controls met criteria for clinical depression.
“At 12 weeks, 10.6% of the telephone-IPT group versus 35% of the controls met the criteria”
From Extending the continuum: Mapping post-6-week nurse/midwife-led interventions for postnatal women – A scoping review (2026) · cites this paper as Dennis et al. (2020)
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The Efficacy of Telemental Health Interventions for Mood Disorders Pre-COVID-19: A Narrative Review
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Pesquisa Multidisciplinar em Saúde - Edição XIII
Freitas, G. B. L. D., & Sleiman, H. K. (2024) · doi:10.59290/978-65-6029-194-2
- Authors
- Dennis, C.-L., Grigoriadis, S., Zupancic, J., Kiss, A., & Ravitz, P.
- Affiliations
- St. Michael's Hospital (CA)
- Sunnybrook Health Science Centre (CA)
- Beth Israel Deaconess Medical Center (US)
- Mount Sinai Hospital (CA)
- Corresponding author
- Dennis, Cindy-Lee
- Venue
- The British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2020-02-07
- Volume
- 216
- Issue
- 4
- Pages
- 189-196
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W3005110894
- Cited by
- 119
- References
- 34
- Citations by year
- 2026: 15 · 2025: 22 · 2024: 31 · 2023: 14 · 2022: 17 · 2021: 10 · 2020: 10
- FWCI
- 9.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eli Lilly and Company
- Pfizer
- Allergan
- Canadian Institutes of Health Research (82332_1)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- postpartum depression, interpersonal psychotherapy, nursing care delivery, postpartum anxiety, attachment avoidance, partner relationship quality, treatment access, rural and urban women, relapse
- MeSH terms
- Interpersonal Psychotherapy, Adult, Anxiety Disorders, Canada, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Nurses, Telephone, Outcome Assessment, Health Care, Telemedicine, Depression, Postpartum, Young Adult
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