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 unpleasant complications needs to be identified and treated. Objective: This study aimed to compare the effect of problem‑solving therapy (PST) and relaxation on the severity of postpartum depressive symptoms. Methods: This randomized controlled trial was performed in health‑care centers of Mashhad city, Iran, in women on the 3rd postpartum week. A total of 120 women were selected conveniently and randomly assigned to three groups (i.e., PST, relaxation, and control groups). The women completed Edinburgh Depression Scale and Beck Depression Inventory (BDI). Problem‑solving skills were educated during six weekly sessions. Progressive muscle relaxation exercises and guided imagery were performed daily and once a week during 6 weeks, respectively. In the control group, women received usual postpartum care. All groups completed a daily checklist for recording depression symptoms. The three groups completed the BDI once again a week after the end of the intervention. Data analysis was conducted using Chi‑square, paired t‑test, analysis of variance (ANOVA), and repeated measures ANOVA. Results: The mean difference of severity of depressive symptoms was 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 ± 4.51 in the control group, P < 0.001). The frequency of mild depression decreased from 57.1% to 3.8% in PST group, from 65.4% to 23.1% in the relaxation group, and from 60.7% to 33.3% in the control group. Conclusion: Both PST and relaxation can reduce the severity of depressive symptoms. However, the effects of PST were more than those of relaxation.