Effectiveness of the 'Thinking Healthy Program' to reduce antenatal depression in pregnant women in a tertiary care hospital: a quasi-experimental study in Pakistan.

BACKGROUND: In developing countries, the prevalence of postpartum depression can range from being comparable to that of developed nations to twice as high. The ‘Thinking Healthy Program’ (THP) is an evidence-based intervention specifically designed to address perinatal depression. This study aimed to evaluate the effectiveness of THP in reducing antenatal depression among pregnant women in Pakistan. METHODS: We recruited 220 participants from the obstetrics and gynecology outpatient department of a tertiary care hospital in Lahore, Pakistan. Depression was screened using the Patient Health Questionnaire (PHQ-9), identifying 80 women (36%) with scores indicating depression (PHQ-9 score > 10). Of these, 40 consented to participate but 22 complete the study. A quasi-experimental design was used to assess the impact of the THP intervention, targeting women aged 18–45 years in their 24–26 week of pregnancy. The intervention included fortnightly psychotherapy sessions aimed at modifying negative thinking patterns and behaviors, particularly in the context of developing mother-child relationships. The effectiveness of the THP sessions was measured using the Student’s t-test. RESULTS: A significant reduction in depression scores post-intervention (p < 0.05) demonstrated the intervention’s efficacy. Additional analysis of demographic characteristics also showed significant improvements. CONCLUSION: This study provides evidence that the THP intervention is an effective, low-intensity psychotherapy treatment during the antenatal period, capable of preventing antenatal depression at clinical setting.