Background
Depression is the single most important contributor to Years Lived With Disability, estimated to affect 400 million people globally. The economic costs of depression are large: depression was estimated to cost $800 billion in 2010 and this is expected to double by 2030. Perinatal depression, which is depression experienced by the mother during pregnancy or in the year after birth, is widespread. It is estimated that 10-35% of children worldwide are exposed to maternal depression in their first year of life. Prevalence is not systematically documented and is typically under-estimated so the condition often goes undiagnosed and untreated. This has potentially harmful consequences for the welfare of women and children, but these have not been rigorously identified. Recent evidence indicates that psychotherapy-based treatments are effective at reducing the severity and duration of perinatal depression, and The World Health Organization (WHO) and United Nations Population Fund (UNFPA) have jointly moved to integrate mental health needs into existing maternal and child health programmes. These organizations are still short of evidence of impacts on children.
Project Aims
- Establish the effects of treating maternal depression on cognitive, socio emotional, and physical development of the child
- Investigate the effects of the treating perinatal depression on the longer-term mental and physical health of the mother
- Identify the mechanisms that may explain how maternal depression affects the development of the child, particularly with respect to how it may modify parental investments in children
Methods
The project analyzes purposively gathered data from a 7-year follow-up of a large-scale Randomized Controlled Trial that provided a cognitive behavioural therapy to perinatally depressed mothers in Pakistan, starting in the third trimester of pregnancy and continuing till the child was ten months old.
Potential Impact
The therapy, called the Thinking Healthy Programme (THP), was adopted by the WHO as a published guide to good practice. Their focus at present is on evidence that the therapy works for women, there remains limited evidence of effects on children, and this is a gap that we propose to fill.
Team members
- Professor Sonia Bhalotra, Professor of Economics, ISER, University of Essex
- Professor Joanna Maselko, Professor, Population Research Institute, Duke University
- Dr. Victoria Baranov, Lecturer in Economics, University of Melbourne
Professor Atif Rahman and Dr Siham Sikander and colleagues at the Human Development Research Foundation (HDRF) conducted the THP trial and shared the baseline data with us.
Funder
Grand Challenges Canada (GCC). This project received two GCC awards, one with PI Joanna Maselko and Siham Sikander and the other with PI Sonia Bhalotra.
Timeframe
2013-2016