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In poor countries, maternal depression during and after pregnancy is associated with infant malnutrition, diarrhea, and growth retardation. To examine the effectiveness of treatment based on cognitive-behavioral therapy in rural Pakistan, researchers conducted an innovative, population-based, cluster-randomized trial involving 40 health units and 903 women with last-trimester depression diagnosed by structured interview. Health workers in 20 randomly selected health units received 2 days of CBT training and monthly expert supervision. Women in both intervention and control units received the same number and length of visits (7 sessions in the 2 months surrounding delivery and 9 monthly follow-ups).
The dropout rate was 22% at 12 months. At e…