HealthDay News — Problem-solving education (PSE) is effective at preventing depressive symptoms among low-income mothers, according to a study published online June 29 in JAMA Network Open.

Michael Silverstein, M.D., from the Boston Medical Center, and colleagues conducted serial assessments of potential intervention mediators and depressive symptoms among low-income mothers with depressed mood, anhedonia, or depression history (but not in a current major depressive episode) seen at one of six Head Start agencies. Participants were randomized to a PSE intervention (111 patients) or usual care (119 patients).

The researchers found that only perceived stress was associated with both PSE participation and depressive symptoms. Perceived stress change scores were 11 percent lower among participants in the PSE group versus controls, with improvement in perceived stress tied to lower odds of depressive symptom elevations (adjusted rate ratio [aRR], 0.42). Standardized behavioral activation change scores were 15 percent greater in the intervention group versus the controls, and problem-focused coping change scores were 17 percent greater in the intervention group versus the controls. However, there was no association with a differential rate of depressive symptom elevations. The direct effect of PSE on depressive symptom elevations (aRR, 0.72) was greater than the effect explained by improvement in perceived stress (aRR, 0.91).

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“PSE is efficacious in preventing depressive symptoms and appears to work by decreasing perceived stress; however, the mechanism for much of PSE’s impact on depression remains unexplained,” the authors write. “These results can be used to simplify the intervention model in preparation for effectiveness testing.”

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