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Sunday, September 24, 2006

Miscarriage- The "Unacceptable" Grief

NEW YORK (Reuters Health) - Mental health counseling given over the phone may ease some women's depression symptoms after a miscarriage, a small pilot study suggests.

The therapy was offered to women with "subsyndromal" depression, which is less severe than major clinical depression but still causes significant symptoms -- such as sleep disturbances, chronic lack of energy, appetite changes and feelings of hopelessness.

Past studies have shown that women who suffer a miscarriage are at risk not only of major depression, but of the considerably more common subsyndromal depression as well.

This latest study, reported in the Journal of Clinical Psychiatry, was a pilot project testing whether phone-based counseling could help women with milder depression following a miscarriage. Such therapy aims to overcome some of the obstacles that keep people from in-person mental health counseling, like lack of time or reluctance to talk face-to-face.

Of the 19 women researchers followed, those who received counseling over the phone a handful of times showed a greater decline in depression symptoms.

The findings suggest the therapy should be studied in a larger clinical trial, according to the study authors, led by Dr. Richard Neugebauer of the New York State Psychiatric Institute and Columbia University in New York.

The study included women who'd lost a pregnancy sometime before the 28th week. Half were randomly assigned to receive telephone counseling from a social worker or psychologist, while the rest served as a comparison group.

Women in the counseling group decided how many phone calls, up to six, they would receive; both groups completed standard questionnaires gauging depression symptoms at the beginning and end of the study.

Over the study period, women in both groups showed a decline in depression, Neugebauer's team found, but those who received counseling made greater strides.

A majority of the study participants were Hispanic and many were on Medicaid, the researchers point out -- suggesting, they say, that phone-based counseling offers a way to reach traditionally underserved women as well.

SOURCE: Journal of Clinical Psychiatry, August 2006.


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