A pragmatic randomized controlled trial to evaluate the effectiveness of a facilitated exercise intervention as a treatment for postnatal depression: the PAM-PeRS trial

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Colleges, School and Institutes


Background: Postnatal depression affects about 10-15% of women in the year after giving birth. Many women and healthcare professionals would like an effective and accessible non pharmacological treatment for postnatal depression.
Methods: Women who fulfilled the ICD-10 criteria for major depression in the first six months postnatally were randomised to receive usual care plus a facilitated exercise intervention or usual care only. The intervention involved two face to face consultations and two telephone support calls with a physical activity facilitator over six months to support participants to engage in regular exercise. The primary outcome was symptoms of depression using the Edinburgh Postnatal Depression Scale (EPDS) at six month post-randomisation. Secondary outcomes included EPDS score as a binary variable (recovered and improved) at six and 12 month post-randomisation.
Results: 146 women were potentially eligible and 94 were randomised. 34% reported thoughts of self-harming at baseline. After adjusting for baseline EPDS, analyses revealed a -2.04 mean difference in EPDS score, favouring the exercise group (95% CI: -4.11 to 0.03, p=0.05). When also adjusting for pre-specified demographic variables the effect was larger and statistically significant (mean difference=-2.26, 95% CI:-4.36 to -0.16, p=0.03). Based on EPDS score a larger proportion of the intervention group were recovered (46.5% versus 23.8%, p=0.03) compared with usual care at six months follow-up.
Conclusions: This trial shows an exercise intervention that involved encouragement to exercise and to seek out social support to exercise may be an effective treatment for women with postnatal depression, including those with thoughts of self-harming.


Original languageEnglish
Pages (from-to)2413-2425
Number of pages13
JournalPsychological Medicine
Issue number11
Early online date25 Mar 2015
Publication statusPublished - 1 Aug 2015


  • postnatal depression, physical activity