Original Research

The Efficacy of Behavioral Activation Therapy (BAT) andPharmacologic Intervention in Postpartum Depression: A PHQ-9Trajectory Analysis Using Protocol-Defined Remission Criteria

Ghulam Zainab1
Quid-E-Azam Medical College, Bahawalpur, Pakistan
Khudija Sundas1
Quid-E-Azam Medical College, Bahawalpur, Pakistan
Syyeda Nargis2
Bahawal Victoria Hospital, Bahawalpur, Pakistan
Muhammad Umar Eatsham3
University of the Punjab, Lahore, Pakistan
Anum Khalid3
University of the Punjab, Lahore, Pakistan
Nauman Rafi Rajput4
Sahara Medical College, Narowal, Pakistan

✉ Correspondence: Ghulam Zainab Email: ghulamzainab46481@import.invalid

DOI https://doi.org/10.70302/jpsim.v7i2.2622
Volume: 7, Issue 2 Pages: 109–115 Published: 03 Jun 2026
Received: 09 Apr 2025 Revised: 12 Apr 2026 Accepted: 04 May 2026 Published Online: 03 Jun 2026

Abstract

Objectives

To compare and assess the efficacy of pharmacologic treatment and Behavioral Activation Therapy PPD in females diagnosed with postpartum depression.

Methods

In this prospective observational study, newly diagnosed females obtained either pharmacological therapy or BAT. PHQ-9 baseline and follow-up scores were used to measure the results. Demographic and clinical history and outcome of treatment were gathered. There was a comparison of descriptive statistics, paired t-tests and between-group comparisons.

Results

The pharmacological group reported an average decrease of PHQ-9 of 11.2 ± 2.89 to 5.8 ± 2.64 and BAT group reported an average decrease of 10.8 ± 2.65 to 5.29 ± 1.99 at six weeks. The remission, response and partial remission was requested in BAT group, as well as in the two groups. Trends were represented as bar, line and scatter plots.

Conclusion

Both interventions significantly improved depressive symptoms, with BAT showing a marginally higher remission rate and lower standard deviation. The findings support the inclusion of BAT as a viable first-line non-pharmacologic intervention for PPD, particularly in resource-limited settings or when pharmacotherapy is declined.

Keywords
Postpartum depression Pharmacologic treatment Behavioral Activation Therapy PHQ-9 Mental health Comparative effectiveness

How to Cite This Article

Zainab G, Sundas K, Nargis S, Eatsham MU, Khalid A, Rajput NR. The Efficacy of Behavioral Activation Therapy (BAT) andPharmacologic Intervention in Postpartum Depression: A PHQ-9Trajectory Analysis Using Protocol-Defined Remission Criteria. J Pak Soc Intern Med. 2026;7(2):109–115. doi:10.70302/jpsim.v7i2.2622

Conflict of Interest

All authors declare no competing interests.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

No specific funding was received for this research.

Funder information follows the Crossref Funder Registry standard.

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Reference list indexed for Google Scholar and ResearchGate. DOI links resolve via doi.org.

CC BY CC BY 4.0 This article is published under the Creative Commons Attribution 4.0 International License. May be shared and adapted with attribution. © 2026 Journal of Pakistan Society of Internal Medicine.
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