Internet delivered Cognitive Behavior Therapy for Antenatal Depression: A Randomised Controlled Trial

Abstract Major depression occurs in 5–10% of pregnancies and is associated with many negative effects for mother and child, yet treatment options are scarce. To our knowledge, this is the first published randomised controlled trial on Internet delivered Cognitive Behavior Therapy (ICBT) for this gro...

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Bibliographic Details
Published in:	Journal of affective disorders Vol. 221; pp. 56 - 64
Main Authors:	Forsell, Erik, Bendix, Marie, Holländare, Fredrik, von Schultz, Barbara Szymanska, Nasiell, Josefine, Blomdahl-Wetterholm, Margareta, Eriksson, Caroline, Kvarned, Sara, Soderbergder Linden, Johanna Lindau van, Söderberg, Elin, Jokinen, Jussi, Wide, Katarina, Kaldo, Viktor
Format:	Journal Article
Language:	English
Published:	Netherlands Elsevier B.V 2017
Subjects:	Adult Antenatal depression Anxiety - psychology Cognitive behavior therapy Cognitive Therapy - methods Depression Depression - psychology Depression - therapy ehealth Female Humans Internet Klinisk medicin Medicin och hälsovetenskap Online Patient Acceptance of Health Care - psychology Perinatal mental health Pregnancy Pregnancy Complications - psychology Pregnancy Complications - therapy Prenatal Care - methods Psychiatric Status Rating Scales Psychiatry Psychology Psychotherapy Psykiatri Psykologi Reproduktionsmedicin och gynekologi Telemedicine - methods Treatment Outcome Pregnancy Antenatal Depression Cognitive behaviour therapy Psychotherapy Depression Perinatal mental health Internet ehealth Online Cognitive behavior therapy Antenatal depression
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Summary:	Abstract Major depression occurs in 5–10% of pregnancies and is associated with many negative effects for mother and child, yet treatment options are scarce. To our knowledge, this is the first published randomised controlled trial on Internet delivered Cognitive Behavior Therapy (ICBT) for this group. Objective To test the efficacy of a pregnancy adapted version of an existing 10-week ICBT-program for depression as well as assessing acceptability and adherence Design Randomised controlled trial. Setting Online and telephone. Population or Sample Self-referred pregnant women (gestational week 10–28 at intake) currently suffering from major depressive disorder. Methods 42 pregnant women (gestational week 12–28) with major depression were randomised to either treatment as usual (TAU) provided at their antenatal clinic or to ICBT as an add-on to usual care. Main Outcome Measures The primary outcome was depressive symptoms measured with the Montgomery-Åsberg depression rating scale-self report (MADRS-S). The Edinburgh Postnatal Depression Scale and measures of anxiety and sleep were used. Credibility, satisfaction, adherence and utilization were also assessed. Results The ICBT group had significantly lower levels of depressive symptoms post treatment (p<.001, Hedges g =1.21) and were more likely to be responders (i.e. achieve a statistically reliable improvement) (RR = 0.36; p=.004). Measures of treatment credibility, satisfaction, utilization, and adherence were comparable to implemented ICBT for depression. Limitations Small sample size and no long-term evaluation. Conclusion Pregnancy adapted ICBT for antenatal depression is feasible, acceptable and efficacious. These results need to be replicated in larger trials to validate these promising findings.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-News-1 ObjectType-Feature-3 content type line 23
ISSN:	0165-0327 1573-2517 1573-2517
DOI:	10.1016/j.jad.2017.06.013